综合干预对手术锐器伤护士睡眠质量及焦虑的影响

Effect of Comprehensive Intervention on the Sleep Quality and Anxiety of Nurses with Sharps Injuries

目的 探讨综合干预对改善手术锐器伤护士睡眠质量及焦虑负性情绪的有效性。方法 便利抽样选取2014年1月至2016年3月上海市某三级甲等医院手术室发生锐器伤护士35名,采用阿森斯失眠量表（Athens insomnia scale,AIS）、焦虑自评量表（self-rating anxiety scale,SAS）评定其睡眠质量及焦虑水平,将AIS总分〉6分存在失眠合并轻、中度焦虑（SAS评分≥50~69分）的29名护士作为研究对象,给予睡眠认知及行为干预、支持性心理干预等综合干预3个月。比较干预前后护士的睡眠进程各参数、焦虑水平等指标。结果 手术室护士发生锐器伤后失眠发生率高达82.6%;SAS总分为（64.98±8.13）分,与常模比较差异有统计学意义（P〈0.01）;经3个月综合干预后护士觉醒时间缩短,觉醒次数减少,睡眠效率和睡眠维持率提高,SAS评分降低,与干预前比较差异均有统计学意义（均P〈0.01）。结论 以睡眠认知及行为干预、支持性心理干预、提高护士应对工作压力的能力等为目的的综合干预,可有效提高手术锐器伤后护士的睡眠质量,改善其焦虑负性情绪。

Objective To discuss the effect of comprehensive intervention on the sleep quality and anxiety of nur-ses with sharps injuries.Methods By convenience sampling,35 nurses with sharps injuries were selected and their sleep quality and anxiety level were investigated by the Athens insomnia scale （AIS）and Self-rating anxiety scale （SAS）.The 29 nurses met the criteria of AIS socre 〉 6 and with insomnia disorder combined mild/moderate level of anxiey （SAS ≥50-69）were selected and received cognitive-behavioral intervention and sequential psychological intervention for 3 months.The indexes of sleep quality before and after intervention,and anxiety level were com-pared.Results There were 82.6% of nurses with insomnia after sharps injuries.The SAS score was （64.98±8. 13）,the difference was statistically significant compared with norm （P 〈0.01）.After 3 months of comprehensive intervention,the time of awakenings during night were reduced,numbers of awakenings during night were less, sleep efficiency and sleep time were improved,and SAS score was reduced （all P 〈0.01）.Conclusions The com-prehensive intervention with cognitive-behavioral intervention and sequential psychological intervention is an effec-tive in improving nurses’sleep quality after sharps injuries,and can improve their anxious emotions.