睡眠障礙患者睡眠與睡眠導因評估__臺灣博碩士論文知識加值系統

睡眠障礙是在台灣社會很常見的問題，其治療方法不能只依賴藥物，而必須進行完整的睡眠評估之後再給予適合的措施。

雖然文獻已提供評估睡眠障礙的諸多方法， ... 資料載入處理中... 跳到主要內容 臺灣博碩士論文加值系統 ::: 網站導覽| 首頁| 關於本站| 聯絡我們| 國圖首頁| 常見問題| 操作說明 English |FB專頁 |Mobile 免費會員 登入| 註冊 功能切換導覽列 (188.166.176.73)您好！臺灣時間：2022/09/2804:47 字體大小：       ::: 詳目顯示 recordfocus 第1筆/ 共1筆  /1頁 論文基本資料 摘要 外文摘要 目次 參考文獻 QRCode 本論文永久網址: 複製永久網址Twitter研究生:賴祈鳳研究生(外文):Chi-FungLai論文名稱:睡眠障礙患者睡眠與睡眠導因評估論文名稱(外文):EvaluationofSleepandSleepRelatedFactorinPatientswithSleepDiffculties指導教授:廖玟君指導教授(外文):Wen-ChunLaio廖玟君學位類別:碩士校院名稱:中山醫學大學系所名稱:護理研究所學門:醫藥衛生學門學類:護理學類論文種類:學術論文論文出版年:2016畢業學年度:104語文別:中文論文頁數:139中文關鍵詞:周全性睡眠評估、量表、影響睡眠之因子外文關鍵詞:comprehensivesleepassessment、Associatedfactorswithsleep相關次數: 被引用:2點閱:1148評分:下載:0書目收藏:1 睡眠障礙是在台灣社會很常見的問題，其治療方法不能只依賴藥物，而必須進行完整的睡眠評估之後再給予適合的措施。

雖然文獻已提供評估睡眠障礙的諸多方法，但大多都只評估睡眠本身，缺乏整體性系統性評估工具。

本研究主要建構一份具有信、效度的「周全性睡眠導因評估量表」，並比較探討有無睡眠障礙主訴個案之睡眠相關因素之差異。

「周全性睡眠導因評估量表」經專家效度及二十名受試者預試，進行再測信度分析，而後修改成正式量表進行施測，量表包括個人因素、生理因素、心理因素、社會因素、環境因素五大面向。

睡眠障礙族群（病人組,n=32）乃因睡眠障礙至睡眠門診求診之病患為收案標準、而非睡眠障礙族群（常人組,n=96）則以性別及年齡相對應為收案標準，另外，為求足夠代表性，非睡眠障礙族群人數設定為睡眠障礙族群之三倍。

研究結果顯示，周全性睡眠導因評估量表其八位專家之CVI值範圍在0.81到1.00之間，平均值為0.94，預試部分全樣本之四週再測信度結果，Pearson相關係數均在0.996-1.000之間，呈現完全與高度相關。

運用中文版匹茲堡睡眠品質量及Epworth嗜睡量表結果顯示病人組過去一個月內的主觀睡眠狀況皆為睡眠品質不良之個案且白天嗜睡狀況介於輕度及中度之間。

其睡眠導因各構面評估結果顯示，個人因素方面，每天工作平均工時過長(χ2=10.315,p=0.001)、需要輪班(χ2=8.964,p=0.003)、夜間工作(χ2=9.395,p=0.004)及自覺工作壓力(χ2=9.503,p=0.002)等會影響睡眠；生理因素方面，身體檢查評估項目病人組張口呼吸、低軟顎、高窄硬腭、安格氏分類法、舌肥大、磨損表面咬合之情形達顯著差異；心理因素方面，壓力知覺越高(χ2=32.542,p=0.000)且焦慮與憂鬱程度越高(χ2=32.868,p=0.000)皆會影響睡眠；社會因素方面，病人組較常人組之休閒活動比例低(χ2=39.857,p=0.000)、飲酒習慣多（χ2=1.798,p=0.018）、每日三餐時間和量不正常的頻率高(χ2=5.086,p=0.024)、晚餐的量總是/經常吃到飽或吃多(χ2=21.511,p=0.000)、前一晚沒睡好隔天無法定時起床(χ2=4.444,p=0.035)等；環境因素方面病人組有燈光(χ2=7.683,p=0.006)、噪音(χ2=5.086,p=0.024)、太冷或太熱醒來(χ2=4.595,p=0.032)等干擾而影響睡眠。

