慢性阻塞性肺疾病病人睡眠质量及疲劳症状与生活质量的相关性研究

[目的]探讨慢性阻塞性肺疾病（COPD）病人睡眠质量及疲劳症状对生活质量的影响。[方法]选择出院后1个月稳定期COPD病人91例,采用匹兹堡睡眠质量指数（PSQI）、疲劳量表（FS-14）、生活质量评定St．George’s呼吸问卷（SGRQ）进行测量。[结果]COPD稳定期病人的睡眠质量与国内常模比较具有统计学意义（P〈0．01）。多元回归分析表明,病人的睡眠质量总分、躯体疲劳症状对生活质量均有影响。[结论]COPD痛人睡眠质量差,躯体疲劳现象严重,会降低病人的生活质量。     

康复治疗对慢性阻塞性肺疾病稳定期病人生活质量的影响

[目的]观察康复治疗对慢性阻塞性肺疾病(COPD)稳定期病人生活质量的影响.[方法]将152例COPD稳定期病人随机分成两组,对照组78例采取一般护理措施,观察组74例在一般的护理措施基础上进行康复护理干预.观察两组病人干预前和干预后6个月第1秒用力呼气容积(FEV1)、第1秒用力呼气容积/用力肺活量(FEV1/FVC);采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评价病人的生存质量.[结果]观察组病人FEV1、WHOQOL-BREF总分高于对照组(P＜0.05).[结论]康复治疗可提高COPD稳定期病人的生活质量.     

健康指导对稳定期慢性阻塞性肺疾病病人生活质量的影响

[目的]探讨健康指导对稳定期慢性阻塞性肺疾病(COPD)病人生活质量的影响。[方法]对36例稳定期COPD病人开展教育指导,教育并督促其进行呼吸肌锻炼、长期家庭氧疗、戒烟、营养支持、用药指导等,确保病人及家属掌握疾病相关知识,确保护理措施得以实施。[结果]干预后病人生活质量显著提高(均P<0.05)。[结论]健康指导可有效提高稳定期COPD病人的生活质量。     

音乐疗法对稳定期慢性阻塞性肺疾病病人睡眠质量的影响

[目的]探讨音乐疗法对稳定期慢性阻塞性肺疾病(COPD)病人睡眠质量的影响。[方法]将60例病人随机分为观察组与对照组,对照组接受常规护理与治疗,观察组则在对照组的基础上实施音乐疗法;采用匹兹堡睡眠质量指数量表进行睡眠测试,比较两组病人的各项指标。[结果]观察组在接受音乐疗法后,其睡眠质量有明显改善,睡眠质量、入睡时间、睡眠时间、睡眠效率、日间功能评分与对照组比较差异有统计学意义。[结论]音乐疗法有助于改善稳定期COPD病人睡眠质量。     

健康教育对慢性阻塞性肺疾病病人生活质量的影响

[目的]观察健康教育对慢性阻塞性肺疾病(COPD)病人生活质量的影响.[方法]将68例COPD病人随机分为观察组和对照组,每组34例,观察组实施系统的健康教育,对照组实施常规护理教育.病人出院1年后采用圣·乔治呼吸问卷(SGRQ)对两组病人的生活质量进行评定.[结果]观察组病人SGRQ评分高于对照组(P＜0.05).[结论] 健康教育对可明显改善COPD病人生活质量.     

老年慢性阻塞性肺疾病稳定期患者睡眠与疲劳情况调查

目的:调查老年慢性阻塞性肺疾病稳定期患者的睡眠情况,探讨睡眠与疲劳的关系及对生活质量影响.方法:应用睡眠状况自评量表(SRSS)调查238例老年慢性阻塞性肺疾病稳定期患者的睡眠情况,同时采用疲劳量表(FS - 14)进行评价,慢性阻塞性肺疾病问卷(CAT)评估患者生活质量,得出患者睡眠与疲劳的关系,进一步探讨对生活质量的影响.结果:老年慢性阻塞性肺疾病稳定期患者均存在中度及以上睡眠问题,与全国常模比较睡眠质量差.相关性分析表明,睡眠情况和疲劳总分、脑力疲劳及生活质量总分相关,与躯体疲劳相关度不明显.生活质量影响因素多元直线回归分析显示,患者的生活质量和脑力疲劳呈正相关,睡眠时间及觉醒不足与生活质量呈负相关.结论:老年慢性阻塞性肺疾病患者睡眠质量差,睡眠情况及疲劳类型与生活质量呈正相关,其中睡眠不足及夜间睡眠时间不足造成的白天觉醒困难及脑力疲劳对患者生活质量影响显著.     

