【作者】 隋欣；

【导师】 李峰；

【作者基本信息】 吉林大学 ， 护理学， 2020， 硕士

【摘要】 目的:本研究通过调查了解冠心病患者睡眠质量、社交回避及孤独感的现状,分析研究冠心病患者睡眠质量与社交回避及孤独感的相关性,以期通过降低冠心病患者社交回避及孤独感程度,进而提高睡眠质量,在临床上通过心理层面和/或社会层面改善和缓解冠心病患者睡眠质量提供理论依据。方法:本研究采用方便抽样的方法,选取2018年11月²019年1月就诊于长春市某三级甲等医院心内科的冠心病患者,对符合纳入标准的249名冠心病患者进行问卷调查。调查工具采用:一般资料调查表、匹兹堡睡眠质量指数量表、社交回避及苦恼量表、孤独感量表。通过频数、构成比描述冠心病患者的一般资料;通过中位数、四分位数描述冠心病患者睡眠质量和孤独感现况;通过均数、标准差描述冠心病患者社交回避现况;通过c²检验、秩和检验分析患者睡眠质量在人口学特征上的差异;通过二元Logistic回归分析影响患者睡眠质量的主要因素;通过Spearman相关性分析探究冠心病患者睡眠质量与社交回避及孤独感之间的关系,所有数据均使用SPSS23.0统计软件进行分析。结果:1.冠心病患者睡眠质量总分中位数、四分位数M(P₂₅,P₇₅)为10（8,12）。有睡眠质量问题的占所调查冠心病患者的82.3%,无睡眠质量问题的占17.7%。按睡眠质量程度的分布情况如下:睡眠质量很好占所调查冠心病患者的10.4%,睡眠质量还行占48.6%,睡眠质量一般占36.5%,睡眠质量很差占4.4%。2.冠心病患者社交回避的总分为（13.20±5.30）分,孤独感的总分中位数、四分位数M（P25,P75）为39（35,44）。3.单因素分析结果显示:冠心病患者睡眠质量在年龄、性别、子女个数、子女亲友探望频次、居住方式、文化程度、职业状态、吸烟、运动情况九个方面具有统计学差异（P<0.05）。4.多因素分析结果显示:冠心病患者睡眠质量在居住方式、文化程度、运动情况三个方面具有统计学差异（P<0.05）。居住方式、文化程度、运动情况是冠心病患者睡眠质量的主要影响因素。5.相关性分析结果显示:冠心病患者的睡眠质量和社交回避呈负相关,和孤独感呈负相关（P<0.01）。结论:1.冠心病患者普遍存在睡眠质量问题,PSQI评分表明患者睡眠质量处于中等严重水平;社交回避和孤独感评分均处于中度偏上水平;2.冠心病患者睡眠质量的主要影响因素为居住方式、文化程度、运动情况;其他影响因素包括年龄、性别、子女个数、子女亲友探望频次、职业状态、吸烟;3.冠心病患者睡眠质量与社交回避呈负相关,与孤独感呈负相关。更多还原

【Abstract】 Objective: Our study is aim to explore the correlation between sleep quality,social avoidance and loneliness in patients with coronary heart disease(CHD)by investigating the current status of the three factors.We hope to reduce the level of social avoidance and loneliness,in order to improve sleep quality.What we have done will provide a theoretical basis and reference from psychosocial aspect to solve the sleeping problem for clinical nursing.Methods: With convenience sampling method,we selected patients with CHD who were being hospitalized in cardiology among three different comprehensensive hospitals of Changchun.From November 2018 to January 2019,249 patients who met the inclusion criteria finally finished our questionnaire including General Information of CHD patients,Pittsburgh Sleep Q uality Index(PSQI),Social Avoidance and Distress Scale(SADS)and UC LA Loneliness Scale.In our study,we used frequency and composition ratio to describe the general data,median and quartile to describe the status of sleep quality and loneliness,mean and standard deviation to describe the status of social avoidance.C hi-square test and rank sum test were used for single factor analysis.Binary Logistic regression analysis was used for multi-factor regression analysis.Finally,we used Spearman analysis to describe the correlation of the three factors.All data were calculated by SPSS23.0.Results: 1.The median and quartile M(P25,P75)of total scores of sleep quality in patients with C HD were 10(8,12).82.3% of the patients had sleep quality problems,while 17.7% of them didn’t.The distribution of sleep quality is as follows: good sleep quality accounts for 10.4% of the patients with CHD surveyed,sleep quality okay accounts for 48.6%,sleep quality generally accounts for 36.5%,and poor sleep quality accounts for 4.4%.2.The total score of social avoidance in patients with C HD was(13.20 ± 5.30),and the median and quartile M(P25,P75)of total scores of loneliness was 39(35,44).3.There were statistically differences on the sleep quality between C HD patients with different characteristics,such as:age,gender,number of children,frequency of visits of children,relatives and friends,living alone,education level,occupational status,smoking,and exercise status(P <0.05).4.Multi-factor regression analysis showed that: three main influential factors were finally included in the regression equation of the score of sleep quality in patients with CHD.Respectively: living alone,education level,and exercise status.5.The correlation analysis showed that sleep quality of patients with C HD was negatively related to social avoidance and loneliness respectively(P < 0.01).Conclusion: 1.Sleep quality problems are common in patients with C HD,and their sleep quality scores are at a moderately severe level;social avoidance and loneliness scores are both moderately high;2.The main influential factors of sleep quality in patients with CHD are living style,education level,and exercise;other influencing factors include age,gender,number of children,frequency of visits by children,relatives and friends,occupational status,smoking;3.Sleep quality of CHD patients was negatively related with social avoidance and loneliness respectively.更多还原