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老年慢性心力衰竭患者睡眠障碍影响因素的质性研究
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Abstract:
目的:探讨老年慢性心力衰竭患者睡眠障碍的影响因素,为针对性干预提供参考依据。方法:采用现象学研究方法,于2023年10月~11月选取在广西某三级甲等医院12例老年慢性心力衰竭患者进行半结构式深入访谈,根据Colaizzi的7步分析法对资料进行整理分析。结果:共提炼出4个主题9个亚主题,分别为疾病因素(呼吸困难、夜尿增多);心理因素(孤独感、焦虑抑郁感、自我应对能力不足);社会环境因素(睡眠环境的改变、缺乏情感及社会支持);其他因素(药物副作用的影响、不良的睡眠习惯)。结论:为了降低老年慢性心力衰竭患者睡眠障碍的发生率,医护人员应加强患者疾病的管理,进行心理疏导,强化家庭和社会支持,以提高病人的睡眠质量。
Objective: To explore the influencing factors of sleep disorders in elderly patients with chronic heart failure and provide reference basis for targeted intervention. Methods: Using phenomenological research methods, 12 cases of elderly chronic heart failure patients in a tertiary-level hospital in Guangxi were selected for semi-structured in-depth interviews in October-November 2023, and the data were collated and analysed according to Colaizzi’s 7-step analysis method. Results: A total of 4 themes and 9 sub-themes were distilled, which were disease factors (dyspnoea, increased nocturia); psychological factors (loneliness, feelings of anxiety and depression, and lack of self-coping skills); socio-environmental factors (changes in the sleep environment, and lack of emotional and social support); and other factors (the effects of medication side-effects, and poor sleep habits). Conclusion: In order to reduce the incidence of sleep disorders in elderly patients with chronic heart failure, healthcare professionals should strengthen the management of patients’ diseases, provide psychological counselling, and strengthen family and social support in order to improve patients’ sleep quality.
[1] | 陈可冀, 吴宗贵, 朱明军, 等. 慢性心力衰竭中西医结合诊疗专家共识[J]. 心脑血管病防治, 2016, 16(5): 340-347. |
[2] | Orso, F., Fabbri, G. and Maggioni, A.P. (2016) Epidemiology of Heart Failure. In: Bauersachs, J., Butler, J. and Sandner, P., Eds., Heart Failure, Springer International Publishing, 15-33. https://doi.org/10.1007/164_2016_74 |
[3] | Crea, F. (2023) Epidemiology and Treatment of Acute and Chronic Heart Failure. European Heart Journal, 44, 329-332. https://doi.org/10.1093/eurheartj/ehad022 |
[4] | 杨九飞. 基于自我管理清单的延续护理在慢性心力衰竭患者中的应用[D]: [硕士学位论文]. 郑州: 郑州大学, 2022. |
[5] | Mamas, M.A., Sperrin, M., Watson, M.C., Coutts, A., Wilde, K., Burton, C., et al. (2017) Do Patients Have Worse Outcomes in Heart Failure than in Cancer? A Primary Care-Based Cohort Study with 10-Year Follow-up in Scotland. European Journal of Heart Failure, 19, 1095-1104. https://doi.org/10.1002/ejhf.822 |
