鼻出血住院病人睡眠状况的调查分析

目的了解鼻出血住院病人的睡眠状况及失眠的影响因素，方法自行设计问卷对68例鼻出血住院病人的睡眠状况及自评影响因素进行访谈式问卷调查。结果64．7％的病人有不同类型、不同程度的失眠，而入睡困难是病人失眠的最常见类型，造成失眠的影响因素中，疼痛不适发生率最高，为79．55％；其次是对疾病的担忧，为63．54％；担心费用过高或不能报销而失眠的发生率为45．45％。结论专科护理人员应关注鼻出血病人的睡眠质量，针对影响病人睡眠的因素做好预见性心理护理，为病人的尽快康复提供一个良好环境     

不同失眠症易患群体的睡眠特征比较

目的：调查老年人群和轮班人员的睡眠状况，对比分析不同失眠症易患群体的睡眠特点，为改善睡眠质量提供帮助。 方法：于2005-07-15／19在解放军总医院对396名年龄〉65岁的老年人、388名轮班人员、100名正常人进行匹兹堡睡眠质量指数的测查和睡眠特征分析，用DSM-IV标准进行失眠症的诊断。分为老年组、轮班人员组、正常组。采用问卷调查法，问卷包括一般情况（包括姓名、性别、年龄、病情等）和匹兹堡睡眠质量自评量表两部分。匹兹堡睡眠质量自评量表由23个条目构成，分为7个成分，包括睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、安眠药物和日间功能，每个成分按0～3计分，各域分相加为匹兹堡睡眠质量指数总分，〉7分者表示睡眠质量差．总分越高示睡眠质量越差。对比老年组、轮班组和正常对照组的失眠率及匹兹堡睡眠质量自评量表中7个成分得分和睡眠质量指数总分情况，分析3组的睡眠质量特征。 结果：共发放问卷调查900份，回收有效问卷884份，调查应答率98．22％，老年组396名、轮班组388名、正常组100名，进人结果分析。①老年组睡眠差者占58．05％，确诊为失眠症的占总群体的32．58％，轮班人员睡眠状况差者占72．02％，确诊失眠的占64．69％。②老年组、轮班组匹兹堡睡眠质量指数均高于正常组，差异有显著性（8．61&;#177;5．07，8．52&;#177;3．57，3．36&;#177;2．24；t=5．903，7．74，P=0．000），老年组、轮班组总体睡眠质量差异无显著性（t=0．3182=-0．753）。⑧轮班组以人睡困难、白天功能障碍为突出表现07=53．970，145．705，P=0．000），老年人以睡眠时间减少、睡眠效率降低、睡眠障碍多、催眠药物使用多为特点（r=38．808，65．943，16．840，91．652,P=-O．000）。④影响夜间睡眠的因素中，老人起夜多（每周〉1～2次）的占总体的72．23％。早醒（每周〉1～2次）的占总体的56．06％。轮班人员早醒的占总体的53．09％，起夜多（每周〉1-2次）的占34．79％。 结论：老年人群和轮班人员的睡眠状况较普通人群差。轮班人员主要表现为人睡困难、白天功能障碍，可能与睡眠剥夺和生物钟紊乱有关；老年人以睡眠时间减少、睡眠效率降低、睡眠障碍多、催眠药物使用多为特点，似乎与脑功能退化有关。临床上应采用针对性的干预措施来改善不同群体的睡眠。     

深圳市企业员工职业倦怠与睡眠状况的相关性研究

目的：探讨深圳市企业员工职业倦怠与睡眠状况的相关性。方法对深圳市194名企业员工采用Pines的倦怠问卷和阿森斯失眠量表进行测评分析。结果本组38．2％存在可疑失眠,38．7％存在失眠;11．0％低度倦怠,57．6％中度倦怠,31．4％高度倦怠。企业员工阿森斯失眠量表总分及夜间睡眠、白天症状因子分与Pines的倦怠问卷总分及耗竭、士气消沉因子分呈显著正相关（P＜0．01）,与动机丧失因子分呈显著负相关（P＜0．01）。结论深圳市企业员工存在明显的职业倦怠和睡眠问题,且两者密切相关;对睡眠问题进行有效的干预有可能降低职业枯竭水平。     

