治疗性沟通联合常规护理对阻塞性睡眠呼吸暂停综合征患者睡眠质量和心理状况的影响

王海燕; 朱亚珍; 潘友让; 余小定; 陶科伟

doi:10.16766/j.cnki.issn.1674-4152.003313

治疗性沟通联合常规护理对阻塞性睡眠呼吸暂停综合征患者睡眠质量和心理状况的影响

doi: 10.16766/j.cnki.issn.1674-4152.003313

绍兴市第七人民医院心身障碍二科(睡眠病区)，浙江绍兴 312000

基金项目:

浙江省医药卫生科技计划项目 2023RC292

详细信息

通讯作者:
潘友让，E-mail：421659943@qq.com

中图分类号: R473.74 R56
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- 文章访问数: 72
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- 被引次数: 0
出版历程
- 收稿日期: 2023-06-28
- 网络出版日期: 2024-01-29

The effect of therapeutic communication combined with routine care on sleep quality and psychological status of patients with obstructive sleep apnea syndrome

Department 2 of Psychosomatic Disorders (Sleep Ward), the Seventh People's Hospital of Shaoxing City, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的观察常规护理联合治疗性沟通干预在阻塞性睡眠呼吸暂停综合征(OSAS)患者中的临床应用效果，分析该方案对患者睡眠质量和心理状况的影响。方法选取绍兴市第七人民医院心身障碍科2021年5月—2023年5月收治的OSAS患者82例，以随机数字表将患者分为2组，各41例，对照组给予常规护理，观察组在对照组基础上加用治疗性沟通。评估患者干预前后心理状况、应对能力、健康行为和睡眠质量。结果干预后，观察组焦虑自评量表、抑郁自评量表评分明显低于对照组(均P < 0.05)；简易应对方式量表积极应对维度评分明显高于对照组(P < 0.05)，消极应对维度评分明显低于对照组(P < 0.05)；观察组健康促进生活方式量表-ⅡR总分明显高于对照组(P < 0.05)；观察组快速眼球运动睡眠(REM)、非快速眼球运动睡眠(NREM)2~3期比例为(15.13±2.87)%、(48.82±6.32)%、(13.52±3.42)%，明显高于对照组的(13.07±2.73)%、(45.24±7.67)%、(11.03±2.51)%(t=3.330、2.307、3.758，均P < 0.05)，微觉醒次数、NREM 1期比例为(14.52±4.32)次、(16.53±3.24)%，明显低于对照组的(17.16±4.53)次、(19.76±4.15)%(t=2.701、3.928，均P < 0.05)。结论对OSAS患者给予治疗性沟通联合常规护理干预能有效缓解患者的不良情绪，转变应对方式和帮助其树立健康行为，并有助于改善其睡眠质量。
- 阻塞性睡眠呼吸暂停综合征 /
- 治疗性沟通 /
- 睡眠质量 /
- 心理状况
Abstract: Objective To observe the clinical application of routine care combined with therapeutic communication intervention in patients with obstructive sleep apnea syndrome (OSAS), and to analyze the impact of this plan on the quality of sleep and psychological status of the patients. Methods A total of 82 OSAS patients admitted to the Department of Psychosomatic Disorders of the Seventh People's Hospital of Shaoxing City from May 2021 to May 2023 were selected. The patients were randomly divided into two groups using a random number table. The control group received routine care, while the observation group received therapeutic communication in addition. The patient's psychological status, coping ability, healthy behavior, and sleep quality were assessed before and after intervention. Results After the intervention, the scores of the anxiety self-assessment scale and depression self-assessment scale in the observation group were significantly lower than those in the control group (all P < 0.05); The positive coping dimension score of the simple coping style questionnaire (SCSQ) was significantly higher than that in the control group (P < 0.05), while the negative coping dimension score was significantly lower than that in the control group (P < 0.05); The total score of health promoting lifestyle profile-Ⅱ R in the observation group was significantly higher than that in the control group (P < 0.05); the proportions of rapid-eye-movement sleep (REM) and nonrapid-eye-movement (NREM) 2-3 phases in the observation group were (15.13±2.87)%, (48.82±6.32)% and (13.52±3.42)%, respectively, which were significantly higher than (13.07±2.73)%, (45.24±7.67)% and (11.03±2.51)% in the control group (t=3.330, 2.307, 3.758, all P < 0.05). The frequency of micro awakening and the proportion of NREM 1 phase were (14.52 ±4.32) times, (16.53±3.24)%, which were significantly lower than those in the control group [(17.16 ± 4.53) times, (19.76±4.15)%, t=2.701, 3.928, all P < 0.05]. Conclusion The use of therapeutic communication combined with routine nursing interventions in OSAS patients can effectively reduce their negative emotions, change their coping styles, help establish healthy behaviors, and improve their sleep quality.
- Obstructive sleep apnea syndrome /
- Therapeutic communication /
- Sleep quality /
- Psychological condition

