社區原住民老年婦女睡眠障礙與耳穴貼壓介入成效之研究

睡眠障礙是老年婦女常見的健康問題，但山地原住民老年婦女的睡眠問題及有效介入措施之相關資料至今卻仍相當匱乏。因此，本研究分為兩部分進行，第一階段以橫斷性研究調查北部山地社區60歲以上330位原住民婦女，探索睡眠障礙盛行率與相關影響因素，結果58.2%婦女為睡眠障礙者，影響睡眠障礙因素為經濟狀態不足、整體健康狀況較差、罹患慢性病、肥胖、心理健康不佳、具有重大壓力與家人情緒支持不足。而以多變項對數複迴歸調整影響睡眠障礙因素後，發現影響原住民老年婦女睡眠障礙的顯著因素為整體健康狀況較差、肥胖及心理健康不佳。第二階段以類實驗設計，將耳穴貼壓做為介入措施，以有睡眠障礙之婦女為對象，分為介入組41位與對照組39位。介入組完成為期三週之介入後，當中34.1%婦女之睡眠障礙獲顯著改善，且介入組在介入後的匹茲堡睡眠品質量表總得分與睡眠潛伏期、睡眠時數、睡眠效率、睡眠困擾之得分均顯示為顯著改善。在控制干擾因素後，介入組顯著較對照組有睡眠障礙顯著改善成效。本實證研究之結果可供衛生所基層照護人員實際應用於睡眠障礙婦女，及未來研究參考。

關鍵字

原住民；老年婦女；睡眠障礙；耳穴貼壓

並列摘要

Sleep disturbance is a common health problem among older women. Evidence-based research on sleep disturbance and its effective intervention among aboriginal older women is rarely done. The first stage of this study was an investigation of the prevalence and influencing factors of sleep disturbance among northern aboriginal aged women over 60, conducted using a cross-sectional survey. The results showed that 58.2% of the subjects suffered from sleep disturbance, and associated factors included poverty, poor general health status, chronic illness, obesity, poor psychological health, significant stress and insufficient emotional support from family members. After adjusting for all influencing factors, it was found that poor general health status, obesity and poor psychological health were the significant influencing factors of the women’s sleep disturbance. The second stage was conducted using a quasi-experimental design, which included 41 women with sleep disturbance as the intervention group and 39 women with sleep disturbance as the control group. After a three-week course of auricular acupressure intervention was applied, 34.1% of the women in the intervention group improved their sleep disturbance as well as the scores on the Pittsburgh sleep quality index and its components, including sleep latency, sleep duration, habitual sleep efficiency, and sleep disturbances. After controlling confounding factors, the intervention group still showed more improvement in sleep disturbance than that of the control group. The results of this study could be used by primary health care providers as a treatment choice for women suffering from sleep disturbances. Future research on this method is warranted.