慢性阻塞性肺病病人社会支持与生存质量的相关性研究

[目的]调查慢性阻塞性肺病(COPD)病人社会支持与生存质量(QOL)的状况,探讨COPD病人社会支持与QOL的关系.[方法]选取稳定期COPD病人60例,采用社会支持评定量表和慢性阻塞性肺病生存质量测评表进行调查,分析COPD病人的社会支持与QOL的相关性.[结果]COPD病人的社会支持与QOL均低,社会支持与QOL呈显著的正相关.[结论] COPD病人的社会支持与QOL密切相关,社会支持高的COPD病人QOL也高;护理过程中要重视病人的社会支持,提高病人的QOL.     

太极拳对改善晚期肺癌病人癌因性疲乏及睡眠质量的影响

[目的]探讨练习二十四式简化太极拳对晚期肺癌病人癌因性疲乏、睡眠质量的影响.[方法]将60例晚期肺癌病人随机分为干预组30例,对照组30例.对照组采用常规护理,干预组在常规护理的基础上采用二十四式简化太极拳进行护理干预,应用简易疲乏量表(BFI)、睡眠状况自评量表(SRSS)进行评价.[结果]干预组病人的综合疲劳影响、睡眠质量与对照组比较差异有统计学意义.[结论]练习二十四式简化太极拳能有效改善晚期肺癌病人的癌因性疲乏及睡眠质量.     

呼吸内科住院病人睡眠质量及其影响因素分析

[目的]探讨呼吸内科病人住院期间的睡眠质量及影响因素.[方法]采用匹兹堡睡眠质量指数(PSQI)量表、自编影响睡眠因素问卷对117例呼吸内科病人进行问卷调查.[结果]117例呼吸内科病人PSQI得分为(9.17±2.50)分;其中83例睡眠质量差,占70.9%.且病人睡眠质量与正常人比较差异有统计学意义(P<0.01).影响病人睡眠质量的主要原因包括睡眠时间颠倒、疾病影响、活动量减少、睡眠环境、医源及非医源性噪声和心理因素.[结论]大部分呼吸内科住院病人存在睡眠质量问题,医护人员应积极采取有效措施,提高病人的睡眠质量.     

肺结核病人睡眠质量调查及其影响因素分析

[目的]探讨肺结核病人的睡眠质量及其影响因素.[方法]采用匹兹堡睡眠质量指数(PSQI)量表和自编影响睡眠质量调查表对住院病人进行调查.[结果]61.7%的肺结核病人有睡眠质量问题,显著高于全国常模(P<0.01),其主要影响因素为身体不适、心理压力、环境、药物和生活习惯的改变.[结论]大多数肺结核病人存在不同程度的睡眠问题,医护人员应高度重视,积极采取有效措施可减少病人失眠,提高睡眠质量.     

住院稳定期慢性阻塞性肺疾病患者睡眠质量及影响因素调查分析

目的：探讨住院稳定期慢性阻塞性肺疾病（COPD）患者的睡眠质量现状及其影响因素。方法：采用匹兹堡睡眠质量指数量表（PSQI）、睡眠个人信念与态度量表（DBAS）、焦虑自评量表（SAS）、抑郁自评量表（SDS）、自制夜间症状调查表对146例住院稳定期COPD患者进行问卷调查,评估其睡眠质量,并分析睡眠质量的影响因素。结果：住院稳定期COPD患者的PSQI总分为（7.05±2.27）分,显著高于国内常模;78例（53.42%）患者存在睡眠质量问题;夜间症状、焦虑、抑郁、睡眠个人信念和态度、吸烟、合并其他慢性病是稳定期COPD患者睡眠质量的主要影响因素。结论：慢性阻塞性肺疾病患者睡眠质量较差;临床医务人员可根据影响因素,开展有针对性的睡眠管理,进而改善患者睡眠质量。     

维持性血液透析患者睡眠质量、抑郁和生活质量相关关系的研究

目的探讨维持性血液透析患者睡眠质量、抑郁与生活质量之间的关系。方法收集符合标准维持性血液透析患者71例,采用匹兹堡睡眠质量指数（PSQI）评估睡眠质量,以简明健康状况调查表（SF-36量表）和BECK抑郁自评问卷（BDI）分别评估生活质量和抑郁情况。记录年龄、性别、婚姻、干体重、血红蛋白、铁蛋白、转铁蛋白饱和度、钙、磷、全段甲状旁腺激素、白蛋白、C-反应蛋白、透析前及透析后血肌酐、尿素氮。结果睡眠质量较差（PSQI评分〉5）的血液透析患者占76.1%;睡眠质量较好组患者的生活质量总分、生理及心理健康总分均高于睡眠质量较差组（P〈0.01）,睡眠质量较差组的抑郁评分高于睡眠质量较好组（P〈0.05）;中-重度抑郁患者（BDI评分≥8分）占63.4%,该组患者生活质量总分、生理及心理健康总分均低于非中-重度抑郁组（P〈0.01）,且睡眠质量差（P〈0.01）;SF-36生活质量总分、生理健康总分及心理健康总分和睡眠质量及抑郁相关（P〈0.01）,睡眠质量和抑郁是生活质量独立的危险因素。结论维持性血液透析患者睡眠质量较差、抑郁较为常见,睡眠和抑郁之间相互影响,并且降低了患者的生活质量。     