[6] | Zambroski, C.H., Moser, D.K., Bhat, G. and Ziegler, C. (2005) Impact of Symptom Prevalence and Symptom Burden on Quality of Life in Patients with Heart Failure. European Journal of Cardiovascular Nursing, 4, 198-206. https://doi.org/10.1016/j.ejcnurse.2005.03.010 |
[7] | 林金华, 范惠琴, 张秀珍. 分析老年慢性心力衰竭患者睡眠障碍原因及护理干预价值[J]. 世界睡眠医学杂志, 2023, 10(6): 1258-1260. |
[8] | 陈垦. 观察加味当归四逆汤联合西药改善心力衰竭(心肾阳虚证)患者睡眠质量的效果[J]. 世界睡眠医学杂志, 2024, 11(4): 755-757, 761. |
[9] | Kishan, S., Rao, M.S., Ramachandran, P., Devasia, T. and Samanth, J. (2021) Prevalence and Patterns of Sleep-Disordered Breathing in Indian Heart Failure Population. Pulmonary Medicine, 2021, Article 9978906. https://doi.org/10.1155/2021/9978906 |
[10] | Nelson, K.A. and Trupp, R.J. (2015) Sleep and Heart Failure. Critical Care Nursing Clinics of North America, 27, 511-522. https://doi.org/10.1016/j.cnc.2015.07.008 |
[11] | 中华医学会心血管病学分会心力衰竭学组, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018 [J]. 中华心血管病杂志, 2018, 46(10): 760-789. |
[12] | 杨莉萍, 亓立东, 张博. 质性研究中的资料饱和及其判定[J]. 心理科学进展, 2022, 30(3): 511-521. |
[13] | 赵英孜. 基于马斯洛需求层次理论的护理在老年慢性心力衰竭患者中的应用效果[J]. 中国民康医学, 2023, 35(17): 169-171, 175. |
[14] | Niu, Y., Li, R., Zhao, P., He, P., Li, Y. and Wang, Y. (2022) Quantitative and Qualitative Research on Management Strategies for Dyspnoea in Elderly Patients with Coronary Heart Disease Complicated with Chronic Heart Failure. Journal of Multidisciplinary Healthcare, 15, 2007-2013. https://doi.org/10.2147/jmdh.s378379 |
[15] | 贾丽倩, 杨元焱, 吴霞, 等. 心脏康复团队协作干预联合正念情绪强化干预对慢性心力衰竭心脏康复的影响[J]. 中国健康心理学杂志, 2023, 31(12): 1820-1825. |
[16] | 张艳梅, 梁媛, 黄海霞, 等. 医院-社区联合延续护理对急性失代偿性心力衰竭出院患者的影响[J]. 护理学杂志, 2019, 34(19): 86-88. |
[17] | 申颖, 丁雯. 空巢老年慢性心力衰竭病人延续护理需求的质性研究[J]. 循证护理, 2021, 7(9): 1221-1224. |
[18] | 贺捷, 陶萍. 慢性心力衰竭患者自我护理影响因素的质性研究[J]. 当代护士(上旬刊), 2020, 27(12): 8-11. |
[19] | 陈祥燕, 陈祥莺. 肠造口患者术后居家睡眠质量的质性研究[J]. 世界睡眠医学杂志, 2019, 6(4): 415-416. |
[20] | 张洪艳. 老年慢性心力衰竭患者睡眠障碍原因分析及护理干预方法[J]. 世界睡眠医学杂志, 2020, 7(9): 1539-1541. |
[21] | 王婷婷, 张舟, 梁燕娟, 等. 吸入性芳香疗法在维持性血液透析病人睡眠障碍、症状困扰、生活质量及负性心理的干预效果研究[J]. 全科护理, 2021, 19(28): 3950-3953. |
[22] | 周玮. 头部穴位按摩改善心内科睡眠障碍患者睡眠质量的有效性研究[J]. 世界睡眠医学杂志, 2021, 8(4): 628-629. |
[23] | 宋红霞, 韩梅, 徐继环. 居家老年慢性心力衰竭患者认知与需求的研究[J]. 中国实用护理杂志, 2018, 34(2): 103-107. |
[24] | 崔丽萍, 冯晓芳, 李月琴, 等. 慢性阻塞性肺疾病病人家庭氧疗依从性影响因素的质性研究[J]. 护理研究, 2022, 36(14): 2586-2590. |
[25] | 张金美, 孙丽美, 刘圣霞, 等. 胃肠道肿瘤患者化疗期间睡眠障碍影响因素的质性研究[J]. 齐鲁护理杂志, 2021, 27(4): 34-37. |