终末期癌症患者失眠现状及影响因素分析

Current status and influencing factors of insomnia inpatients with end-stage cancer

目的调查终末期癌症患者的失眠现状,并分析其影响因素,为临床医护人员制定终末期癌症患者失眠干预方案提供依据。方法采用便利抽样法,于2023年12月-2024年1月使用一般资料调查问卷、失眠严重程度指数量表、安德森症状评估量表、麦吉尔生活质量问卷、医院焦虑抑郁量表对湖南省中西医结合医院安宁疗护病房的终末期癌症患者进行问卷调查。结果共纳入281例终末期癌症患者,其失眠发生率为65.1%。二元logistic回归分析结果显示,疼痛、疲劳乏力、气短、焦虑以及社会支持维度得分是终末期癌症患者失眠的独立影响因素(P<0.05)。结论终末期癌症患者的失眠发生率较高,临床医护人员应积极采取干预措施改善患者的疼痛、疲劳乏力、气短和焦虑等症状,为其提供有效的社会支持,从而减少终末期癌症患者失眠的发生,提升安宁疗护服务质量。

Objective To investigate the current sleeping status of terminal cancer patients and analyze the influencing factors,so as to provide evidence for developing intervention plans.Methods Using the convenience sampling method,281 inpatients treated in the palliative care ward of the hospital of traditional Chinese and western medicine of Huna province between December 2023 and January 2024 were selected and surveyed using the general information questionnaire,insomnia severity index scale,M.D.Anderson′s symptom scale,McGill quality of life questionnaire and hospital anxiety and depression scale.Binary logistic stepwise regression analysis was used to analyze the influencing factors of insomnia.Results Among the 281 patients,the insomnia incidence was 65.1%.According to the logistic stepwise regression analysis,pain,fatigue,sleep discomfort,shortness of breath,anxiety and social support were the influencing factors of insomnia in terminal cancer patients(P<0.05).Conclusion The incidence of insomnia is high among terminal cancer patients.Therefore,clinical medical staff should take active intervention measures to relieve their pain,fatigue,shortness of breath and anxiety,as well as provide effective social support,so as to lower the occurrence of insomnia and promote nursing quality.