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表 1 2组OSAS患者基线资料比较

Table 1. Comparative analysis of baseline data between two groups in patients with OSAS

组别	例数	性别(男性/女性，例)	病情程度(轻度/中度，例)	受教育程度(高中及以上/高中以下，例)	年龄(x±s，岁)	体重指数(x±s)
观察组	41	26/15	18/23	31/10	43.56±5.32	26.42±4.32
对照组	41	28/13	16/25	33/8	44.05±4.82	26.18±5.24
统计量		0.217^a	0.201^a	0.285^a	0.437^b	0.226^b
P值		0.641	0.654	0.594	0.663	0.822
注：^a为χ²值，^b为t值。

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表 2 2组OSAS患者心理状态比较(x ±s，分)

Table 2. Comparison of psychological status between two groups in OSAS patients(x ±s, points)

组别	例数	SAS		SDS
组别	例数	干预前	干预后	干预前	干预后
观察组	41	60.48±5.43	46.08±3.42^a	58.32±4.24	45.23±3.92^a
对照组	41	59.72±5.87	48.72±4.28^a	57.88±4.28	47.92±4.02^a
t值		0.609	3.086	0.468	3.068
P值		0.545	0.003	0.641	0.003
注：与同组干预前比较，^aP < 0.05。

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表 3 2组OSAS患者SCSQ评分比较(x ±s，分)

Table 3. Comparison of SCSQ scores between two groups in patients with OSAS(x ±s, points)

组别	例数	积极应对		消极应对
组别	例数	干预前	干预后	干预前	干预后
观察组	41	16.24±4.35	27.54±4.28^a	15.34±3.86	9.24±2.14^a
对照组	41	15.87±4.76	23.67±4.56^a	16.08±4.20	11.36±3.12^a
t值		0.367	3.962	0.831	3.588
P值		0.714	< 0.001	0.409	0.001
注：与同组干预前比较，^aP < 0.05。

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表 4 2组OSAS患者健康行为比较(x ±s，分)

Table 4. Comparison of health behaviors between two groups in patients with OSAS(x ±s, points)

组别	例数	IR		HR		SM		N
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	41	12.26±2.46	15.83±2.74^a	24.62±4.26	36.53±5.24^a	8.76±2.15	15.72±3.08^a	13.42±2.04	17.85±3.46^a
对照组	41	11.75±2.28	14.52±2.42^a	24.87±4.18	33.82±4.46^a	8.24±1.89	13.86±2.88^a	12.87±2.12	16.18±3.25^a
t值		0.974	2.295	0.268	2.522	1.163	2.824	1.197	2.253
P值		0.333	0.024	0.789	0.014	0.248	0.006	0.235	0.027

组别	例数	PA		SG		总分
组别	例数	干预前	干预后	干预前	干预后	干预前		干预后
观察组	41	15.82±3.12	25.36±4.27^a	8.03±1.56	15.74±2.13^a	82.91±5.74		127.03±5.67^a
对照组	41	16.43±3.34	23.16±3.85^a	7.92±1.86	14.62±2.05^a	82.08±5.86		116.16±5.94^a
t值		0.855	2.450	0.290	2.426	0.648		8.476
P值		0.395	0.017	0.773	0.018	0.519		< 0.001
注：与同组干预前比较，^aP < 0.05。

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表 5 2组OSAS患者睡眠质量比较(x ±s)

Table 5. Comparison of sleep quality between two groups in patients with OSAS (x ±s)

组别	例数	总睡眠时长(min)		微觉醒次数(次)		REM比例(%)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
观察组	41	403.26±24.53	426.35±32.26^a	22.35±5.26	14.52±4.32^a	8.24±3.15	15.13±2.87^a
对照组	41	396.53±26.37	418.54±30.85^a	21.86±4.85	17.16±4.53^a	8.03±2.84	13.07±2.73^a
t值		1.197	1.120	0.439	2.701	0.414	3.330
P值		0.235	0.266	0.662	0.008	0.680	0.001

组别	例数	NREM 1期比例(%)		NREM 2期比例(%)		NREM 3期比例(%)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
观察组	41	28.32±5.82	16.53±3.24^a	43.86±9.56	48.82±6.32^a	9.18±2.27	13.52±3.42^a
对照组	41	27.93±6.33	19.76±4.15^a	43.17±8.77	45.24±7.67^a	9.08±1.89	11.03±2.51^a
t值		0.290	3.928	0.341	2.307	0.217	3.758
P值		0.772	< 0.001	0.734	0.024	0.829	< 0.001
注：与同组干预前比较，^aP < 0.05。

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