综合护理干预对ICU失眠症护士睡眠质量的影响

Effects of Comprehensive Nursing Interventions on Sleep Quality among ICU Nurses with Insomnia

目的探讨综合护理干预对改善ICU失眠症护士睡眠质量的有效性。方法 2011年2月至2012年5月方便性抽样选取第二军医大学长征医院ICU(包括综合ICU、脑外科及胸心外科ICU)失眠症护士共76名,按照随机数字表法随机分为干预组和对照组各38例。两组护士均按常规给予睡眠健康宣教,遵医嘱每晚服用酒石酸唑吡坦片(商品名:思诺思)10mg;干预组在此基础上进行睡眠认知及行为、工作及休息环境、社会支持等护理干预3个月。结果睡眠时间无规律(55.26%)、准备睡觉前担心睡眠的能力(59.21%)是ICU失眠症护士最常见的不良睡眠卫生习惯。两组护士干预后不良睡眠卫生习惯发生率和睡眠进程各参数值比较,差异有统计学意义(均P<0.01),干预组护士的觉醒时间缩短、觉醒次数减少,睡眠效率和睡眠维持率均得以提高。结论以改变护士不良睡眠卫生习惯、改善工作及休息环境、提高护士应对工作压力的能力为目的的综合护理干预,可有效提高ICU失眠症护士的睡眠质量和生活质量。

Objective To verify the effect of comprehensive nursing interventions in improving sleep quality among ICU nurses with insomnia. Methods From February 2011 to May 2012, 76 ICU （general ICU, brain surgery and cardiothoracic surgery ICU） nurses with insomnia were randomly divided into observational group and control group with 38 nurses in each group. Both groups received the sleep hygiene education and drug treatment （Zolpidem, 10mg per night）. In the observational group, we implemented a 3-month nursing interventions addressing sleep cognition-behavior, work and sleep environments and social support. Results Irregular bedtime routine（55.26G）and emotionally upsetting before trying to go to sleep （59.21 % ）were the most common factors of insomnia nurses. Significant differences were detected on the irreguley bedtime routine, sleep process parameters after the intervention between the two groups（P〈0.01）. After the intervention, the sleep quality （arousal time, arousal frequency, sleep efficiency and sleep maintenance） of the observational group was significantly improved. Conclusion Comprehensive nursing interventions can effectively improve the sleep quality and quality of life for ICU nurses with insomnia by changing the poor sleep hygiene habits, improving the working and resting environment and enhancing the nurses＇ ability to deal with work pressure.