本文選題：糖尿病　切入點(diǎn)：睡眠障礙　出處：《天津醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的1調(diào)查影響住院老年糖尿病睡眠障礙患者睡眠影響因素;2探討對住院老年糖尿病睡眠障礙患者給予“生理-行為”睡眠護(hù)理干預(yù)后的睡眠效果。方法本研究采用隨機(jī)對照試驗(yàn)方法,按照納入排除標(biāo)準(zhǔn),選擇2015年9月~2016年5月天津醫(yī)科大學(xué)代謝病醫(yī)院內(nèi)在住院期間發(fā)生睡眠障礙的老年糖尿病患者作為研究對象。通過隨機(jī)數(shù)字表法將住院老年糖尿病患者分為試驗(yàn)組和對照組。采用詢問及患者自評相結(jié)合的調(diào)查方式,由經(jīng)過統(tǒng)一培訓(xùn)的調(diào)查人員根據(jù)調(diào)查表的內(nèi)容詢問研究對象后填寫。調(diào)查問卷的內(nèi)容包括研究對象人口學(xué)相關(guān)資料、生活習(xí)慣、疾病狀況以及相關(guān)臨床生化指標(biāo)等,再通過匹茲堡睡眠質(zhì)量指數(shù)量表(Pittsburgh Sleep Quality Index,PSQI)對住院老年糖尿病患者進(jìn)行睡眠質(zhì)量的測量評價(jià)。對于試驗(yàn)組患者,本研究在常規(guī)睡眠護(hù)理干預(yù)的基礎(chǔ)上提供給患者“生理-行為”睡眠護(hù)理干預(yù)措施;對照組患者,本研究僅接受常規(guī)睡眠護(hù)理干預(yù)。睡眠護(hù)理干預(yù)時(shí)間為7天;給予睡眠護(hù)理干預(yù)7天后再次對研究對象進(jìn)行匹茲堡睡眠質(zhì)量指數(shù)量表測量,了解睡眠護(hù)理干預(yù)后研究對象的睡眠質(zhì)量,同時(shí)通過病歷收集研究對象血糖的相關(guān)生化指標(biāo),利用Epidata3.0軟件進(jìn)行數(shù)據(jù)錄入,統(tǒng)計(jì)分析數(shù)據(jù)則使用SPSS21.0軟件。通過方差分析、t檢驗(yàn)、多元線性回歸分析、Pearson積距相關(guān)分析及協(xié)方差分析對量表測評結(jié)果進(jìn)行分析。結(jié)果1調(diào)查分析結(jié)果1.1根據(jù)納入排除標(biāo)準(zhǔn),本研究實(shí)際共納入研究對象120例,其中男性52例(43.3%),女性68例(56.7%);60~70歲組的人數(shù)最多占55%,70~75歲組次之,80以上歲人群最少。1.2通過對住院老年2型糖尿病患者的睡眠影響因素進(jìn)行單因素分析、Pearson相關(guān)分析以及多因素分析,結(jié)果顯示高齡、高身體質(zhì)量指數(shù)、糖化血紅蛋白(hemoglobin Alc,Hb Alc)值高、合并有心腦血管疾病的2型糖尿病患者睡眠質(zhì)量差,而規(guī)律運(yùn)動(dòng)是睡眠障礙的保護(hù)因素。1.3本研究將住院老年2型糖尿病患者匹茲堡睡眠質(zhì)量指數(shù)量表總分及各項(xiàng)目得分與全國常模進(jìn)行比較,其中主觀睡眠質(zhì)量(1.50±0.76)、睡眠潛伏期(1.55±0.93)、睡眠時(shí)間(1.85±0.56)、睡眠效率(1.88±0.43)、睡眠障礙(1.37±0.52)5個(gè)因子得分均高于比國內(nèi)常模,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05),住院老年2型糖尿病患者睡眠質(zhì)量比國內(nèi)一般人群差。2干預(yù)結(jié)果本研究對試驗(yàn)組研究對象進(jìn)行干預(yù)后,即在常規(guī)睡眠護(hù)理基礎(chǔ)上給予“生理-行為”睡眠護(hù)理干預(yù)的患者其主觀睡眠質(zhì)量、睡眠潛伏期、睡眠時(shí)間、睡眠效率、睡眠障礙5個(gè)因子得分和匹茲堡睡眠質(zhì)量指數(shù)量表總分明顯降低,試驗(yàn)組干預(yù)前后的5個(gè)因子得分及匹茲堡睡眠質(zhì)量指數(shù)量表總分差異具有統(tǒng)計(jì)學(xué)意義,而僅給予常規(guī)睡眠護(hù)理干預(yù)的對照組患者在干預(yù)前后測量其匹茲堡睡眠質(zhì)量指數(shù)量表總分?jǐn)?shù)值及各因子得分差異不具有統(tǒng)計(jì)學(xué)意義。結(jié)論1住院老年2型糖尿病患者普遍存在睡眠問題,睡眠質(zhì)量比國內(nèi)一般人群差,睡眠障礙發(fā)生率遠(yuǎn)高于正常人群,影響了老年糖尿病患者的生活質(zhì)量和康復(fù)效果。同時(shí)本研究發(fā)現(xiàn)年齡、身體質(zhì)量指數(shù)四個(gè)方面是住院老年2型糖尿病患者睡眠障礙的危險(xiǎn)因素。2本研究提出的“生理-行為”睡眠敢于措施對住院老年2型糖尿病患者睡眠質(zhì)量的改善有明顯效果。
[Abstract]:The factors of sleep sleep disorders affect the hospitalized elderly patients with diabetes to 1 Investigation on 2; senile patients with diabetes for sleep disorders "physiology" sleep sleep effect after nursing intervention. Methods the method of randomized controlled trials, according to the inclusion and exclusion criterion, sleep disorder occurred September 2015 ~2016 year in May the metabolic disease Hospital of Medical University Of Tianjin the hospitalization of elderly patients with diabetes as the research object. The hospitalized elderly patients with diabetes were divided into experimental group and control group by random number table method. Self evaluation methods of combining and by asking the patient by investigators trained according to the content of the questionnaire about the research object. After completing the questionnaire including study on demographic information, lifestyle, disease status and clinical biochemical indicators, recanalization Pittsburgh sleep quality index scale (Pittsburgh Sleep Quality Index, PSQI) on the measurement and evaluation of sleep quality in elderly patients with diabetes. For patients in the experimental group, based on routine nursing intervention on sleep provides "physiological behavior" sleep in patients with