Non-Adherence is Correlated with Poor Quality of Sleep in Diabetic Hemodialysis Patients

長期血液透析的糖尿病患者的醫囑遵從性與睡眠品質相關

詹培梅(Pei-Mei Chan) ； 黃淑貞(Shu-Chen Huang) ； 彭渝森(Yu-Sen Peng) ； 楊如燁(Ju-Yeh Yang)

《Acta Nephrologica》 24卷3期 (2010/07) Pp. 145-150

摘要

研究目的：睡眠問題常造成長期血液透析患者的困擾，醫囑遵從性則是影響糖尿病患者及透析患者預後的因子之一。本研究的目的在釐清睡眠問題與醫囑遵從性兩者之間的關連性，
研究方法：我們研究76位在台灣北部某一醫學中心長期血液透析的糖尿病患者，蒐集其基本資料，利用匹茲堡睡眠品質問卷評估睡眠品質，醫囑遵從性則利用飲食控制問卷、藥物數量計數及透析問體重增加來評估。
研究結果：平均的睡眠品質分數為9.7±4.5。我們發現在有無睡眠困擾的兩組患者間的基本性質及一般生化檢查沒有不同。主觀的飲食醫囑遵從性越好，透析間體重增加越少，但兩者與藥物醫囑遵從性之間皆無相關性。主觀的飲食醫囑遵從性越好的患者其主觀的睡眠品質越好。
結論：睡眠及醫囑遵從性都是臨床上令醫病雙方困擾的棘手問題，我們報告兩者在長期血液透析的糖尿病患者的關連性，暗示可能有一些共同影響的因子值得進一步探討。

關鍵字

糖尿病 ； 血液透析 ； 醫囑遵從性 ； 睡眠品質

並列摘要

Conflict of interest statement: The results presented in this paper have not been published previously in whole or part, except in abstract format. The authors, singly or collectively, have had no involvement that might raise the question of bias in the work reported.
Objectives: Sleep disturbance is a common complaint of end-stage renal-disease (ESRD) patients. Non-adherence is popular and frustrating amongst diabetes (DM) and hemodialysis (HD) patients. This study examined the relationship between quality of sleep (QOS) and adherence for diabetic patients on HD.
Methods: The study subjects included 76 diabetic patients undergoing regular hemodialysis in one medical centre in Northern Taiwan. We collected biochemical parameters and demographic data. The quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Adherence was measured by self-reported questionnaires and pill counting.
Results: The average PSQI score was 9.7±4.5. There was no difference in any demographic or biochemical parameters between good and poor sleepers. The subjective diet compliance is consistent with interdialytic weight gain (r=-0.331, p=0.004) but sot medication adherence (r=-0.012, p=0.917). Patients with subjective better diet compliance slept better (r=-0.287, p=0.013). There was no correlation between medication adherence and quality of sleep (r=-0.039, p=0.740).
Conclusions: Both non-adherence and sleep disturbance were challenging to deal with. The correlation between subjective quality of sleep and diet adherence amongst diabetic HD patients merits further research to explore potentially modifiable common factors.

並列關鍵字

dialysis ； quality of sleep ； adherence ； diabetes