失眠的中西医联合治疗

失眠症(insomnia),是入睡困难和(或)睡眠持续时间绝对或相对不足而影响日常生活的一种疾病[1]。目前,公认的机制认为脑干的中缝核、孤束核能使睡眠发生,而脑桥背内侧被盖的蓝斑头部保持觉醒[2]。失眠患者的就医率呈逐年上升的趋势。在美国成年人的发病率约6%~10%[3-6]。据CSRS公布,我国成年人的失眠率为38.2%,长期失眠的人达15%,有过失眠现象的人约50%[7]。老年人机体功能衰退,失眠的     

医务人员心理健康状况调查

目的探讨医务人员的心理健康状况,为实施有效的心理干预提供参考数据。方法对西安市某三级甲等教学医院700名医务人员采用症状自评量表评定心理健康状况,采用自拟睡眠状况问卷统计睡眠障碍状况。结果共发放问卷700份,回收有效问卷480份（68．57％）。医务人员症状自评量表强迫、抑郁、敌对因子分均显著高于全国成人常模（P〈0．05）。其中护理人员人际关系敏感、抑郁、焦虑、敌对、偏执等心理问题检出率显著高于总体人群以及其他专业;外科医生躯体化、人际关系敏感、抑郁、焦虑、敌对、偏执等心理问题检出率显著高于总体人群及内科医生和医技人员。医务人员30％经常出现睡眠障碍,63．3％睡眠〈8h·d^-1结论医务人员存在不同程度的心理问题和睡眠障碍。     

社区老年人失眠影响因素及干预措施研究进展

正失眠是一种最常见的睡眠障碍,是以入睡及睡眠维持困难、早醒、醒后精神无恢复等为特征,睡眠的质或量达不到正常需求的一种主观体验。国内外研究显示,有30%~50%的社区老年人存在失眠现象~([1-3])。失眠不仅导致注意力和记忆力下降,降低人体免疫力,增加心脑血管疾病的发生率,影响机体的功能,降低老年人的生活质量。本文对国内外关于社区老年人失眠的研究进行综述,以了解社区老年人的失眠现     

727例老年人睡眠质量及影响因素调查分析

目的：了解老年人睡眠质量现状及其影响因素,为护理干预和健康教育提供依据,从而提高老年人的睡眠质量。方法：在失眠慢病管理平台选取2020年4月至2021年12月管理的727例年龄≥60岁的老年人进行分析,应用匹兹堡睡眠质量指数量表(PSQI)、失眠严重程度指数量表(ISI)和睡眠信念与态度问卷(DBAS-16)进行问卷调查。结果：PSQI、ISI、DBAS-16评分显示,不同的年龄段、性别、学历、有无配偶、是否患有高血压糖尿病的受访者睡眠质量差异明显,与其他受访者比较差异有统计学意义(P<0.05)。PSQI评分>7分的400例失眠组老年人的ISI、DBAS及各维度评分均较非失眠组差,差异均有统计学意义(均P<0.05)。结论：老年人的睡眠质量相对较差,对其睡眠质量造成影响的因素较多,需要临床提高对此问题的重视程度,加强对患者的护理干预,缓解不适感,改善其不良心理情绪,从而提高其睡眠质量。     

驻岛官兵不同睡眠自评量表测评结果分析

目的 探讨驻岛官兵不同睡眠自评量表测评结果.方法对某部349名驻岛官兵采用自制官兵心理卫生调查问卷、匹兹堡睡眠质量指数、阿森斯失眠量表和睡眠状况自评量表进行评定.结果 驻岛官兵匹兹堡睡眠质量指数、阿森斯失眠量表测评显示睡眠障碍检出率高于正常人群,睡眠状况自评量表测评显示睡眠障碍检出率低于常模;单因素分析显示,匹兹堡睡眠质量指数、阿森斯失眠量表和睡眠状况自评量表测评驻岛官兵睡眠障碍的危险因子数量依次为7个、6个和5个;多因素回归分析显示,匹兹堡睡眠质量指数、阿森斯失眠量表发现有影响自我睡眠的因素存在为驻岛官兵睡眠障碍最主要的危险因子,睡眠状况自评量表发现认为训练强度大为最主要的危险因子.结论 匹兹堡睡眠质量指数和阿森斯失眠量表较睡眠状况自评量表更容易发现群体的睡眠质量问题,匹兹堡睡眠质量指数较阿森斯失眠量表、睡眠状况自评量表更能发现群体睡眠质量的危险因子,评估群体的睡眠状况应当应用多种量表、多种方式进行综合评估.     

