【摘要】：目的:開發(fā)一套針對中國認知癥老年人睡眠障礙的老年撫觸保健操,評價該老年撫觸保健操在改善認知癥老年人睡眠障礙中的效果。方法:1老年撫觸保健操的開發(fā):借鑒瑞典觸摸技術(shù)(Tactile Massage)和日本撫觸照護技術(shù)(Tactile care),結(jié)合我國認知癥老年人睡眠障礙護理現(xiàn)狀、老年人身體狀況,充分閱讀文獻,在神經(jīng)內(nèi)科專家、康復(fù)醫(yī)學(xué)專家、老年醫(yī)學(xué)專家、老年護理專家指導(dǎo)下,歷時10個月,開發(fā)了一套針對中國認知癥老年人睡眠障礙的老年撫觸保健操。本老年撫觸保健操包括背部、手部兩部分,累計15節(jié)。2老年撫觸保健操的實施:采用便利抽樣法,于2016年2月至9月,選取河北省石家莊市某養(yǎng)老機構(gòu)為研究基地,抽取該養(yǎng)老機構(gòu)中符合納入、排除標(biāo)準(zhǔn)的38名認知癥伴睡眠障礙老年人為干預(yù)對象。老年人在常規(guī)照護基礎(chǔ)上,由經(jīng)過專業(yè)培訓(xùn)的研究者為老人提供每周3次、每次約30分鐘、累計8周的老年撫觸保健操。采用便攜式睡眠記錄儀(ACT)、匹茲堡睡眠質(zhì)量指數(shù)量表(PSOI)、Epworth嗜睡量表(ESS)、唾液α淀粉酶活性(sAA)、睡眠日志(SD)評估老年撫觸保健操干預(yù)前、干預(yù)4周、干預(yù)8周老年人的睡眠狀況,評價該老年撫觸保健操對認知癥老年人睡眠障礙的效果。使用Epidata3.1建庫、錄入數(shù)據(jù),SPSS21.0進行統(tǒng)計學(xué)分析。計量資料做正態(tài)性檢驗,滿足正態(tài)分布的結(jié)果用x±s表示,不滿足正態(tài)分布的結(jié)果用中位數(shù)、四分位間距表示,采用秩和檢驗;使用重復(fù)測量方差分析各測量指標(biāo)的時間效應(yīng),不滿足球?qū)ΨQ檢驗時使用多元分析;使用配對t檢驗或方差分析比較撫觸前后唾液淀粉酶活性變化。P0.05表示差異有統(tǒng)計學(xué)意義。結(jié)果:本研究共納入38位老人,4位老人脫落,最終34位老年人完成老年撫觸保健操的干預(yù)和資料收集。研究結(jié)果顯示:1經(jīng)過8周老年撫觸保健操的干預(yù),老年人PSOI評分由(14.15±2.96)分降至(6.24±1.52)分;ACT總睡眠時間由(294.48±28.00)分鐘增至(351.63±28.17)分鐘、入睡時間由(83.74±30.83)分鐘減少到(27.70±10.22)分鐘、睡眠效率由(63.46±7.88)%提高到(84.18±3.96)%;SD總睡眠時間由(265.03±28.34)分鐘增至(357.03±15.71)分鐘、入睡時間由(100.22±33.36)分鐘減少到(33.57±11.21)分鐘、睡眠效率由(55.58±6.76)%提高到(80.61±3.95)%,老年人睡眠障礙狀況等到明顯改善(P0.01)。2經(jīng)過8周老年撫觸保健操的干預(yù),老年人ESS評分由(6.74±3.47)分降至(5.26±1.7)分;PSOI評分由(2.26±0.84)分降至(0.82±0.63)分;老年人日間功能障礙狀況得到一定改善(P0.05)。3老年撫觸保健操第4周、第8周,撫觸前后唾液淀粉酶活性分別由(10.0,8.0)降至(12.0,5.0),老年人焦慮情緒得到有效改善(P0.01)。結(jié)論:老年撫觸保健操可有效改善認知癥伴睡眠障礙老年人睡眠障礙、提高老年人睡眠質(zhì)量,一定程度上緩解其日間功能障礙、降低焦慮情緒,是一項值得在我國認知癥伴睡眠障礙老年人群體中推廣的措施。
[Abstract]:Aim: to develop a set of senile touch exercises for the elderly with cognitive disorders in China and to evaluate the effect of the exercise in improving sleep disorders in the elderly with cognitive disorders. Methods: 1 the development of the elderly touch exercises: using the Swedish touch technique (Tactile Massage) and Japanese touch care technology (Tactile care), for reference, combining with the nursing status of the elderly with cognitive disorders in China, the health status of the elderly, fully reading the literature, and the experts in the neurology department. Under the guidance of rehabilitation medical experts and geriatric nursing specialists, a set of geriatric touch exercises was developed for the elderly with cognitive disorders in China. The geriatric touch exercise consists of two parts of the back and the hand, and accumulates 15 sections. 