nursing intervention; patients in the control group, this study received only routine sleep sleep nursing. Nursing intervention for 7 days; give again to study on Pittsburgh sleep quality index scale sleep nursing intervention for 7 days, the object of study about sleep after nursing intervention on sleep quality and related biochemical indicators through medical records collected blood glucose, input the data by using Epidata3.0 software, statistical analysis of data use the SPSS21.0 software. Through variance analysis, t test, multiple linear regression analysis, correlation analysis and covariance from the Pearson product division Analysis of the scale evaluation results were analyzed. Results of the 1 survey results of 1.1 according to the exclusion criteria, this study included 120 subjects, including 52 cases of male (43.3%), 68 cases were female (56.7%); 60~70 age group accounted for 55%, 70~75 years old group, 80 years old to the crowd at least.1.2 through single factor analysis of influencing factors of sleep in hospitalized elderly patients with type 2 diabetes, Pearson correlation analysis and multivariate analysis, results showed that older age, higher body mass index, glycosylated hemoglobin (hemoglobin Alc, Hb Alc) with high value of sleep in patients with type 2 diabetes quality and cardiovascular disease, and regular exercise is.1.3 protective factors of sleep disorders in this study of hospitalized elderly type 2 diabetic patients in Pittsburgh sleep quality index score and each item score compared with the national norm, the subjective quality of sleep among them (1.50 + 0.76), Sleep latency (1.55 + 0.93), sleep time (1.85 + 0.56), sleep efficiency (1.88 + 0.43), sleep disorders (1.37 + 0.52) 5 factor scores were higher than the national norm, the difference was statistically significant (P0.05), the quality of sleep in patients with type 2 diabetes than in the general population of domestic.2 intervention the results of test group of subjects intervention in hospitalized elderly, namely "physiological behavior" sleep nursing intervention in routine care on the basis of sleep in patients with subjective sleep quality, sleep latency, sleep time, sleep efficiency, sleep disorders 5 factor scores and Pittsburgh sleep quality index score decreased significantly. The experimental group before and after the intervention of the 5 sleep factor score and the Pittsburgh quality index scores the difference was statistically significant, but only routine sleep nursing intervention for patients in the control group before and after intervention to measure the sleep quality in Pittsburgh Volume index scale scores and each factor score difference was not statistically significant. Conclusion 1 hospitalized elderly patients with type 2 diabetes are common sleep problems, sleep quality than the general population in China, the incidence of sleep disorder is far higher than the normal population, affecting the quality of life and rehabilitation effect of elderly patients with diabetes. The study found that age, four aspects of body mass index is the physiological behavior of.2 risk factors in hospitalized elderly patients with type 2 diabetes mellitus patients with sleep disorders in this study proposes to improve sleep of elderly type 2 to measure the quality of sleep in patients with diabetes mellitus have obvious effect.

【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.5

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本文編號(hào)：1698672