睡眠障碍、抑郁和焦虑情绪对医护人员认知功能的影响

Influence of sleep disturbance, depression and anxiety on cognitive function of medical staff

目的探讨医护人员认知功能与睡眠障碍、抑郁及焦虑程度的关系。方法采用重复性成套神经心理状态测验量表(repetitive neuropsychological status questionnaire,RBANS)、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)、抑郁自评量表(depression self-rating scale,SDS)、焦虑自评量表(anxiety self-rating scale,SAS)对333名医护人员进行调查。结果①不同性别医护人员在视觉广度[男:(81.87±13.48)分、女:(77.12±13.09)分]维度上差异具有统计学意义(t=2.928,P<0.05)。②不同年龄医护人员在即刻记忆、语言功能、注意功能及RBANS总分上差异具有统计学意义(F=9.654,8.370,11.465,11.112,均P<0.01)。③不同职业医护人员在即刻记忆、视觉广度、注意功能、延时记忆、RBANS总分上差异具有统计学意义(t=5.374,4.730,3.389,4.359,5.675,均P<0.01)。④不同PSQI水平医护人员在RBANS总分、即刻记忆及延时记忆维度上差异具有统计学意义(F=3.475,4.892,4.087,均P<0.05)。⑤是否伴有抑郁症状的医护人员在RBANS总分[(88.87±12.47)分、(83.69±13.03)分]、即刻记忆[(86.18±16.09)分、(80.56±15.38)分]、视觉广度[(79.39±13.32)分、(73.47±12.46)分]、延时记忆[(89.03±10.26)分、(85.49±11.41)分]维度上差异具有统计学意义(t=2.794,2.380,3.042,2.295,均P<0.01)。⑥医护人员的RBANS总分与PSQI、SDS及SAS得分呈负相关(r=-0.158,-0.233,-0.117,均P<0.05)。⑦SDS、年龄、职业、受教育年限、睡眠时间及PSQI总分进入逐步回归方程,可解释认知功能变异的39.9%。结论医护人员认知功能受性别、年龄、职业、受教育程度、抑郁程度及睡眠质量的影响。医护人员的睡眠质量越差,抑郁程度越高,其认知功能表现越差。

Objective To explore the relationship between cognitive function and sleep disturbance, depression and anxiety. Methods Totally 333 medical staff were investigated using the repetitive neuropsychological status questionnaire (RBANS), the Pittsburgh sleep quality index (PSQI), the depression self-rating scale (SDS) and the anxiety self-rating scale (SAS). Results ①The difference of visual span in gender(male:(81.87±13.48) vs female:(77.12±13.09)) was statistically significant (t=2.928, P<0.05).②Differences in immediate memory, language function, attention function and total score of RBANS among patients of different ages were statistically significant (F=9.654, 8.370, 11.465, 11.112, all P<0.01).③There were significant differences in the RBANS, immediate memory, visual span, attention function and delayed memory between doctor and nurse(t=5.374, 4.730, 3.389, 4.359, 5.675, all P<0.01).④There were significant differences in the RBANS, immediate memory, and delayed memory between different PSQI levels (F=3.475, 4.892, 4.087, all P<0.05).⑤There were significant differences in RBANS ((88.87±12.47) vs (83.69±13.03)), immediate memory ((86.18±16.09) vs (80.56±15.38)), visual span ((79.39±13.32) vs (73.47±12.46)), and delayed memory ((89.03±10.26) vs (85.49±11.41))between the depressive symptoms and not depressive symptoms groups(t=2.794, 2.380, 3.042, 2.295, all P<0.05).⑥The total score of medical staff's RBANS was significantly negatively correlated with their PSQI, SDS and SAS scores (r=-0.158,-0.233,-0.117, all P<0.05).⑦SDS, age, occupation, education, time of sleep and PSQI entered multiple stepwise regression equations, which explain 39.9% variation in cognitive function of medical staff. Conclusion The cognitive function of medical staff is affected by gender, age, occupation, education, depression, and sleep disturbance.The worse the sleep quality, the higher the degree of depression and anxiety, and the poorer the cognitive function.