老人睡眠品質之探討

背景：睡眠障礙在老年族群中盛行率極高，尤其對於長照機構的老人，由於環境、作息、缺乏人際互動等因素，都可能不利於睡眠。目的：本研究目的為探討老人的睡眠品質及其相關因素。方法：採橫斷式調查研究，研究對象有33位老人來自三間長照機構及55位來自二家健康服務中心，以匹茲堡睡眠品質量表評估老人睡眠狀況。結果：1.88位老人平均年齡77.01±10.56歲，67.0%有慢性病史。2.長照機構老人（84.8%）睡眠品質不佳（PSQI＞5分）比例顯著高於社區老人（38.2%；χ^2=18.202, p＜.001）；兩組老人在七個睡眠品質面向均有顯著差異（p＜.05）。3.年齡越大睡眠品質越差（Spearman correlation coefficient=.437, p＜.001）；婚姻狀況和睡眠品質有顯著相關（H=2.227, p＜.05），離婚者睡眠品質較差；有服用鎮靜安眠藥者睡眠品質較差（U=3.121, p＜.05）。結論：長照機構老人睡眠品質比社區老人差，而較長的睡眠潛伏期為主要影響睡眠品質不佳的原因，因此應鼓勵老人於白天多參加活動，養成規律運動習慣，再者，晚間無睡意時勿躺在床上，以減少躺在床上睡不著時間。

關鍵字

老人；長照機構；睡眠品質；匹茲堡睡眠品質量表

並列摘要

Background: Thee is a high prevalence of sleep problems in the elderly, especially for the institutional elderly. Due to environment, care schedule, and lack of interpersonal interaction, it may be detrimental for them to sleep. Purposes: The purpose of this study was to investigate the sleep quality of the elderly and its related factors. Methods: A cross-sectional study was conducted. 33 elderly were recruited from three long-term care (LTC) institutions and 55 elderly were from two health service centers. The Pittsburgh Sleep Quality Index was used to assess the sleep quality of the elderly. Results: 1. The mean age of elderly was 77.01±10.56 years old, and 67.0% had a history of chronic diseases. 2. The percentage of poor sleep of quality was significantly higher in institutional elderly (84.8%) than that in community elderly (38.2%; χ^2= 18.202, p ＜ .001). There were significant differences in the seven sleep quality domain between the two groups of elderly (p＜ .05). 3. The older the age, the worse the quality of sleep (Spearman correlation coefficient =.437, p ＜ .001). The marital status was significantly related with quality of sleep (H=2.227, p ＜ .05). The divorce elderly had poorer sleep quality. Using sedative hypnotics was significantly related with quality of sleep (U=3.121, p ＜ .05). Conclusions: The LTC institutions elderly had poorer sleep quality than that of community elderly. The long sleep latency is the main cause of poor sleep quality. Therefore, the elderly should be encouraged to participate in activities during the day and develop regular exercise habits. Furthermore, it is important to encourage the elderly not to lie in bed when they are not sleepy.

並列關鍵字

elderly ； long-term care institutions ； sleep quality ； Pittsburgh Sleep Quality Index (PSQI)

參考文獻

Gindin, J., Shochat, T., Chetrit, A., Epstein, S., Ben Israel, Y., Levi, S., … Bernabei, R. (2014). Insomnia in long-term care facilities: A comparison of seven European countries and Israel: The services and health for elderly in long term care study. Journal of the American Geriatrics Sociaty, 62(11), 2033-2039. doi:10.1111/jgs.13099

Hilmisson, H., Sveinsdottir, E., Lange, N., & Magnusdottir, S. (2019). Insomnia symptoms in primary care: A prospective study focusing on prevalence of undiagnosed co-morbid sleep disordered breathing. European Journal of Internal Medicine, 63, 19-26. https://doi.org/10.1016/j.ejim.2019.01.011

Stone, K. L., Ensrud, K. E., & Ancoli-Israel, S. (2008). Sleep, insomnia and falls in elderly patients. Sleep Medicine, 9(Suppl. 1), S18-S22. doi:10.1016/S1389-9457(08)70012-1

行政院國家發展委員會（2018）‧「中華民國人口推估（2018至2065年）」報告‧https://www.ndc.gov.tw/Content_List.aspx?n=84223 C65B6F 94D72