疗养基层军官失眠相关因素调查分析及护理对策

目的 探讨疗养基层军官失眠的发生率及相关因素，提出护理对策。方法 通过问卷方法对71例疗养基层军官进行调查。结果 46．4％的疗养员有不同程度的失眠，表现为入睡困难、睡眠减少和睡眠持续障碍。结论 疗养员失眠的因素为各种心理压力；针对这些因素，应采取心理护理和行为矫正等措施，使疗养员养成良好的睡眠习惯。     

影响老年人睡眠质量的相关因素研究

我国老龄人口是世界上绝对数最多的国家,目前已经超过我国人口总数的10％以上。如何适应新的医学挑战,解决庞大群体的医疗卫生、健康保健等是我们要考虑的主要问题。睡眠障碍是老年人中常见的健康问题,蒋平等报道59．4％的老年人有睡眠障碍。而睡眠是一种最基本的生理需要,它对人的体力、精力的恢复具有非常重要的作用。长期失眠会给老年人的身心健康带来困扰,严重者可导致中枢神经系统的活动失调,从而并发一系列的其他疾病。而睡眠质量好坏不足用时问长短来判断的,应以是否消除了疲劳、精力是否充沛来评判。本研究中我们应用汤慈美等。睡眠状况调查量表,调查老年人的睡眠质量和影响因素,旨在为更好地解决老年人的睡眠问题提供依据。     

青光眼病人的睡眠状况调查及其影响因素

[目的]了解青光眼病人睡眠状况及其影响因素。[方法]选取131例原发性青光眼住院病人,采用自行设计问卷,对其睡眠状况、影响因素及术后不良反应发生情况进行调查。[结果]90.8%青光眼病人存在入睡困难,93.1%病人睡眠不深。情绪不稳定、焦虑、恐惧等不良心理是影响青光眼病人睡眠的主要因素。[结论]住院青光眼病人存在睡眠质量问题,心理因素是其主要的影响因素。     

Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo controlled trial

BACKGROUND: COLD-fX (CVT-E002), a proprietary extract of the roots of North American ginseng (Panax quinquefolium), rich in poly-furanosyl-pyranosyl-saccharides, has been found efficacious in the prevention of respiratory infections in institutionalized seniors and healthy adults. OBJECTIVE: We examined the efficacy of COLD-fX in the prevention of acute respiratory illness (ARI) in community dwelling seniors. DESIGN: This was a randomized, double-blind, placebo controlled trial. INTERVENTION: The participants were asked to take 2 capsules/day of either COLD-fX or placebo (200 mg/ capsule) for a period of 4 months. SUBJECTS: A total of 43 community-dwelling adults aged 65 years or older were recruited. Following one month of intervention, subjects were immunized with influenza vaccine. OUTCOME MEASURES: Subjects recorded the incidence and duration of respiratory symptoms during the study. They also recorded the incidence of adverse events during the study. RESULTS: The frequency and duration of ARI during the first two months of the study was found to be similar in the two groups. However, during the last 2 months (November and December) significantly fewer subjects in the COLD-fX group 32% reported ARI compared to the placebo group 62%. The duration of symptoms during the last 2 months was significantly shorter in the COLD-fX group than the placebo group (5.6 days in the COLD-fX group vs 12.6 days in the placebo group). There was no influenza illness circulating in the community during the period of the study. CONCLUSIONS: Ingestion of COLD-fX by immunocompetent seniors during an early "cold and flu" season reduced the relative risk and duration of respiratory symptoms by 48% and 55%, respectively. Daily COLD-fX administration can thus be a safe, natural therapeutic means for the prevention of ARI in healthy seniors.     

