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肝硬化患者睡眠质量的潜在类别分析及生活质量的差异研究

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  • 上海交通大学医学院附属瑞金医院 a. 护理部; b. 感染科,上海 200025

收稿日期: 2023-06-27

  网络出版日期: 2024-03-18

基金资助

上海申康医院发展中心《促进市级医院临床技能与临床创新三年行动计划》研究型医师创新转化能力培训项目(SHDC2022CRS002A);上海市公共卫生体系建设三年行动计划重点学科建设计划(GWV-10.1-XK13);上海交通大学医学院附属瑞金医院护理科研基金项目(RJHK-2022-9)

Identification of latent class of sleep quality and analysis of differences of quality of life in liver cirrhosis patients with different sleep quality

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  • a. Department of Nursing, b. Department of Infectious Disease, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2023-06-27

  Online published: 2024-03-18

摘要

目的:对肝硬化患者的睡眠质量进行潜在类别分析,探讨不同睡眠质量类别患者的生活质量差异。方法:采用便利抽样法,选取2020年6月至2021年6月入住本院感染科的肝硬化患者221例,采用匹兹堡睡眠质量指数和慢性肝病问卷进行调查,使用Mplus 8.0对肝硬化患者睡眠质量进行潜在类别分析。结果:肝硬化患者的睡眠质量分为低质量-低效率睡眠(24.4%)、睡眠良好(43.9%)、睡眠时长不足(12.7%)和入睡困难-日间困乏(19.0%) 4个潜在类别,睡眠障碍发生率分别为98.2%、4.1%、60.7%和76.2%;以睡眠良好组为参照,各潜在类别患者的生活质量存在差异(P<0.05);多元线性逐步回归提示日间功能障碍、主观睡眠质量差和睡眠紊乱是影响生活质量的主要睡眠问题(P<0.05)。结论:肝硬化患者的睡眠质量存在异质性,生活质量下降与睡眠质量不佳总体一致,应对不同睡眠质量类别的特点和差异加强关注,通过针对性的干预措施改善睡眠和生活质量。

本文引用格式

蒋萍梅, 项晓刚, 蔡晓兰, 薛敏, 钱珠萍 . 肝硬化患者睡眠质量的潜在类别分析及生活质量的差异研究[J]. 内科理论与实践, 2023 , 18(06) : 410 -415 . DOI: 10.16138/j.1673-6087.2023.06.007

Abstract

Objective To identify the classification characteristics of sleep quality in liver cirrhosis patients, and explore the difference of quality of life(QOL) among the patients with different sleep quality categories. Methods A total of 221 liver cirrhosis patients in the infectious disease department of our hospital were selected as the research subjects from June 2020 to June 2021 by using convenient sampling method, in which Pittsburgh sleep quality index (PSQI) and chronic liver disease questionnaire(CLDQ) were investigated. Results According to sleep quality,the patients with liver cirrhosis were divided into 4 potential categories, which were sleep disorder group (24.4%), good sleep quality group (43.9%), lack of sleep group (12.7%) and prolonged sleep latency-daytime sleepy group (19.0%); and the incidence of sleep disturbance in 4 groups was 98.2%, 4.1%, 60.7% and 76.2%, respectively. Using good sleep quality group as reference, the score of QOL among the other groups of potential categories showed significant difference (P<0.05); the multiple linear stepwise regression suggested that daytime dysfunction, poor subjective sleep quality and sleep disorder were the main sleep problems affecting life quality(P<0.05). Conclusions There is heterogeneity in the sleep quality of cirrhosis patients, and the decreased QOL is generally consistent with poor sleep quality. It is necessary to learn the characteristics and differences of different sleep quality categories and improve the quality of sleep and life through targeted intervention.