本研究結果顯示周全性睡眠導因評估量表是一份具有良好信度與效度之工具，研究結果提供睡眠門診睡眠障礙評估方法之參考。

SleepdisorderiscommoninTaiwan’ssociety.Thetreatmentofsleepdisordergoesbe-yondtheuseofmedications;itrequiresacomprehensivesleepassessmentandtailoredinter-ventions.Thoughliteratureprovidedrichinformationaboutassessingandevaluatingsleepdisorderinthegeneralpopulation,formulatingacomprehensiveassessmentofsleepdisorderinaclinicalsettingisstillachallenge.Thisstudybuiltareliableandeffective"Comprehensivesleepassessmentscale"basedonreliabilityandvalidationtestingandinvestigatedwhetherthisscaledifferentiatesbetweenpatientswithsleepdisorderandthecontrol."Comprehensivesleepassessmentscale"wasevaluatedbyexpertvalidityandby20par-ticipantswithtest-retestreliability.Thescaleiscomposedoffivedimensions:"personalfac-tors","physiologicalfactors","psychologicalfactors","socialfactors"and"environmentalfactors."Patientswhovisitedsleepclinicswithasleepdisorderwereidentifiedasthepatientssubjects(n=32).Age-andgender-matchedsubjectswithoutanysleepdisorderwererandom-lyselectedataratioof1:3(sleepdisordervs.non-sleepdisorder)andidentifiedasthenon-sleepdisordersubjects(n=96).TheContentValidityIndex(CVI)ofthisscalewas0.94andthealphaoftheconsistencyreliabilitywas0.996-1.000.Resultsshowthatallpatientswithsleepdisorderhadpoorsleepquality(PSQI>5)andmildtomoderatedaytimesleepiness(ESS>11).Personalfactorsofworkinglonghours(χ2=10.315,p=0.001),shiftworkers(χ2=8.964,p=0.003),nightshift(χ2=9.395,p=0.004)andperceivedstress(χ2=9.503,p=0.002)candisruptsleep.Physiologicalfactorsfromphysicalexaminationincludingbreathbymouth,lowsoftpalate,highnarrowpalate,EdwardAngle,tonguehypertrophy,andocclusionofthewornsurfacewerepresentinpatients.Psychologicalfactorsincludinghigherperceivedstress(χ2=32.542,p=0.000),anxietyanddepression(χ2=32.868,p=0.000);socialfactorsincludinglackofleisureactivities(χ2=39.857,p=0.000),moredrinkinghabits（χ2=1.798,p=0.018),irregularamountandfrequencyinmeals(χ2=5.086,p=0.024),eatingtoomuchindinner(χ2=21.511,p=0.000),cannotgetupwithoutagoodnightsleep(χ2=4.444,p=0.035);anden-vironmentalfactorsincludinglighting(χ2=7.683,p=0.006),noise(χ2=5.086,p=0.024),toocoldortoohot(χ2=4.595,p=0.032)canaffectsleep.TheComprehensivesleepassessmentisavalidandreliableinstrumentforevaluatingsleeprelatedfactors.Resultsofthisstudyprovidereferenceforassessingpatientswithsleepdisorder. 中文摘要iAbstractiii目次vi表次viii圖次ix第一章緒論1第一節研究動機與重要性1第二節研究目的4第二章文獻分析5第一節睡眠的生理機轉5第二節影響睡眠因素及睡眠相關評估量表8第三節評估影響睡眠因子之量表29第三章研究方法31第一節研究設計與流程31第二節研究對象35第三節研究個案權益維護與倫理考量36第四節研究工具36第五節資料統計與分析52第四章研究結果54第一節受試樣本之人口學特性統計分析54第二節受試樣本之匹茲堡睡眠品質指標量表與Epworth嗜睡量表之差異56第三節受試樣本之個人因素差異57第四節受試樣本之生理因素差異59第五節受試樣本之心理因素差異62第六節受試樣本之社會因素差異63第七節受試樣本之環境因素差異66第五章討論67第一節周全性睡眠導因評估量表信度與效度分析67第二節睡眠導因各構面評估結果68第三節研究限制74第六章結論與建議76第一節研究結論76第二節未來應用與建議77參考文獻78附錄97 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闕可欣、張嘉娟(2014)．護理在職女學生睡前激發狀態與睡眠品質相關探討．輔仁醫學期刊，12(4)，253-262。

