| 摘要: | 睡眠困擾是燒傷病患常見的問題，故本研究採縱貫性設計，針對燒傷病患住院第一週之睡眠品質及其相關因素進行探討。本研究共完成47位個案資料收集，並根據研究目的，應用匹茲堡睡眠量表、簡明疼痛量表及數字評估量表（包括疼痛、焦慮、憂鬱及疲倦），進行連續五天之調查性研究。以SPSS統計軟體進行描述性統計、成對t檢定、One way ANOVA、重複測量變異數分析、皮爾森積差相關及複迴歸分析，進行資料統計分析。
研究結果發現，（1）比較病患燒傷前後睡眠情形，達顯著差異(P < .05)，代表燒傷後睡眠情形改變；（2）睡眠品質不良者佔72.34％（34人）；（3）睡眠困擾程度為輕度至中度；（4）疼痛、焦慮、憂鬱及疲倦等相關影響因素，與睡眠困擾呈正相關；（5）最痛疼痛強度、平均疼痛強度、焦慮、憂鬱、疲倦及疾病特性（自變項）與睡眠品質（依變項），僅最痛疼痛強度有達統計上之顯著差異（F = 11.568, p < .05），總變異量為20.5％。
故本研究結果支持疼痛、焦慮、憂鬱及疲倦皆會影響燒傷病患之睡眠品質，依據研究結果，建議在臨床照護上，應針對燒傷病患建立一套系統性的評估模式，並依評估結果，給予病患有效的醫療及護理措施，進而提升臨床照護品質。
關鍵字：燒傷、睡眠品質、疼痛、焦慮、憂鬱、疲倦。
Sleep disturbances are frequently reported in victims following burn injury. The purpose of this longitudinal study was to investigate the sleep quality and related factor within the first week of hospitalization. Forty-seven patients were interviewed during five consecutive days to collect information about Pittsburgh Sleep Quality Index (PSQI), Brief Pain Inventory Taiwanese (BPI-T) and Numeric Rating Scale (NRS-pain, anxiety, depression and fatigue). Data were analyzed by descriptive statistics, paired t-test, one-way ANOVA, repeated measured ANOVA, Pearson’s correlation and multiple regression. The results showed that (1) the sleep quality were significantly statistical difference after burn injury; (2) 72.34% (n = 34) patients reported sleep disturbances; (3) sleep disturbances in acute burn patients was mild level in general; (4) pain intensity, anxiety, depression and fatigue were positive correlated with sleep disturbances analyzed by Pearson’s correlation; and (5) However, only pain intensity could explain the variance of sleep disturbances (R2 = 20.5%). The results of this study confirmed that pain, anxiety, depression and fatigue were related to sleep quality of acute burn patients, especially level of pain intensity. Results of the study suggest that building a systemic pain assessment and management are important to help acute burn patients to have better sleep quality.
Key words: burn, sleep quality, pain, anxiety, depression, fatigue |