八段锦对血液透析患者疲劳症状及睡眠质量的影响*

目的: 探讨八段锦运动在降低血液透析患者疲劳,改善其睡眠质量中的作用,为改善患者症状,提高生活质量提供理论依据。方法: 将70例维持性血液透析的患者随机分为观察组（35例）和对照组（35例）。对照组采用常规治疗护理,观察组在此基础上给予八段锦锻炼3个月。采用修订版Piper疲乏量表和匹兹堡睡眠质量指数量表于干预前后评估疲劳和睡眠情况。结果: 干预后观察组的疲劳总分及各维度得分、睡眠质量总分及各维度得分优于对照组,差异有统计学意义（P<0.05）。结论: 八段锦锻炼可以改善血液透析患者睡眠质量,减轻疲劳症状。     

COPD 患者营养状况与睡眠质量的相关分析

目的：探讨营养状况对COPD患者睡眠的影响。方法采用匹兹堡睡眠质量指数量表（PSQI）、主观综合性营养评估量表（SGA）测评248例COPD患者的营养状况与睡眠质量,并分析其关系。结果248例COPD患者中正常或轻度营养不良占65．0％,中度营养不良占32．2％,重度营养不良占2．8％;PSQI总分＞7分者占92．7％,PSQI总平均分为（10．01±2．87）分;正常或轻度营养不良患者PSQI总分（8．86±1．71）分,中重度营养不良患者PSQI总分（11．24±1．84）分,两组比较差异有统计学意义（t＝10．183,P＜0．05）。回归分析结果显示,主观睡眠质量、睡眠潜伏期、睡眠持续性、睡眠紊乱、日间功能障碍、PSQI总分与COPD患者的营养状况有关（ P＜0．05）。结论 COPD患者营养状况越好,其睡眠质量则越好,加强营养状况可以改善睡眠质量。     

老年女性压力性尿失禁患者睡眠质量及影响因素的调查分析

目的调查老年女性压力性尿失禁(stress urinary incontinence,SUI)患者的睡眠质量及影响因素。方法应用睡眠状况自评量表(self-rating scale of sleep,SRSS)和自行设计的影响睡眠因素调查问卷,对100例老年女性SUI患者进行问卷调查,了解其睡眠状况及影响因素。结果老年女性SUI患者SRSS评分较常模得分高;发生睡眠障碍的有61例,占61.00%;不良情绪、经济负担加重、夜间起床、躯体不适、噪声、环境陌生及生活习惯改变、灯光、日间活动量减少是影响患者睡眠质量的因素。结论老年女性SUI患者睡眠质量明显低于健康人群,其影响因素包括社会心理因素、生理因素及环境因素,应加强护理干预,提高患者睡眠质量。     

老年人睡眠呼吸暂停综合征的睡眠质量调查

INTRODUCTIONObstructivesleepapneasyndrome（OSAS）isoneofthecommonsleepdisorders，especiallyintheelderly．PatientswithOSASusu－allycomplainofexcessivedaytimedrowsinessandtiredness，lackofconcentration，memoryimpairment，andsometimespsychologicaldisturbances．Asaresultofthesesymptomsandfunctionalimpair－ments，OSASpatientsoftenreporthavingapoorsleepquality犤１－２犦．Inthisstudy，wewereinterestedinevaluatingthesubjectivesleepqualityinelderlypatientssufferingfromOSAS．MATERIALSAND…     

呼吸训练对缓解期老年重度COPD患者生存质量及日常生活活动的影响

目的：探讨呼吸训练对缓解期老年重度慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）患者的生存质量及日常生活活动的影响.方法：选择缓解期老年重度COPD患者30例,随机分为对照组10例,呼吸训练组20例.对照组常规内科治疗,呼吸训练组除常规内科治疗外采用缩唇呼吸和腹式呼吸训练3个月.呼吸训练前后分别评价生存质量（QOL）和日常生活活动（ADL）,同时测定肺功能和呼吸次数/分钟,与非训练组及训练前进行比较.结果：尽管呼吸训练组呼吸训练后与对照组及与训练前比较肺功能和ADL均无明显差异,但呼吸训练组呼吸频率与训练前比较明显降低（P＜0.05）,与对照组比较呼吸频率明显降低（P＜0.01）,呼吸短促症状明显减轻（P＜0.05）,QOL部分提高.结论：①生存质量指标中呼吸短促症状评价,结合呼吸次数/分钟评估呼吸康复效果较好;②即使是老年严重的COPD患者,也能通过呼吸训练使他们在生存质量上得到改善,呼吸康复适用于所有COPD患者.     

