合肥市医学院校护生睡眠质量与焦虑抑郁共病症状的关联

Association between sleep quality and anxiety-depression co-morbid symptoms among nursing students of medical college in Hefei City

目的 了解护生睡眠质量及焦虑抑郁共病症状的流行现状及关联,为促进护生心理健康提供科学依据。方法 于2019年1月,在安徽省合肥市3所医科院校中采用整群随机抽样的方法选取护理专业1 716名学生进行基线调查,于2019年10月对抽样人群进行随访调查,与基线匹配后有效人数为1 573人。采用抑郁-焦虑-压力量表(DASS-21)评估护生的焦虑抑郁共病症状,采用匹兹堡睡眠质量指数量表(PSQI)评估护生睡眠质量。结果 护生在基线和随访中焦虑抑郁共病检出率分别为16.9%和18.2%,睡眠质量差的检出率分别为10.1%和10.3%。二元Logistic回归分析结果显示,基线的睡眠质量得分与基线焦虑抑郁共病症状检出率(OR=1.49,95%CI=1.40~1.59)及随访焦虑抑郁共病症状检出率(OR=1.22,95%CI=1.16~1.28)呈正相关,进一步分析发现,基线睡眠质量对焦虑抑郁共病症状检出风险的影响主要集中在入睡时间、睡眠效率、睡眠障碍、催眠药物及日间功能障碍维度,且入睡时间、睡眠障碍及日间功能障碍在随访调查中仍存在这种影响(P值均<0.05)。结论 护生睡眠质量差可增加焦虑抑郁共病症状的发生风险,改善护生睡眠质量对促进心理健康有积极作用。

Objective To describe the prevalence and association of sleep quality and anxiety-depression co-morbid symptoms among nursing students,in order to provide a reference basis for promoting the development of nursing students'mental health.Methods Using a prospective study design,baseline survey was conducted in January 2019 among a random cluster sample of 1716 individuals in three medical universities in Hefei,Anhui Province,and a follow-up survey was conducted in October 2019,with a valid number of 1573 individuals after matching with the baseline survey.The Pittsburgh Sleep Quality Index(PSQI)was used to assess nursing students'sleep quality,and the Depression-Anxiety-Stress Scale(DASS-21)to assess the anxiety-depression co-morbid symptoms.Results The detection rates of anxiety-depression co-morbidities among nursing students at baseline and follow-up survey were 16.9%and 18.2%,respectively,and the detection rates of poor sleep quality among nursing students at baseline and follow-up survey were 10.1%and 10.3%,respectively.The results of the binary Logistic regression model showed that baseline PSQI score were positively associated with the risk of anxiety-depression co-morbid symptoms among nursing students at baseline(OR=1.49,95%CI=1.40-1.59)and after nine months of follow-up(OR=1.22,95%CI=1.16-1.28).Furthermore,the influence of baseline sleep quality on the risk of anxiety-depression co-morbid symptoms were mainly concentrated in the five dimensions of sleep time,sleep efficiency,sleep disorders,hypnotic drugs and daytime dysfunction,and such effects of sleep time,sleep disorders and daytime dysfunction still existed in the follow-up investigation.Conclusion Poor sleep quality of nursing students can increase the risk of anxiety-depression co-morbidities.Improving sleep quality of nursing students has a positive effect on improving their mental health.