老年慢性病患者睡眠质量、反刍思维与负面情绪的相互作用

Interaction of sleep quality, rumination and negative emotions in elderly patients with chronic diseases

目的探讨老年慢性病患者睡眠质量、反刍思维与负面情绪的相互作用。方法随机选取2016年1—3月郑州市4个社区医疗中心的203例老年慢性病患者为研究对象,采用一般情况问卷、反刍思维量表、视觉模拟评分(VAS)、D型行为量表收集数据(其中VAS评分表用来评价主观睡眠质量,D型行为量表用来评价负面情绪),分析反刍思维、睡眠质量、负面情绪三者的关系及作用机制。结果问卷有效率为90.64%(184/203)。睡眠质量VAS评分和反刍思维量表评分与D型行为量表得分均呈负相关(r=-0.185、-0.220,均P<0.01)。反刍思维量表评分与D型行为量表得分呈正相关(r=0.415,P<0.01)。以反刍思维3个维度为自变量、以负面情绪为因变量进行回归分析,症状反刍和强迫思考进入回归模型(均P<0.05),反省深思项被排除。反刍思维在睡眠质量对负面情绪的影响中起部分中介作用,中介效应占总效应的比例为31.6%。结论较低的睡眠质量和反刍思维均可直接导致老年慢性病患者负面情绪的产生,反刍思维还可作为睡眠质量与负面情绪的中介因素,进一步加强睡眠质量对负面情绪的影响。

Objective To explore the interaction of sleep quality,rumination and negative emotions in elderly patients with chronic diseases.Methods A total of 203 elderly patients with chronic diseases in Zhengzhou’s 4 community medical centers from January to March 2016 were randomly selected.Data were collected by general questionnaire,rumination scale,visual analogue scale(VAS),and D-type behavioral scale(VAS was used to assess subjective sleep quality and D-type behavioral scale was used to evaluate negative emotions).Analyze the relationship between rumination,sleep quality,and negative emotions.Results The effective rate of the questionnaire was 90.64%(184/203).VAS score and rumination scale score were negatively correlated with D-type behavior scale score(r=-0.185,-0.220,both P<0.01).The rumination scale score was positively correlated with D-type behavior scale score(r=0.415,P<0.01).Regression analysis was carried out with 3 dimensions of rumination as independent variables and negative emotion as dependent variable;symptom rumination and forced thinking entered the regression model(both P<0.05),but reflection was excluded.Rumination played an intermediary role in the impact of sleep quality on negative emotions,and the ratio of mediating effects to total effects was 31.6%.Conclusion Low sleep quality and rumination can both directly lead to negative emotions in elderly patients with chronic diseases.Rumination can also enhance the impact of sleep quality on negative emotions as an intermediary factor.