外科加護病房病患睡眠品質及其相關因素探討

The Quality of Sleep and its Associated Factors Among Patients in the Surgical Intensive Care Units

方楸淑(Chiu-Shu Fang)

指導教授 ： 王瑞霞

高雄醫學大學/護理學院/護理學系研究所/碩士(2006年)

https://doi.org/10.6832/KMU.2006.00122

摘要

本研究探討外科加護病房病患睡眠品質及其相關因素，研究目的為：（1）探討外科加護病房病患之睡眠品質。（2）探討外科加護病房病患人口學屬性、疾病特性、疼痛、焦慮、噪音感受、治療活動和睡眠品質間的相關性。（3）探討影響外科加護病房睡眠品質的重要預測因子。採描述相關性研究設計，以立意取樣，在南部二所醫學中心及一所區域醫院的外科加護病房，選取18歲以上、意識清楚、手術後入加護病房至少24小時之病患共102人。由研究者翻閱病歷收集病患資料記錄，包括人口學屬性、疾病特性及治療活動總頻率等，並以結構式問卷調查，問卷包括：疼痛視覺類比量表、焦慮量表、自覺噪音感受量表、治療活動干擾感受量表、中文維辛式睡眠量表（Verran and Snyder-Halpern Sleep Scale; VSH sleep scale）。將所得資料以描述性統計、標準化得分指標[公式＝（量表得分之平均值÷滿分數）×100]、t檢定、單因子變異數分析、皮爾森積差相關分析、簡單線性迴歸以及逐步複迴歸進行統計分析。研究結果發現：(1)本研究對象的睡眠品質為中高程度的睡眠受擾、中低程度的有效睡眠和中高程度需要補償睡眠。整體睡眠品質的得分指標為40.31，屬於中度至低度的整體睡眠品質。(2)年齡愈大者、疾病嚴重度分數愈高，整體睡眠品質愈差。(3)焦慮、自覺噪音感受程度及治療活動干擾感程度愈高，整體睡眠品質愈差。(4)自覺噪音感受和急性生理及慢性健康評值是整體睡眠品質的顯著預測因子，可解釋整體睡眠品質的總變異數26.1%。本研究結果可提供醫護人員在照護外科加護病房病患之臨床實務及未來介入性研究之參考。

關鍵字

睡眠品質 ； 外科加護病房

並列摘要

This study was to explore the quality of sleep and its associated factors among patients in surgical intensive care units (SICU). The purpose of this study were to: (1) understand the quality of sleep of SICU patients, (2) examine the relationship of demographic variables, illness characteristics, pain intensity, anxiety levels, perception of noise, therapeutic activities to the quality of sleep, and (3) explore the important explanatory factors for the quality of sleep. This is a cross-sectional and correlation study. A convenience sample of 102 patients aged 18 years or above with clear consciousness and remaining in the ICU at least 24 hours after operation, was selected from two medical centers and one regional hospital in Southern Taiwan. Demographic variables, illness characteristics, and frequency of therapeutic interventions of patients were collected from patients’ charts. Questionnaires including Visual Analogue Scale(VAS) for Pain, anxiety Scale, perception of noise scale, perception of therapeutic intervention interruption scale and the Verran and Snyder-Halpern Sleep Scale (VSH sleep scale) were also applied in the study. The collected data were analyzed by descriptive statistics, standardization by the index of mean score [（mean score/total possible score）×100], t-test, one-way ANOVA, Pearson’s product moment correlation, Simple linear regression analysis and stepwise multiple regression analysis. Patients reported moderate to high levels of sleep disturbance, moderate to low levels of sleep effectiveness, and moderate to high levels of need for sleep supplementation. Overall, the standardized score of quality of sleep was 40.31, considered as low to moderate level. Age, severity of illness, high anxiety levels, environmental noise, and sleep interruption caused by therapeutic interventions had significant negative effects on sleep quality. Perception of noise and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scores were the significant explanatory factors of sleep quality, and explained 26.1 % of the total amount of variance. Study results may assist nursing staff in understanding sleep quality in SICU patients. The study may also serve as a reference for future intervention programs in this field.

並列關鍵字

Quality of Sleep ； surgical intensive care

參考文獻

一、中文部份

王桂芸（1988）•加護病房中影響病患睡眠型態之因素-噪音及持續性護理活動•護理雜誌，35（2），57-62。

王潤清（2003）•慢性疼痛對情緒狀態及睡眠品質之影響：慢性癌痛與慢性每日頭痛之比較•未發表的碩士論文，台北：台北醫學大學護理研究所。

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