好眠團體對憂鬱症合併失眠患者睡眠改善之成效

失眠是現代人普遍健康問題的抱怨之一，造成白天生活疲憊感，情緒易怒憂鬱，工作表現及專注度下降，影響職業與社會功能，長期未能改善失眠問題，日後產生憂鬱症或焦慮症可能也隨之增加。本研究以續發性失眠個案為對象，憂鬱程度達住院標準，合併失眠之抱怨為研究對象。根據CBT-I與神經心理模式為基礎，以好眠團體介入方案，團體治療方式進行，治療流程共為6週，每次90分鐘，一週一次為限。以量表與腕動計測量收集前測、中測、團體結束當天後測一及團體結束後追蹤第一個月資料分析。本研究以PSQI為主要睡眠品質指標分析，調整控制Propensity score與BZD藥物，顯示組別與時間交互作用之成效，結果發現整體睡眠品質在好眠團體協助下有明顯改善，此CBT-I能提供臨床上續發性失眠患者照護策略及參考，改善失眠情形，增進生活品質。

關鍵字

好眠團體；失眠；憂鬱症

並列摘要

Insomnia is one of the common health problems complained of for modern people, which causes daytime life fatigue, emotional irritability, depression, decreased job performance and concentration and affects occupation and social functioning. Failing in improving insomnia for a long term may also increase the possibility of depression or anxiety disorders in future. This study took secondary insomnia as subject and those who complain of both depression and insomnia and can be hospitalized as study object. Based on CBT-I and neuropsychological model, the study adopted group therapy approach with good sleep group intervention program; the treatment process was a total of six weeks, with 90 minutes each and once a week at most. Scale and actigraphy were employed to measure and collect the data analysis of pre-test, mid-test, post-test of the day when the group finished and the first month after the group finished. This study mainly took PSQI as sleep quality index analysis and adjusted the controlled Propensity score and BZD drugs, showing the effectiveness of the interaction between group and time. And it’s found that overall sleep quality had significant improvement with the assistance of good sleep group and that CBT-I could provide clinical strategies and reference for nursing patients with secondary insomnia and improve insomnia and life quality.