护理人员急进高原干预策略对睡眠质量影响的研究

Study on the influence and intervention strategy of nursing staff rushing to plateau on sleep quality

目的了解急进高原护理人员援藏期间睡眠质量的变化特征,制订综合干预措施,提高护理人员的保障能力,为有效完成高原援藏工作提供依据。方法选取2017年11-12月急进海拔3 650 m拉萨地区参加援藏工作的护士12名为急进组,选取西藏某医院护士12名为高原组。采用匹兹堡睡眠质量指数量表(PSQI)对急进组入藏前、后与高原组分别进行睡眠质量调查;采用睡眠质量调查量表对急进组入藏后与高原组护理人员在5个不同班次当天晚上睡眠质量进行调查。结果急进组入藏前睡眠总分、睡眠质量、入睡时间、睡眠时间、睡眠效率、日间功能障碍得分分别为(3.77±1.79)、(0.89±0.47)、(0.78±0.36)、(0.76±0.41)、(0.19±0.05)、(0.54±0.07)分,入藏后分别为(5.37±1.23)、(1.57±0.36)、(1.53±0.43)、(1.21±0.38)、(0.72±0.10)、(0.99±0.91)分,入藏前后比较差异有统计学意义(t=2.327~4.399,P均<0.05)。急进组入藏后入睡时间、睡眠时间、睡眠效率、睡眠障碍得分分别为(1.53±0.43)、(1.21±0.38)、(0.72±0.19)、(1.16±0.21)分,高原组分别为(1.04±0.21)、(0.86±0.32)、(0.39±0.31)、(0.76±0.33)分,2组比较差异有统计学意义(t=2.441~3.547,P<0.05或0.01)。急进组入藏后与高原组护理人员睡眠质量调查量表得分比较,急进组白班、中班、下夜班3个不同班次结束后当晚睡眠质量总得分分别为(11.76±0.12)、(11.98±0.23)、(12.43±0.52)分,高于高原组的(11.18±0.04)、(11.23±0.57)、(11.98±0.54)分,2组比较差异有统计学意义(t=15.554、4.227、2.079,P<0.01或0.05);休息班当晚睡眠质量得分为(11.38±0.36)分,低于高原组的(11.92±0.38)分,差异有统计学意义(t=-3.574,P=0.002)。急进组入藏后护理人员睡眠质量调查量表得分比较,休息当晚睡眠质量、入睡延迟分别为(1.87±0.57)、(1.93±0.61)分,高原组分别为(1.39±0.39)、(1.25±0.42)分,2组比较差异有统计学意义(t=2.408、3.181,P<0.05或0.01)。结论急进高原医疗护理人员在援藏工作中普遍存在睡眠问题,提前采取综合干预措施、早期开展科普宣教及卫生技术指导、改善心理健康状况、必要时采取药物预防可援藏医疗护理人员睡眠质量。

Objective To understand the changing characteristics of sleep quality of acute plateau nursing staff during the period of assistance to Tibet,formulate comprehensive intervention measures,improve the support ability of nursing staff,and provide the basis for effectively completing the work of plateau assistance to Tibet.Methods From November to December 2017,12 nurses who participated in the assistance work for Tibet in Lhasa region with an altitude of 3,650 m were selected as the emergency group,and 12 nurses from a hospital in Tibet were selected as the plateau group.Pittsburgh sleep quality index(PSQI)was used to investigate the sleep quality of the acute group before and after Tibet entry and the plateau group respectively.A sleep quality survey scale was designed to investigate the sleep quality of nursing staff in the emergency group and the plateau group at 5 different shifts on the same night after admission to Tibet.Results The scores of total sleep score,sleep quality,sleep time,sleep time,sleep efficiency and daytime dysfunction in the acute group were 3.77±1.79,0.89±0.47,0.78±0.36,0.76±0.41,0.19±0.05,0.54±0.07,and 5.37±1.23,1.57±0.36,1.53±0.43,1.21±0.38,0.72±0.10,0.99±0.91 respectively.The differences before and after Tibet were statistically significant(t=2.327-4.399,P<0.05).The scores of sleep time,sleep time,sleep efficiency and sleep disorder in the acute group were 1.53±0.43,1.21±0.38,0.72±0.19,1.16±0.21,and 1.04±0.21,0.86±0.32,0.39±0.31 and 0.76±0.33 respectively.The differences between the two groups were statistically significant(t=2.441-3.547,P<0.05 or 0.01).Radical groups after Tibet plateau and nursing staff sleep quality scale scores compare,radical group day shift,middle shift,night after night under three different shifts the total score of sleep quality,respectively 11.76±0.12,11.98±0.23,12.43±0.52,higher than that of plateau group 11.18±0.04 11.23±0.57,11.98±0.54,the difference between two groups was statistically significant(t=15.554,4.227,2.07,P<0.01 or 0.05).The sleep quality score(11.38±0.36)in the night of the rest class was lower than that of the plateau group(11.92±0.38),and the difference was statistically significant(t=-3.574,P=0.002).The score of sleep quality and sleep delay of the acute group were 1.87±0.57,1.93±0.61,and 1.39±0.39,1.25±0.42 respectively.The difference between the two groups was statistically significant(t=2.408,3.181,P<0.05 or 0.01).Conclusions It is a common sleep problem for medical and nursing personnel in Tibet who rush into the plateau.Comprehensive intervention measures should be taken in advance,scientific popularization,education and health technical guidance should be carried out in the early stage,mental health conditions should be improved,and drug prevention should be taken when necessary to help medical and nursing personnel in Tibet sleep quality.