接受體外受精胚胎植入之台灣婦女的身心症狀與睡眠困擾

Somatic symptoms, psychological distress and sleep disturbance among Taiwanese Women with In Vitro Fertilization and Embryo Transfer

吳湘茹(Xiang-Ru Wu)

指導教授 ： 李宗賢

中山醫學大學/護理學院/護理學系碩士班/碩士(2016年)

摘要

研究背景與目的：不孕婦女在接受生殖科技治療時，會經歷一定程度的壓力，接受卵巢刺激排卵藥物及進行許多侵入性治療如取卵及胚胎植入等皆造成許多身體不適症狀及心理壓力，因而影響睡眠狀態，甚或影響身心健康。本研究想要探討正在接受體外受精胚胎植入之婦女之人口學屬性、身體症狀、心理反應對睡眠困擾之差異與影響。
研究方法：本研究採橫斷性及相關性研究調查法。在中部某不孕症治療中心收案，共計60位正在接受體外受精胚胎植入之婦女在接受胚胎植入後一週進行研究資料之收集。測量工具包括匹茲堡睡眠品質量表、睡眠日誌、身體不適症狀量表、台灣人憂鬱量表及情境特質焦慮量表。所得問卷資料以「t檢定」、「卡方檢定」、「Pearson相關分析」及「邏輯斯迴歸」分析其相關性。
研究結果：體外受精胚胎植入婦女在治療時有68.3%有睡眠困擾。接受體外受精胚胎植入婦女之「懷孕次數」及「自然流產次數」與睡眠困擾達統計顯著差異。身體不適症狀量表之「腹脹」、「乳房腫脹」、「其他不適症狀」及「身體不適症狀量表總分」與睡眠困擾達統計顯著差異。而焦慮及憂鬱與睡眠困擾未達統計顯著差異。以二元邏輯斯迴歸分析睡眠困擾影響因子結果顯示有睡眠困擾患者腹脹的勝算比為無睡眠困擾的1.83倍(OR=1.83，95% CI=1.09-3.06)，達統計上顯著差異(p = .02)；有睡眠困擾患者其他身體不適症狀的勝算比為無睡眠困擾的1.88倍(OR=1.88，95% CI=1.08-3.25)，達統計上顯著差異(p =.03)。
結論與建議：本研究發現在胚胎植入後的婦女有68.3%出現睡眠困擾，若個案此時身體不適症狀較為嚴重時，應及時協助其緩解，以減少對於睡眠的影響。臨床醫護人員可主動提供有關身心不適及睡眠困擾的相關資訊，如身體不適症狀包括腹脹、腹痛及乳房腫脹會影響睡眠困擾，提出身體不適症狀症狀緩解方法，提供睡眠困擾諮詢管道，加強個案對於睡眠的評估技巧及睡眠管理，找出睡眠困擾原因。且提供個別性的護理措施以促進其睡眠品質的提升。

關鍵字

體外受精胚胎植入 ； 身體症狀 ； 心理情緒 ； 睡眠困擾

並列摘要

Background and purpose: In an interview infertile women of reproductive technology treatment, will experience some degree of pressure to undergo ovarian stimulation drugs and invasive treatment such as oocyte retrieval and embryos implantation mused cause many physical symptoms and psychological stress, thus affecting sleep, or even affect the physical and mental health. This study wants to explore demographic undergoing in vitro fertilization and embryos implantation property of women, the physical symptoms, psychological distress of the differences in response to sleep.
Methods: The cross-sectional study and other related research study were used in this survey. Total 60 IVF women were studied and collected data after one week of embryos transferring in a reproductive and infertility center in Taichung. The measurement tools include Pittsburgh sleep quality index (PSQI), sleep log, somatic symptoms scale, Taiwanese Depression Scale, and Situational Trait Anxiety Inventory. The questionnaires were analyzed its relevance and predictability according to t-test, chi-square test, Pearson correlation analysis and logistic regression.
Results: 68.3% IVF women experienced sleeping disturbance according to statistic. There are obviously differences of statistic on pregnancy numbers, miscarriage numbers and sleeping disturbance of women who undergo IVF. The Scale of somatic symptoms of " abdominal distension,", "engorgement", "other symptoms" and " uncomfortable somatic symptoms total score" and sleep disturbance of statistically significant differences. There were no statistically significant differences on anxiety and depression and sleep disturbance . Dualistic logistic regression analysis showed that sleep disturbance factor in patients with sleep troubled by. Abdominal distension odds ratio of 1.83 times without sleep disturbance (OR = 1.83, 95% CI = 1.09-3.06) difference was statistically significant (p = .02), sleep troubled by other somatic symptoms in patients with odds ratio of 1.88 times without sleep disturbance (OR = 1.88, 95% CI = 1.08-3.25), up statistically significant differences (p = .03).
Conclusions and suggestions: The study found that women after the embryo implantation 68.3% had sleep disturbance, somatic symptoms at this time if the case is serious, they should promptly assist its mitigation, to reduce the impact of sleep. Therefore, clinical staff can take the initiative to provide relevant information about the physical and psychological discomfort and sleep disturbance, such as somatic symptoms include abdominal distension, abdominal pain and swelling of the breast can affect sleep disturbance, somatic symptoms can be informed in advance of cases medication may occur proposed somatic symptoms , method, providing counseling troubled sleep pipeline, strengthening the case for the assessment of sleep and sleep management techniques to identify reasons for disturbed sleep. And provides individuality, appropriateness of care measures to promote the quality of sleep.

並列關鍵字

in vitro fertilization and embryo implantation ； somatic symptoms ； psychological emotional ； sleep disturbance

參考文獻

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