腹膜透析患者睡眠相关疲乏的质性研究

A Qualitative Research of Tiredness Related to Poor Sleep in Peritoneal Dialysis Patients

目的了解腹膜透析患者睡眠相关疲乏的感受和经历。方法采用目的抽样法,于2012年12月—2013年8月选取在郑州大学第一附属医院行腹膜透析治疗的患者13例为本研究对象。应用质性研究方法,对13例因睡眠质量差而致疲乏的腹膜透析患者进行深度访谈,采用Colaizzi描述性现象学研究法分析资料。结果腹膜透析患者睡眠相关疲乏的感受可提炼出三个主题:(1)患者对疲乏的感知:心理和身体疲乏,嗜睡;(2)疲乏的结果:产生愧疚、担心、易怒、恐惧、孤独等消极情绪,影响患者的活力、创造力和集中注意力,虚弱;(3)自我适应疲乏的能力和策略:与疲劳斗争,变得顺从和冷漠,接受和适应疲劳。结论持续的疲乏状态使腹膜透析患者产生不同的心理和生理感知,困顿和嗜睡的消极状态限制了患者的活动、对身体功能的感知和正常的社会活动,并产生相应的心理负担。为了应对疲乏,患者必须要与之斗争,最终接受或者是变得顺从冷漠。医护人员需要更加关注患者的疲乏问题,及时评估患者睡眠质量和日常活动能力,采取针对性措施改变患者对疲乏的认知,减少其疲乏程度,提高睡眠质量。

ObjeCtive To understand the experience of tiredness related to poor sleep in peritoneal dialysis（ PD） patients. Methods A qualitative method was used to conduct in _ depth interviews with 13 PD patients receiving peritoneal dialysis in the First Affiliated Hospital of Zhengzhou University from December,2012 to August,2013 recruited by purposive sampling. Data were analyzed by Colaizzi phenomenotogical research method. Results The tiredness feelings fell into 3 themes, including patientsˊ perception of fatigue：mental and physical tiredness,sleepiness;the results of the fatigue：having such negative emotions as shame,concern,irritability,anxiety and loneliness,inactive,less creative and less concentrated, fragile;self fatigue _ adapting abilities and strategies：fighting for tiredness,being more obedient and indifferent,accepting and adapting to fatigue. ConClusion Constant tiredness makes PD patients have different feelings and physiological perception. Negative responses like perplexity and sleepiness confine their physical activity,awareness of their physical function and normal social activity,causing them under corresponding psychological burden. In their fight for tiredness,they finally accept or become obedient and indifferent. The medical workers should pay more attention to the problem of tiredness,evaluate their sleep quality and daily activities in time,take appropriate measures to change patientsˊ awareness of PD so as to help them reduce their tiredness and improve their sleep quality.