重症医学科住院患者焦虑与失眠发生状况及其影响因素分析

Analysis of anxiety and insomnia of inpatients in intensive care department and its influencing factors

目的调查重症医学科住院患者焦虑与失眠发生状况,探讨患者焦虑、失眠的影响因素。方法选取70例重症医学科住院患者为研究对象,调查入组患者的临床资料,采用焦虑自评量表及匹兹堡睡眠质量指数量表评定焦虑、失眠状况,比较不同临床资料患者焦虑、失眠发生率,对影响重症医学科患者焦虑、失眠发生率的因素进行单因素及多因素回归分析。结果入组患者发生焦虑32例(45.7%),发生失眠27例(38.6%),焦虑合并失眠10例(14.3%)。急性生理与慢性健康状况评分系统评分>20分、重症医学科住院时间>2 d、有创机械通气、无家属探视的患者焦虑发生率更高(P<0.01),急性生理与慢性健康状况评分系统评分>20分、重症医学科住院时间>2 d、使用镇静/镇痛药物的患者失眠发生率更高(P<0.01)。急性生理与慢性健康状况评分系统评分、重症医学科住院时间、有创机械通气、家属探视为重症医学科患者焦虑发生率的影响因素(P<0.01);急性生理与慢性健康状况评分系统评分、使用镇静/镇痛药物、重症医学科住院时间为影响重症医学科患者失眠发生率的影响因素(P<0.01)。结论重症医学科患者焦虑与失眠发生率较高,临床应关注患者焦虑与失眠发生率的影响因素,并及时干预。

Objective To investigate the occurrence of anxiety and insomnia in hospitalized patients in intensive care unit(ICU),and to explore the influencing factors of anxiety and insomnia.Methods The clinical data of 70 inpatients in ICU of hospital were retrospectively analyzed.All patients were evaluated by the self-rating anxiety scale(SAS)and the Pittsburgh sleep quality index(PQSI).The incidence of anxiety and insomnia in patients with different clinical data was compared.Univariate and multivariate regression analysis were used to analyze the factors influencing the incidence of anxiety and insomnia in ICU patients.Results Of 70 patients in ICU,there were 32 cases of anxiety,and the incidence was 45.7%,27 cases of insomnia,and the incidence was 38.6%,10 cases of anxiety and insomnia,and the incidence was 14.3%.The incidence of anxiety was higher in patients with APACHEⅡscore greater than 20,ICU hospital stay more than 2 days,invasive mechanical ventilation and no family visit(P<0.01).The incidence of insomnia was higher in patients with APACHEⅡscore greater than 20,ICU hospital stay more than 2 days and the use of sedative/analgesic drugs(P<0.01).APACHEⅡscore,length of stay in ICU,invasive mechanical ventilation and family visit were the influencing factors of the incidence of anxiety in ICU patients(P<0.01).APACHEⅡscore,the use of sedative/analgesic drugs,length of stay in ICU were the influencing factors of the incidence of insomnia in ICU patients(P<0.01).Conclusions The incidence of anxiety and insomnia in ICU patients is high.Clinicians should pay attention to the influencing factors of the incidence of anxiety and insomnia and intervene in time.