慢性心力衰竭患者健康相关生活质量与睡眠质量的关系

目的探讨慢性心力衰竭(chronic heart failure,CHF)患者健康相关生活质量(health-related quality of life,HRQOL)与睡眠质量及其他因素之间的关系。方法采用方便抽样法于2010年9月至2011年9月对144例稳定性CHF患者进行调查,调查内容包括堪萨斯城心脏病患者生活质量评分(Kansas city cardiomyopathy questionnaire,KCCQ)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、社会人口学特点和心力衰竭特点。结果 144例稳定性CHF患者的KCCQ总分为(71.7±22.9)分,其中症状得分最高,心理得分最低;PSQI总分为(9.5±4.8)分,49.3%的患者睡眠质量差,其中入睡时间得分最高、催眠药物得分最低。相关分析发现,文化程度、经济状况、NYHA分级、PSQI总分、主观睡眠质量、睡眠时间、入睡时间、睡眠效率、睡眠障碍和日间功能障碍与KCCQ相关。结论 CHF患者常伴有睡眠障碍,KCCQ各领域以心理问题最突出,且KCCQ与睡眠质量、文化程度、经济状况和NYHA分级密切相关;加强心理护理、改善睡眠质量对于提高CHF患者的生活质量具有重要意义。

Correlations between Quality of Life and Sleep Quality and Other Factors in Patients with Chronic Heart Failure

Objective To assess the correlations between health-related quality of life （HRQOL） and sleep quality and other factors in patients with chronic heart failure. Methods HRQOL and sleep quality of 144 chronic stable heart failure patients were evaluated using Kansas City Cardiomyopathy Questionnaire（KC- CQ）,Pittsburgh Sleep Quality Index（PSQI） and self-designed demographic and CHF related characteris- tics questionnaire. Results The overall KCCQ score was （71.7±22.9）. Physical symptom domain scored the highest, while psychological satisfaction scored the lowest. The global PSQI score was （9.5 ± 4.8）, 49.3% of the participants were identified as poor sleepers. Among the PSQI components, sleep latency scored the highest, and use of sleeping medication scored the lowest. Education, financial status, NYHA classification, global PSQI, subjective sleep quality, sleep duration, sleep latency, sleep efficiency, sleep dis- turbances and daytime dysfunction were identified as influencing factors of HRQOL. Conclusion Sleep disturbances are prevalent in patients with chronic heart failure. Psychological domain quality decreases most obviously in all domains of KCCQ, and sleep quality, education, economic status and NYHA class are closely correlated with HRQOL. It is important to strengthen psychological care and improve sleep quality for a better HRQOL in patients with chronic heart failure.