北京某社区慢性失眠患者对失眠的认识及行为现状调查

Investigation of cognition and behavior of chronic insomnia patients in community

2018年1—6月在首都医科大学附属复兴医院月坛社区就诊的已签约家庭医生的慢性失眠患者中,以便利抽样法抽取410例进行问卷调查,调查患者的基础资料、失眠疾病认识情况及行为习惯等,采用健康问卷抑郁量表(PHQ-9)评估患者抑郁情况。调查对象以女性(74.1%,304/410)、已婚(84.9%,348/410)、退休老年人(71.9%,295/410)为主。在失眠认识方面,正确率前3位依次为"紧张、焦虑易致失眠"(92.2%,378/410)、"失眠除了睡不好,对身体没危害"(72.2%,296/410)、"打鼾说明睡得香"(70.2%,288/410),后3位依次为"夜间梦多说明睡眠差"(11.5%,47/410)、"长期吃安眠药会依赖、成瘾"(12.7%,52/410)、"失眠一定是身体有病带来的"(12.7%,52/410)。在行为习惯方面,仅22.2%(91/410)睡前1 h适量读书看报或无其他不良习惯,规律运动、午休者分别占70.2%(288/410)和34.1%(140/410)。在治疗方面,分别59.5%(244/410)、40.5%(166/410)尝试西药、中药治疗,仅7.3%(30/410)尝试心理治疗。PHQ-9评估结果显示,46.3%(190/410)患者无抑郁,19.8%(81/410)患者存在中度至重度抑郁。提示本地区失眠患者对疾病知识认识需提高,行为需改善,全科医师应进行健康教育转变患者疾病认识及行为,从而提高治疗效果。

From January 2018 to June 2018,410 patients with chronic insomnia visiting the Yuetan community were selected by the convenience sampling method for a questionnaire survey.The basic data,behaviors and habits,disease awareness,and disease treatment of patients were analyzed.Health Questionnaire Depression Scale(PHQ-9)was used to assess patients′depression level.The patients were mainly women(74.1%,304/410),the married(84.9%,348/410)and the retired(71.9%,295/410).In terms of insomnia cognition,the top three were"insomnia can be caused by tension and anxiety"(92.2%,378/410),"insomnia is not harmful to the body except sleeping well"(72.2%,296/410),"snoring means sleeping soundly"(70.2%,288/410).The last three were"nighttime dreams indicate low quality of sleep"(11.5%,47/410),"long-term use of sleeping pills can cause drug dependence and addiction"(12.7%,52/410),"insomnia must be caused by physical illness"(12.7%,52/410).In terms of behavior and habit,only 22.2%(91/410)had regular exercise and 34.1%(140/410)took nap after lunch.In terms of treatment,59.5%(244/410)of patients tried western medicine,40.5%(166/410)tried psychotherapy,only 7.3%(30/410)of patients tried psychotherapy;46.3%(190/410)of patients had no depression,19.8%(81/410)of patients had moderate to severe depression.The survey indicates that patients with insomnia in the community have a relatively low awareness of disease knowledge,and their daily life and medication habits need to be changed to improve sleep quality.