参考文献

[1] Peng JK, Hepgul N, Higginson IJ, et al. Symptom prevalence and quality of life of patients with end-stage liver disease[J]. Palliat Med, 2019, 33(1): 24-36.
[2] Nouri-Vaskeh M, Afshan H, Malek Mahdavi A, et al. Curcumin ameliorates health-related quality of life in patients with liver cirrhosis: a randomized, double-blind placebo-controlled trial[J]. Complement Ther Med, 2020, 49: 102351.
[3] Hutka P, Krivosova M, Muchova Z, et al. Association of sleep architecture and physiology with depressive disorder and antidepressants treatment[J]. Int J Mol Sci, 2021, 22(3): 1333.
[4] Wang X, Tu Q, Huang D, et al. A latent profile analysis of emotional expression among patients with unintentional injuries[J]. BMC Psychiatry, 2022, 22(1): 729.
[5] 倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4): 378-380.
[6] Kumar M, Kainth S, Kumar S, et al. Prevalence of and factors associated with sleep-wake abnormalities in patients with cirrhosis[J]. J Clin Exp Hepatol, 2021, 11(4):453-465.
[7] 李萍. 肝硬化患者睡眠质量改变情况及影响因素分析[J]. 世界睡眠医学杂志, 2021, 8(2): 189-190.
[8] 中华医学会肝病学分会. 肝硬化诊治指南[J]. 实用肝脏病杂志, 2019, 22(6): 770-786.
[9] Acharya G, Kaushik RM, Gupta R, et al. Child-turcotte-pugh score, MELD score and MELD-Na score as predictors of short-term mortality among patients with end-stage liver disease in Northern India[J]. Inflamm Intest Dis. 2020 Feb; 5(1): 1-10.
[10] Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research[J]. Psychiatry Res, 1989, 28(2): 193-213.
[11] 刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996, 29(2): 103-107.
[12] Younossi ZM, Guyatt G, Kiwi M, et al. Development of a disease specific questionnaire to measure health related quality of life in patients with chronic liver disease[J]. Gut, 1999, 45(2): 295-300.
[13] 胡鑫才, 张华, 林彦, 等. 慢性肝病量表在乙型肝炎肝硬化中的应用评价[J]. 中华肝脏病杂志, 2012, 20(8): 621-627.
[14] 韦素雨, 黄丽芝, 陆柳雪, 等. 肝硬化患者生活质量测评工具的研究进展[J]. 中国继续医学教育, 2021, 13(32): 191-195.
[15] Doycheva I, Ehrmann DA. Nonalcoholic fatty liver disease and obstructive sleep apnea in women with polycystic ovary syndrome[J]. Fertil Steril, 2022, 117(5): 897-911.
[16] 林丽燕, 王碧芬, 赖瑾. 住院乙型肝炎肝硬化患者睡眠障碍与社会支持的相关性研究[J]. 护理实践与研究, 2021, 18(10): 1469-1473.
[17] Miyaaki H, Hiraoka A, Haraguchi M, et al. Proposal for new sleep disorder criteria in patients with chronic liver disease[J]. Hepatol Res, 2022, 52(4): 364-370.
[18] Bruyneel M, Sersté T. Sleep disturbances in patients with liver cirrhosis: prevalence, impact, and management challenges[J]. Nat Sci Sleep, 2018, 10: 369-375.
[19] Sherlock S, Summerskill WH, White LP, et al. Portal-systemic encephalopathy neurological complications of liver disease - sciencedirect[J]. Lancet, 1954, 264(6836): 453-457.
[20] Steindorf K, Clauss D, Tjaden C, et al. Quality of life, fatigue, and sleep problems in pancreatic cancer patient[J]. Dtsch Arztebl Int, 2019, 116(27-28): 471-478.
[21] Marjot T, Ray DW, Williams FR, et al. Sleep and liver disease: a bidirectional relationship[J]. Lancet Gastroenterol Hepatol, 2021, 6(10): 850-863.
[22] 耿朝辉, 方琼, 张男, 等. 乳腺癌患者化疗期睡眠特征潜在剖面分析及其生命质量差异比较[J]. 中国实用护理杂志, 2022, 38(6): 431-437.
[23] McBeth J, Dixon WG, Moore SM, et al. Sleep disturbance and quality of life in rheumatoid arthritis[J]. J Med Internet Res, 2022, 24(4): e32825.
[24] 尹美玲, 孙晓媛, 岳利峰, 等. 基于文献计量学的国内外睡眠障碍研究现状与热点分析[J]. 世界科学技术-中医药现代化, 2022, 24(1): 436-445.
[25] Plotogea OM, Gheorghe G, Stan-Ilie M, et al. Assessment of sleep among patients with chronic liver disease[J]. J Pers Med, 2021, 11(12): 1387.
[26] Kim M, Seol J, Sato T, et al. Effect of 12-week intake of nicotinamide mononucleotide on sleep quality, fatigue, and physical performance in older Japanese adults[J]. Nutrients, 2022, 14(4): 755.
[27] Sun Y, Li Y, Wang J, et al. Effectiveness of smartphone-based mindfulness training on maternal perinatal depression[J]. J Med Internet Res, 2021, 23(1): e23410.
[28] 黄诚台, 阮清发. 肝硬化患者睡眠障碍的研究进展与中医治疗[J]. 世界睡眠医学杂志, 2020, 7(8): 1484-1488.
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