打鼾程度评价及嗜睡量表对老年OSAS初筛作用的研究

[目的 ]探讨打鼾程度评价及嗜睡评价量表评分对老年阻塞性睡眠呼吸暂停综合征 (OSAS)初筛作用。 [方法 ]对 15 13名老年人打鼾、嗜睡情况进行问卷调查 ,并运用打鼾程度评价及嗜睡评价量表评分进行初筛。 [结果 ]有 10 5名老年人嗜睡评分 >5分 ,被建议到医院就诊 ,经专科医生进行多导睡眠图监测 ,有 68名被诊断为阻塞性睡眠呼吸暂停综合征 ,诊断符合率 64 .76%。 [结论 ]打鼾程度及嗜睡量表对老年OSAS具有可靠的初筛作用 ,方法简便易行 ,准确率较高 ,可作为OSAS初筛手段、缩小多导睡眠图的监测范围 ,减少医疗费用支出。     

Accuracy of electrocardiogram interpretation improves with emergency medicine training

Objective: To assess whether electrocardiogram (ECG) interpretation accuracy improves with advancing years of emergency medicine training. Methods: A prospective cross‐sectional double‐blinded study of emergency medicine trainees attending teaching sessions in ACEM accredited Victorian hospitals. Subjects completed a survey about level of training, rotations completed and ECG training. They were then asked for the ‘main diagnosis’ on 10 clinically significant ECG. Those in their fourth year of advanced training onwards, or in active preparation for fellowship examination (senior trainees) were compared with trainees in earlier years (other trainees). Results: There were 122 trainees surveyed in total. In the present study, 48/122 were senior trainees and 74/122 were other trainees. The overall accuracy of ECG interpretation was 67.5% (95% confidence interval [CI] 63.2–71.8%) for the senior trainees and 49.6% (95% CI 45.2–53.9%) for the others. Results for some of the individual ECG were: left bundle branch block: 81.3% (95% CI 69.9–92.6%) seniors and 58.1% (95% CI 46.6–69.7%) others; ventricular tachycardia: 43.8% (95% CI 29.3–58.2%) seniors and 37.8% (95% CI 26.5–49.2%) others; and ventricular fibrillation: 70.8% (95% CI 57.6–84.1%) seniors and 63.5% (95% CI 52.2–74.9%) others. Conclusion: There is an improvement in ECG interpretation accuracy with advancing years of emergency medicine training in Victoria. There exists, however, a low level of accuracy for some critical ECG diagnoses. There is a call by trainees for more formalized and regular ECG education to begin earlier in their training.     

住院癌症病人的睡眠质量及其影响因素

目的了解癌症病人住院期间的睡眠质量和影响因素。方法采用匹兹堡睡眠质量指数（PSQI）量表和自制的影响睡眠因素调查表,对160例癌症住院病人进行问卷调查。结果160例癌症住院病人PSQI总分为（7．575±3．209）分,57．5％的病人有睡眠质量问题。主要影响因素依次为：渴望得到家人的关心,经济负担,手术、放疗或化疗的恐惧等。结论癌症住院病人睡眠质量总体评分高于正常人组;癌症住院病人的睡眠问题应引起医护人员高度重视,应探讨建立规范化、系统化的睡眠护理模式,提高癌症住院病人的睡眠质量。     

北京市部分离退休老年人睡眠质量调查分析

目的：调查老年人睡眠状况，为老年失眠症的研究提供更多依据。方法：396例年龄〉65岁的军队离退休老年人（老年组）与100例年龄18—20岁青年人（正常组）进行匹兹堡睡眠质量指数（PSQI）的测查和睡眠特征分析。结果：与正常组比较，老年组睡眠质量差（PSQI〉7分）占72．7％，其中确诊为失眠症的占32．6％；总体睡眠质量与性别、年龄、生活环境无显著相关性。PSQI各单项目中，睡眠效率及日间功能评分，住院患者差于社区老人（P〈0．05，P〈0．01），男性差于女性（P〈0．05）；入睡时间及睡眠时间评分，女性差于男性（P〈0．01，P〈0．05），男女均存在因夜尿多影响睡眠的状况。结论：老年人失眠的发生率较高，男女性睡眠不良有各自特点，治疗以调整心理因索，适当运动及中医补肾温阳等为主，可能改善睡眠。     

A Community Intervention by Firefighters to Increase 911 Calls and Aspirin Use for Chest Pain