doi:10.3966/181020932014121204005 推文 網路書籤 推薦 評分 引用網址 轉寄                                                                                                                                                                                                                    top 相關論文 相關期刊 熱門點閱論文 1. 工時變遷與過長工時對健康的影響 2. 心臟衰竭病人之日間嗜睡、睡眠品質與生活品質 3. 某新訓中心受訓人員使用電子煙、傳統紙菸與睡眠品質之研究 4. 公衛護理人員工作壓力、睡眠品質與自覺健康狀態相關性之探討-以臺中市為例   1. 林育儀、林佳靜（2014）．結腸直腸癌病人疼痛、憂鬱、焦慮與睡眠品質之相關性探討．新臺北護理期刊，16（1），29–40。

2. 林嘉玲、連心瑜、吳雪菁、張媚(2013).第二型糖尿病患者之睡眠品質．臺灣醫學，17(4)，441-446。

3. 陳崇賢、陳昭源、林忠順（2010）．失眠之評估與治療．家庭醫學與基層醫療，25:3，92-99。

4. 陳乃釧、洪宗杰（2010）．阻塞型睡眠呼吸中止症與心血管疾病．家庭醫學與基層醫療，25（6），206–211。

5. 劉惠瑚、陳玉敏、李月萍(2005)．老人睡眠問題之探討．長庚護理，16(4)，408-413。

6. 謝昌成、蕭雅尤.(2013)．老年人的失眠．家庭醫學與基層醫療，28(7)，180-185。

7. 雷啟文、林旭龍(2003)．中年婦女身體活動與睡眠品質之相關研究，衛生教育學報，20，151-169。

8. 闕可欣、張嘉娟(2014)．護理在職女學生睡前激發狀態與睡眠品質相關探討．輔仁醫學期刊，12(4)，253-262。

doi:10.3966/181020932014121204005   1. 環溫改變對健康人的腦波、睡眠品質及自律神經功能參數的影響:以探討環溫改變影響睡眠品質之機轉及睡眠過程中最適合代表人體舒適度的指標 2. 睡眠教育對大學生的睡眠知識、睡眠型態及情緒的影響 3. 睡眠呼吸中止症病患的睡眠障礙與睡眠效能相關因子探討 4. 探討男性久坐工作者睡眠呼吸中止症與睡眠覺醒對清醒與睡眠QT與Tp-e延長之研究 5. 開發一套基於單通道睡眠生理訊號的自動睡眠判讀系統與其在睡眠環境控制上之應用 6. 睡眠障礙患者身體活動、睡眠品質與憂鬱程度之關係研究 7. 睡眠臨床照護指引對改善外科重症加護病房夜間睡眠環境與病人睡眠品質之成效探討 8. 睡眠障礙病人藥品使用與睡眠特質及健康生活品質相關性探討 9. 偏頭痛與睡眠:睡眠疾患於偏頭痛病患之相關性、臨床睡眠影響與影像學研究 10. 探討影響老年人睡眠障礙之因素 11. 針灸介入後對於睡眠障礙的患者睡眠品質及生活品質之提升成效－以嘉義市某區域醫院為例 12. 護理人員輪班、睡眠衛生、睡前智慧型手機使用行為與睡眠品質之關係探討 13. 睡眠障礙之危險因子及其在原漢間之差異 14. 台灣學齡期兒童睡眠狀況與相關因素探討 15. 應用個案自陳資訊系統(PROMIS)的憂鬱，焦慮，生氣，睡眠困擾，以及睡眠相關障礙量表於台灣精神疾病患者之效度研究     簡易查詢 | 進階查詢 | 熱門排行 | 我的研究室