上海市某社区老年高血压患者睡眠质量与睡眠信念的调查分析

Investigation and Analysis of Sleep Quality and Sleep Belief of Elderly Hypertensive Patients in a Community of Shanghai

目的通过对社区卫生服务中心就诊的老年高血压患者睡眠质量与个人信念和态度关系进行调查分析,探讨认知心理干预改善睡眠进而辅助稳定血压的可行性。方法随机抽取上海市某社区卫生服务中心门诊和病房的老年高血压合并睡眠障碍患者60例为A组,老年高血压无睡眠障碍患者60例为B组,同时按照性别、年龄和文化程度均衡性匹配无高血压疾病的正常老年患者40例为对照组,分别通过匹茨堡睡眠质量指数量表(PSQI)、睡眠个人信念和态度量表(DBAS)等量表调查其睡眠质量与个人信念和态度关系,并随访即时血压。通过统计分析了解3组人群在睡眠质量、睡眠信念领域的关联与差异,推断认知心理干预改善睡眠进而辅助稳定血压的可行性。结果高血压患者PSQI量表与DBAS量表的部分因子呈具有统计学意义的负相关;高血压患者PSQI量表因子中的睡眠持续性、习惯性睡眠效率与即时血压值呈正相关;DBAS量表中的睡眠方法、后果、控制和预测、失眠原因及总分等因子与患者收缩压呈负相关,患者舒张压与DBAS控制和预测因子呈负相关。3组人群DBAS量表中的睡眠期望、后果、控制和预测、失眠原因及DBAS总分等因子具有统计学差异,且高血压伴睡眠障碍组在各差异因子中的均数低于无睡眠障碍组和正常人群组。结论睡眠信念是高血压患者伴发睡眠障碍的重要影响因素。通过调整睡眠信念改善高血压患者伴发睡眠障碍具有较高的可行性。

OBJECTIVE To analyze the relationship between the sleep quality and personal beliefs and attitude of the elderly patients with hypertension by the community health service center, explore the feasibility of cognitive psychological intervention to improve the sleep and help stabilize blood pressure. METHODS Randomly selected from the outpatient and ward aged patients with a community health service center in Shanghai, 60 cases of elderly hypertension patients with sleep disorder, and 60 cases with no sleep disturbance in aged hypertension patients. At the same time, according to sex, age and education level of the normal elderly patients with no hypertension matched normal elderly patients as the control of 40 cases, investigate the relationship between sleep quality and personal beliefs and attitude to use pittsburgh sleep quality index PSQI and DBAS scale, and follow up blood pressure. To understand the correlation and difference of the sleep quality and sleep belief in the three groups by statistical analysis, inferring the feasibility of cognitive psychological intervention to improve the sleep and the stability of blood pressure. RESULTS The correlation between the PSQI scale and the partial factor of the DBAS scale in the patients with hypertension was statistically significant; the sleep persis- tence and habitual sleep efficiency of PSQI in the patients with essential hypertension were positively correlated with the immediate BP values; the sleep methods, consequences, control and prediction, insomnia cause and total score of the DBAS were negatively cor- related with the systolic pressure of patients, the diastolic pressure of the patients was negatively correlated with the DBAS control and predictor. The total score of 3 groups of sleep expectation, consequence, control and forecast, insomnia cause and DBAS DBAS were different. The average number of hypertensive patients with sleep disorder in each difference factor was lower than that in the normal group. CONCLUSION Sleep belief was the important factor of the sleep disturbance in the patients with hypertension. The feasibility of improving the sleep belief to improve the sleep disturbance in patients with hypertension was feasible.