2 the implementation of the geriatric touch exercise: from February to September 2016, a pension institution in Shijiazhuang City, Hebei Province, was selected as the research base by using the convenient sampling method. Thirty-eight elderly patients with cognitive disorder with sleep disorder were selected as intervention objects. On the basis of routine care, the elderly were provided with three times a week, each time for 30 minutes, for 8 weeks. (ESS), saliva 偽 amylase activity (sAA), sleep log (SD) was used to evaluate the sleep status of the elderly before, 4 weeks and 8 weeks of intervention with the portable sleep recorder (ACT), Pittsburgh Sleep quality Index scale (PSOI), Epworth) and (ESS), saliva 偽 amylase activity (sAA), sleep log (SD). To evaluate the effect of this exercise on sleep disorders in the elderly with cognitive disorder. Use Epidata3.1 to build database, input data, SPSS21.0 for statistical analysis. The results of normal distribution are expressed by x 鹵s, the results of non-normal distribution are expressed by median, quartile spacing and rank sum test, and the time effect of each measurement index is analyzed by repeated measurement variance. Multivariate analysis was used when dissatisfied with soccer symmetry test; paired t test or variance analysis was used to compare saliva amylase activity before and after touching. P0.05 indicated that the difference was statistically significant. Results: a total of 38 elderly people were included in the study, 4 of them dropped off, and 34 of them completed the intervention and data collection of touching exercises for the elderly. The results showed that: 1After 8 weeks of intervention, the PSOI score of the elderly decreased from (14.15 鹵2.96) to (6.24 鹵1.52), the total ACT sleep time increased from (294.48 鹵28.00) minutes to (351.63 鹵28.17) minutes, and the sleep time decreased from (83.74 鹵30.83) minutes to (27.70 鹵10.22) minutes. The sleep efficiency increased from (63.46 鹵7.88)% to (84.18 鹵3.96)%, the total sleep time of SD increased from (265.03 鹵28.34) minutes to (357.03 鹵15.71) minutes, and the sleep time decreased from (100.22 鹵33.36) minutes to (33.57 鹵11.21) minutes. The sleep efficiency increased from (55.58 鹵6.76)% to (80.61 鹵3.95)%, and the condition of the elderly sleep disorder improved significantly (P0.01). 2 after 8 weeks of intervention, the ESS score of the elderly decreased from (6.74 鹵3.47) to (5.26 鹵1.7), the PSOI score from (2.26 鹵0.84) to (0.82 鹵0.63). 3 the activity of saliva amylase decreased from (10.0 ~ 8.0) to (12.0 ~ 5.0) before and after touching (P0.05). The anxiety of the elderly was improved effectively (P0.01). Conclusion: touch exercise can effectively improve sleep disorder, improve sleep quality, relieve daytime dysfunction and reduce anxiety in the elderly with cognitive disorder and sleep disorder. It is a measure worth popularizing in the elderly with cognitive disorder and sleep disorder in our country.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.74

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