工伤抑郁症患者的睡眠质量及相关影响因素分析

Sleep disorders after industrial injury

目的调查工伤康复人群中抑郁症患者的睡眠质量及相关影响因素。方法共选取工伤康复抑郁症患者112例，其中男106例，女6例，年龄22～79岁，病程35d～25年。采用生活满意度指数A（LSIA）、A型行为类型问卷（TABP）、匹兹堡睡眠质量指数（PSQI）及Barthel指数评分对上述患者进行评定，所有患者均由同一位专业人员完成评定。结果112例工伤康复抑郁症患者中睡眠障碍发生率为40．18％（45／112），其中轻度抑郁症患者睡眠障碍发生率为34．29％（24／70），中度抑郁症患者睡眠障碍发生率为42．86％（15／35），重度抑郁症患者睡眠障碍发生率为85．71％（6／7）。随着抑郁程度加重，患者睡眠障碍发生率有增加趋势，其中重度抑郁症患者睡眠障碍发生率明显高于中度及轻度抑郁症患者（P〈0．05），中度与轻度抑郁症患者睡眠障碍发生率组间差异无统计学意义（P〉0．05）。重度及中度抑郁症患者PSQI得分均显著高于轻度抑郁症患者，重度与中度抑郁症患者PSQI得分组间差异无统计学意义（P〉0．05）；睡眠障碍组与非睡眠障碍组主要在睡眠质量及入睡时间方面有差异（P〈0．05）。睡眠障碍组与非睡眠障碍组比较，其性别、年龄、文化程度、婚姻状况、社会关系、家庭和社会支持以及病程等方面组间差异均无统计学意义（P〉0．05），但在患者家庭收入、生活满意程度、性格类型及疾病种类方面组间差异具有统计学意义（P〈0．05）。结论工伤康复人员是一个特殊群体，工伤抑郁症患者睡眠障碍发生率相对较低，其影响因素主要包括抑郁严重程度、家庭经济收入、生活满意度、病损类型及患者性格等方面。

Objective To survey the incidence of sleep disorders among patients with industrial injuries and analyze the relevant factors. Methods A total of 112 depressed patients （ male 106, female 6 ; aged 22-79 years, course of disease 35 d-25 years） were assessed by a professional psychologist using life satisfaction index A, the type A behavior pattern scale, the Pittsburgh sleep quality index （PSQI） and the Barthel index. Results The incidence of disordered sleep was 40. 18% （45/112） , of whom mildly depressed patients were 34.29% , moderately depressed patients 42.86% and severely depressed patients 85.71%. The incidence of sleep disorders increased with increasing depression severity. The incidence of disordered sleep was significantly higher among the severely depressed patients than among those mildly or moderately depressed, but there was no significant difference in incidence between moderately and mildly depressed patients. PSQI scores among the severely and moderately depressed patients were significantly higher than among those mildly depressed, but there was no statistically significant difference in average PSQI scores between the severely and moderately depressed patients. The sleep disorder group suffered significantly poorer sleep quality and took significantly longer to get to sleep. There were no significant differences in average age, educational level, marital status, social relations, family and social support, gender distribution or course of disease between the two groups. There were, however, significant differences in family income, life satisfaction, character type and disease species between the groups. Conclusion The incidence of disordered sleep among depressed patients after industrial injury is correlated with the severity of depression, family income, life satisfaction, the type of injury and the patient＇s character.