Objectives: To test the effectiveness of an intervention, delivered face-to-face by local firefighters, designed to increase utilization of 911 and self-administration of aspirin for seniors experiencing chest pain.
Methods: King County, Washington was divided into 126 geographically distinct areas that were randomized to intervention and control areas. A mailing list identified households of seniors within these areas. More than 20,000 homes in the intervention areas were contacted by local firefighters. Data on all 911 calls for chest pain and self-administration of aspirin were collected from the medical incident report form (MIRF). The unit of analysis was the area. Firefighters delivered a heart attack survival kit (that included an aspirin) and counseled participants on the importance of aspirin and 911 use for chest pain. Main outcome measures were 911 calls for chest pain and aspirin ingestion for a chest pain event, obtained from the MIRFs that are collected by emergency medical services personnel for 2 years after the intervention.
Results: There were significantly more calls (16%) among seniors on the mailing list in the intervention than control areas in the first year after the intervention. Among the seniors who were not on the mailing list, there was little difference in the intervention and control areas. The results were somewhat sensitive to the analytical model used and to an outlier in the treatment group.
Conclusions: A community-based firefighter intervention can be effective in increasing appropriate response to symptoms of a heart attack among elders.     

Role of homocysteine, cystathionine and methylmalonic acid measurement for diagnosis of vitamin deficiency in high-aged subjects

BACKGROUND: Intracellular B-vitamin and folate deficiency indicated by hyperhomocysteinemia is very frequent in the elderly population. Hyperhomocysteinemia increases the risk of atherothrombotic diseases and neuropsychiatric complications. Our aim was to evaluate the prevalence of increased serum metabolite concentrations in subjects of a higher age, and whether the measurement of metabolite concentrations is more effective in diagnosing B-vitamin deficiency than mere homocysteine. MATERIALS AND METHODS: Homocysteine (HCY), cystathionine (CYS) and methylmalonic acid (MMA) were investigated in serum together with vitamin B-12, B-6 and folate in 90 high-aged subjects (85-102 years), 92 seniors (65-75 years), and in 50 younger subjects (19-50 years). RESULTS: Elderly subjects (high-aged and senior) had elevated serum concentrations of metabolites. High-aged subjects had a higher frequency of pathological increases than seniors: HCY 62% vs. 24%; MMA 62% vs. 23%; CYS 81% vs. 36%. Folate and vitamin B-6 concentrations were significantly decreased in both elderly groups; vitamin B-12 was only decreased in high-aged subjects. Utilising vitamin B-6, B-12 and folate for diagnosis of intracellular vitamin deficiency, the rate was 30% in seniors and 55% in high aged subjects. However, utilising the metabolites (HCY, MMA and CYS) for the diagnosis of intracellular vitamin deficiency, there was a distinctly increased rate of 55% in seniors respective to 90% in high-aged subjects. Backward multiple regression analysis revealed that only folate, MMA, creatinine and age were independent variables influencing the HCY concentration. Furthermore, the MMA concentration was significantly and independently influenced by folate, vitamin B-12, HCY and creatinine, and the serum concentration of CYS by vitamin B-12, creatinine and age. CONCLUSION: The metabolites HCY, MMA and CYS are sensitive indicators diagnosing impaired remethylation of homocysteine to methionine with parallel activation of catabolic pathway. Compared to mere HCY or B-vitamins in serum, the efficiency of diagnosing a disturbed HCY metabolism increases very much in utilising the metabolites HCY, MMA and CYS. For differential diagnosis, parallel measurement of folate and creatinine is recommended. The early and correct diagnosis of B-vitamin deficiency in elderly subjects is of high clinical relevance.     

慢性肝病病人的睡眠状况研究

[目的]研究慢性肝病病人睡眠状况。[方法]采用睡眠状况自评量表(SRSS)对197例慢性肝病病人的睡眠状况进行调查。[结果]慢性肝病病人睡眠状况自评总分显著高于常模及内科住院病人(P<0.01),中度、重度睡眠障碍发生率是常模的3倍多。其中10个因子中有7个得分明显高于常模。睡眠时间、入睡困难、睡眠不稳及早醒是反映慢性肝病病人睡眠状况的主要因子。年龄对睡眠状况有影响。[结论]慢性肝病病人睡眠障碍发生率高,程度严重,病人年龄对睡眠质量有一定的影响。