中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (02): 172-176.doi: 10.3969/j.issn.1671-4091.2025.02.016

• 护理研究 • 上一篇    

维持性血液透析患者睡眠质量的潜在类别分析及影响因素探讨

马荣荣    邓思妍    赵 娟    郑 晶    陈 辰    胡化刚    陈东英   

  1. 214002 无锡，1江南大学附属中心医院(无锡市第二人民医院)急诊科EICU
    215006 苏州，2苏州大学苏州医学院护理学院
    224001 盐城，3盐城市亭湖区人民医院血液透析中心
    510310 广州，4广东药科大学护理学院
    519000 珠海，5中山大学附属第五医院肾内科
    215000 苏州，6苏州大学附属第一医院老年医学科
  • 收稿日期:2024-05-14 修回日期:2024-11-12 出版日期:2025-02-12 发布日期:2025-02-12
  • 通讯作者: 陈东英 E-mail:dongyingchen2022@126.com
  • 基金资助:
    苏州市科技局医学应用基础研究项目（SKY2023124）；无锡市科学技术协会2024年立项课题(KX-24-C290)

Analysis of potential classes and influencing factors for sleep quality in maintenance hemodialysis patients

MA Rong-rong, DENG Si-yan, ZHAO Juan, ZHENG Jing, CHEN Chen, HU Hua-gang, CHEN Dong-ying   

  1. Emergency Intensive Care Unit, Department of Emergency Medicine, The Central Hospital Affiliated to Jiangnan University (The Second People's Hospital of Wuxi), Wuxi 214002, China; 2School of Nursing, Suzhou Medical College, Soochow University, Suzhou 215006, China; 3Blood Purification Center, Yancheng City Tinghu District People's Hospital, Yancheng 224001, China; 4School of Nursing, Guangdong Pharmaceutical University, Guangzhou 510310, China; 5Department of Nephrology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China;  6Department of Geriatrics, The First Affiliated Hospital of Soochow University, Suzhou 215000, China
  • Received:2024-05-14 Revised:2024-11-12 Online:2025-02-12 Published:2025-02-12
  • Contact: 215000 苏州，6苏州大学附属第一医院老年医学科 E-mail:dongyingchen2022@126.com

摘要： 目的  探讨维持性血液透析(maintenance hemodialysis，MHD)患者睡眠质量的潜在类别及影响因素。 方法  通过方便抽样法选取江南大学附属中心医院等4家医院血液透析中心的480例MHD患者为研究对象。采用一般资料调查表、匹兹堡睡眠质量量表 (Pittsburgh sleep quality index，PSQI)、患者健康问卷、广泛性焦虑量表进行调查，根据PSQI睡眠指标进行潜在类别分析，采用无序多分类Logistic回归分析进行多因素分析。 结果  MHD患者睡眠障碍的发生率为50.7%，选取最优模型，睡眠质量可分4个潜在类别：整体睡眠较好组(C1，22.8%)、典型失眠组(C2，14.2%)、日间功能障碍伴夜间睡眠障碍组(C3，28.4%)及整体睡眠较差组(C4，34.6%)。Logistic回归分析显示以C1为参照组，MHD患者被分到C4的影响因素包括年龄(OR=1.028，95% CI：1.005～1.052，P=0.015)、抑郁(OR=16.097，95% CI：6.397～40.503，P＜0.001)、焦虑(OR=3.511，95% CI：1.038～11.873，P=0.043)；以C2为参照组，MHD患者被分到C4的影响因素包括抑郁(OR=13.683，95% CI：5.072～36.917，P＜0.001)、透析龄(OR=6.983，95% CI：1.510～32.284，P=0.013)。 结论  MHD患者的睡眠质量存在异质性，医护人员要重点关注老年、透析龄超过10年、存在抑郁及焦虑症状MHD患者的睡眠状况，给予针对性干预措施，以改善其睡眠质量。

关键词: 维持性血液透析, 睡眠质量, 潜在类别分析, 影响因素, 护理

Abstract: Objective To explore the potential categories and influencing factors for sleep quality in maintenance hemodialysis (MHD) patients.  Methods  A total of 480 MHD patients were recruited from hemodialysis center of The Central Hospital Affiliated to Jiangnan University and other 3 hospitals by convenient sampling method. General information questionnaire, Pittsburgh Sleep Quality Scale (PSQI), Patient Health Questionnaire, and Generalized Anxiety Scale were used for the investigation.  Results  The prevalence of sleep disorders in MHD patients was 50.7%. By selecting the optimal model, sleep quality could be classified into four potential categories: overall better sleep group (C1, 22.8%), typical insomnia group (C2, 14.2%), daytime dysfunction with nocturnal sleep disorder group (C3, 28.4%), and overall worse sleep group (C4, 34.6%). Logistic regression analysis showed that the influencing factors for sleep disorders in C4 group included age (OR=1.028, 95% CI: 1.005～1.052, P=0.015), depression (OR=16.097, 95% CI: 6.397～40.503, P＜0.001) and anxiety (OR=3.511, 95% CI: 1.038～11.873, P=0.043), when C1 group was used as the reference group; the influencing factors for sleep disorders in C4 group included depression (OR=13.683, 95% CI: 5.072～36.917, P＜0.001) and dialysis age (OR=6.983, 95% CI: 1.510～32.284, P=0.013), when C2 group was used as the reference group.  Conclusion The sleep quality is heterogeneous in MHD patients. Clinical healthcare professionals should focus on the sleep status and intervene the sleep disorders in MHD patients especially in those with older age, having dialysis age more than 10 years, and complicated with  depression and anxiety.

Key words: Maintenance hemodialysis, Sleep quality, Potential category analysis, Influencing factor, Nursing

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