肠造口患者术后居家睡眠质量的现况调查

Investigation of the sleep quality at home of the postoperative patients with fecal ostomies

目的调查结直肠肿瘤术后肠造口患者居家睡眠质量及影响因素。方法采用便利抽样的方法,选择2016年3月至2017年12月在安徽省肿瘤医院伤口造口门诊就诊或院内外咨询会诊的263例肠造口患者(包括临时性造口和永久性造口)作为研究对象,采用自制一般情况调查表、匹兹堡睡眠质量指数量表(PSQI)及造口自我护理能力量表对其进行调查。结果肠造口患者的PSQI总分为(6.39±4.07)分,其中睡眠较差者(PSQI>7分)有150例占57.0%。PSQI7个维度得分由高到低依次是睡眠时间(1.22±1.05)分、入睡时间(1.12±0.98)分、主观睡眠质量(1.00±0.92)分、睡眠障碍(1.02±0.95)分、睡眠效率(0.95±0.43)分、日间功能紊乱(0.83±0.76)分、催眠药物(0.25±0.24)分,不同年龄(Z=-2.937)、造口时间(t=3.450~3.896)、造口种类(t=3.998~4.011)、有无胀袋(t=3.230~4.001)、1个月内有无渗漏史(t=3.454~6.774)、造口并发症(t=2.976~3.582)、造口护理知识(Z=-3.202,t=3.971)及造口护理技能(t=3.061)的患者睡眠质量差异有统计学意义(P<0.05)。结论肠造口患者睡眠质量普遍较差,应采取针对性措施,降低其发生率或及时予以干预。

Objective To investigate the sleep quality at home and the influencing factors in patients with colorectal tumor after enterostomy. Methods Using convenience sampling method, during March 2016 to December 2017 in Anhui Provincial Cancer Hospital wound and stoma outpatient, choose 276 patients with enterostomy (including temporary enterostomy and permanent enterostomy), using self-made general questionnaire ostomy, Pittsburgh Sleep Quality Index (PSQI) and self nursing competence scale to investigate them. Results The total PSQI score of enterostomy patients was 6.39±4.07, among which 150 patients (57.0%) had poor sleep (PSQI>7). The score of the 7 dimensions of PSQI from high to low was sleep time (1.22±1.05), sleep time (1.12±0.98), subjective sleep quality (1.00 ±0.92), sleep disorder (1.02±0.95), sleep efficiency (0.95±0.43), daytime dysfunction (0.83±0.76), hypnotic drugs (0.25±0.24).There were statistically significant differences in sleep quality among patients with different ages (Z=-2.937), duration of stoma (t=3.450-3.896), types of stoma (t=3.998-4.011), whether or not they had a history of leakage within 1 month (t=3.454-6.774), whether or not they had bloating bags (t=3.230-4.001), stoma complications (t=2.976-3.582), enterostomy self-care knowledge (Z=-3.202, t=3.971) and nursing skills (t=3.061)(P<0.05). Conclusions The present study shows that the sleep quality of patients with enterostomy is generally poor, and targeted measures should be taken to reduce its incidence or to intervene in time.