基于拉扎勒斯应激理论的脊髓损伤患者睡眠障碍模型初步构建

目的：了解脊髓损伤患者的失眠障碍，构建失眠障碍模型的初步模型。方法：采用创伤后应激障碍筛查表，广泛性焦虑自评量表、病人健康问卷抑郁自评量表以及失眠严重指数对130例脊髓损伤患者进行问卷调查，并采用结构方程的方法，构建脊髓损伤患者睡眠障碍的结构方程模型，探究各因素对其睡眠障碍的作用机制。结果：脊髓损伤患者失眠严重指数得分为（16.461±8.022）分。其中中重度临床失眠患者75例（57.7%）。创伤后应激障碍对睡眠障碍的影响最大，抑郁对失眠睡眠的作用效果强于焦虑。结论：改善脊髓损伤患者睡眠障碍应建立科学精准的管理模式，重点关注患者的创伤后应激障碍情况。同时针对患者焦虑抑郁症状，采取个体化的干预措施，改善其不良心理状态，减轻此类患者的睡眠障碍。

Study on construction of a model for insomnia disorder in patients with spinal cord injury based on Lazarus stress theory

Objective: To understand the insomnia disorders of patients with spinal cord injury, and to construct a preliminary model of insomnia disorders. Methods: Using a convenient sampling method, a questionnaire survey was performed on 130 hospitalized patients with spinal cord injury. The questionnaires included: post-traumatic stress disorder screening form, generalized anxiety scale, patient health questionnaire, depression scale, and insomnia severity index. The structural equation method was used to construct the structural equation model of insomnia disorder in patients with spinal cord injury, and the mechanism of various factors was explored. Results: The score of insomnia severity index for patients with spinal cord injury was （16.461 ± 8.022）, of which 75 patients (57.7%) had moderate to severe clinical insomnia. Post-traumatic stress disorder had the greatest impact on insomnia, and depression had a stronger effect on insomnia than anxiety. Conclusion: A scientific and accurate management model should be established to improve the insomnia disorder of patients with spinal cord injury, and pay attention to the post-traumatic stress disorder of patients. Meanwhile, individualized intervention measures should be taken to improve the adverse psychological state of patients and alleviate the insomnia disorder.