Longitudinal effects of noninvasive positive-pressure ventilation in patients with amyotrophic lateral sclerosis

OBJECTIVE:To evaluate the duration of benefit on symptoms, quality of life, and survival derived from the use of noninvasive positive-pressure ventilation by patients with amyotrophic lateral sclerosis. DESIGN: In this prospective, cohort study, 30 of 36 consecutively referred symptomatic patients tolerated nightly noninvasive positive-pressure ventilation and undertook pulmonary function testing and 12 symptom and quality-of-life instruments concerning sleep quality, daytime sleepiness, physical fatigue, mental fatigue, and depression that were administered during a 10-mo period. RESULTS: With treatment, there was a significant improvement in the majority of patients in sleep quality, daytime sleepiness, physical fatigue, and depression; however, significant improvements lasted for up to 10 mo only in sleep quality. Partial pressure of arterial oxygen, partial pressure of arterial carbon dioxide, and oxyhemoglobin saturation remained stable or even improved for up to 7 mo during use of part-time noninvasive positive-pressure ventilation. A total of 14 patients had survival prolonged by continuous dependence on noninvasive positive-pressure ventilation. CONCLUSIONS: Noninvasive positive-pressure ventilation provides a long-lasting benefit on symptoms and quality of life indicators for amyotrophic lateral sclerosis patients and should be offered to all patients with symptoms of sleep disordered breathing or inspiratory muscle dysfunction. It can also prolong tracheostomy-free survival.     

Living with chronic obstructive pulmonary disease at the end of life: a phenomenological study

Title. Living with chronic obstructive pulmonary disease at the end of life: a phenomenological study Aim. This paper is a report of a study to describe the essential structure of the lived experience of living with severe chronic obstructive pulmonary disease (COPD) during the palliative phase of the disease. Background. Chronic obstructive pulmonary disease is one of the most common diseases throughout the world. Shortness of breath, fatigue and cough are the most troublesome symptoms, and living with COPD often imposes limitations on daily living. The disease has a great impact on quality of life and affects the extent to which people can be active in daily life. Methods. We conducted qualitative interviews of eight people with COPD and collected data over a 2‐month period in 2003. Our patients were recruited from two pulmonary disease clinics in West Sweden. We used a phenomenological methodology to analyse the interviews. Findings. Daily life for people with COPD is affected in several different ways. The patients described how their physical limitations forced them to refrain from meaningful activities in everyday life and led to social isolation. Everyday emotions vacillated between viewing life as meaningful and meaningless. A sense of involvement and the belief that life was meaningful gave the individual the energy and the desire to continue living and to envision a future. Conclusion. Nursing care should include support and facilitation, so that patients can live rather than exist to the end of their lives. It is important to learn from patients and tailor activities to their social, existential and physical priorities, where appropriate family‐centred support may be most effective.     

Transient Effects of Sleep on Next-Day Pain and Fatigue in Older Adults With Symptomatic Osteoarthritis

Poor sleep quality has been associated with greater pain and fatigue in people living with osteoarthritis (OA). The objective of this micro-longitudinal study was to determine whether sleep impacts the diurnal pattern of next-day OA-related pain and fatigue. Community-dwelling older adults (≥65 years) with hip and/or knee OA provided data over 5 days using daily diaries and wrist-worn actigraphs. Pain and fatigue intensity were measured on awakening, at 11 am, 3 pm, 7 pm, and bedtime. Subjective previous night sleep quality was measured on awakening. Multilevel linear regression models examined interactions between sleep variables and time of next-day symptom reports. One hundred sixty participants provided 785 days of data (median age = 71 years; 62% female). Analysis of time interaction effects identified an association between poor sleep quality and more morning pain and fatigue. Although the effect on awakening was more pronounced for fatigue, differences in both symptoms attributable to sleep quality attenuated as the day progressed. Investigation of actigraphy-based sleep parameters revealed no significant interactions with time of symptom measurement. These findings observed in a sample of older adults with mild-to-moderate OA symptoms warrant further investigation in a sample with more severe symptoms and more pronounced sleep dysfunction and/or sleep disorders.PerspectiveThis article investigates the impact of sleep on next-day pain and fatigue of older adults with OA. On awakening from a night of poor quality sleep, pain and fatigue intensity were heightened. However, the effect was not sustained throughout the day, suggesting the morning may be an optimal time for symptom interventions.