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  • 學位論文

早產兒母親睡眠品質及其相關性因素之研究

Sleep Quality and Related Factors in Mothers of Preterm Infants

指導教授 : 高碧霞

摘要


研究背景及目的:由於醫學的進步,早產兒的存活率大為提升,而在傳統社會中母親一向被視為嬰兒主要的照顧者,早產對母親而言是一壓力事件,不僅經歷到住新生兒加護病房壓力,早產兒出院後還需負起養育照顧責任,很多母親都描述到她們遭受很嚴重的睡眠混亂情形。因此本初步研究的目的是瞭解早產兒母親的睡眠品質現況以及影響睡眠品質之相關因素。 研究方法:本研究運用混合方法(Mixed method design),結合量性及質性的研究設計進行研究。於2006年12月1日至2007年5月30日期間,分別在早產兒出生一週、轉出加護病房一週以及返家後一週,以匹茲堡睡眠品質量表(PSQI)、社會支持量表、親職壓力量表,重複追蹤14位初經產婦並進行半結構式深度訪談,以更深入了解早產兒母親之睡眠品質及其影響因素,研究對象有效答覆率為93.33%。 研究結果:睡眠品質PSQI總得分≦5表示睡眠品質良好,而本研究之早產兒母親睡眠品質差,以早產兒出生一週最差(12.3分),而以轉出加護病房一週時,母親的睡眠品質最理想(6.4分),以Kruskal Wallis Test檢定呈顯著差異性(χ2=16.33, p<.01)。早產兒母親在孩子出生一週及返家一週個人的主觀睡眠品質差,母親平均睡眠時數,以孩子轉出加護病房一週時最多(6.5小時),而在早產兒返家後一週最少(4小時)。早產兒母親的睡眠品質與其基本屬性、早產兒特性未達顯著的差異性,與社會支持是呈現負相關(r = -.28, p>.05),尤其在情緒性方面與早產兒母親睡眠品質呈現顯著的負相關(r=-.41, p<.01)。母親的睡眠品質與親職壓力呈現正相關(r=.68, p<.01),即早產兒母親的壓力越大,睡眠品質越差。早產兒母親睡眠品質之質性分析可歸納為四個主軸:輾轉反側難以入眠-早產兒是一切緣由的開始,母親會因而有一些情緒反應,造成夜間的失眠。惶恐不安睡不安寧-早產兒在加護病房住院期間,母親常隨著早產兒的進展狀況情緒起伏不定。倒吃甘蔗漸入佳境-一旦早產兒轉至中重度病房,母親會開始覺得早產兒是安全的,睡眠狀況會得到改善。作息重整晝夜不分-早產兒返家後日夜作息顛倒,常使母親在照顧上造成很大的困擾,白天休息時間少夜間睡眠易中斷,嚴重影響睡眠品質。 討論/結論:根據本研究結果,呼籲臨床護理人員應重視早產兒母親在面臨突然的生產,對母親身、心所造成的壓力及睡眠剝削的影響。本研究建議早產兒醫療團隊,需要即早評估早產兒返家後對母親睡眠的困擾,協助母親尋求有效的支持系統、事先安排日後計劃,以改善母親睡眠品質,進而提升早產兒家庭的生活品質。

並列摘要


Background/Purpose: With the advance of medicine, the survival of premature infants increases markedly. The mother always is regarded as the major caregiver in the traditional society; mothers of preterm infants also experience considerable stress, not only during hospitalization, but also after discharge. Many mothers describe themselves suffering from the very serious sleep disorders. This preliminary study is to explore the quality of sleep and multiple factors that affect sleep quality in mothers of premature infants. Methods: A mixed method design combining quantitative and qualitative methodologies was conducted. During December 1st 2006 to May 30th 2007, data collection was conducted by the semi-structural in-depth interviews and questionnaires of Pittsburg Sleep Quality Index (PSQI), social support scale and Parental Stress Index to repeatedly measure 14 primipara and multipara in three time periods: the first week after the birth, the first week after the infant is transferred out, and the first week after they go home. The valid response rate was 93.33%. Results: The global score of PSQI less than 5 indicates good quality of sleep. Poor sleep quality was reported by mothers of premature infants in this study; the worst happened in the first week after the birth of a premature infant (mean = 12.3), the best in the first week after the infant is transferred out of the intensive care unit (mean = 6.4). Significant differences were found the three time periods (χ2=16.33, p<.01). Poor subjective sleep quality was presented at both the first week after the birth and they go home. The average sleep duration was longest (6.5 hours) in the first week after the infant was transferred out of the intensive care unit, and shortest (4 hours) in the first week after they go home. There were no significant differences in the relationship between sleep quality and other maternal basic profiles or infant characters. The sleep quality and social support was of negative correlation(r = -.28, p >.05), especially emotional support(r = -.41, p <.01). The sleep quality and parenting stress was of positive correlation(r =.68, p <.01); the more stress of a mother, the worse quality of sleep she had. Four themes of sleep quality of mothers were inductively identified as follows. 1) Hard to fall asleep: The mother had insomnia caused by emotional reaction to having premature baby. 2) Hard to sleep well: While the premature infant was in the intensive care unit, the critical condition affected the mother’s mood deeply. 3) From bitter to sweet: As the premature infant was transferred out of NICU, the mother started to feel the baby becoming stable and then to experience good sleep quality. 4) Reorganized the normal daily life activities: The premature infant had time conflicts to adapt to the regular family life, the mother always bore the care burdens and scarified her resting and sleeping time day and night. Conclusions: Results lead researcher to conclude that clinical nursing staffs should value the impacts of a premature delivery on the mother and its great consequences of physiological, psychological stress and sleep quality deprivation. These results suggested the premature health care team to evaluate the sleep disturbance of the mother, to strengthen the support system to plan for the premature infant, to better the sleep quality of the mother and then to improve the life quality of the family.

參考文獻


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被引用紀錄


劉綉靖(2009)。早產兒出院ㄧ個月內主要照顧者的生活品質及相關因素探討〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2009.01379

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