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    政大機構典藏 > 理學院 > 心理學系 > 學位論文 >  Item 140.119/64325
    Please use this identifier to cite or link to this item: https://nccur.lib.nccu.edu.tw/handle/140.119/64325


    Title: 慢性腎臟病患者的睡眠:心理及行為因素之影響
    Sleep in Chronic Kidney Disease: the Impact of Psychological and Behavioral Factors.
    Authors: 林昱萱
    Lin, Yu Hsuan
    Contributors: 許文耀
    Hsu, Wen Yau
    林昱萱
    Lin, Yu Hsuan
    Keywords: 慢性腎臟病
    睡眠品質
    失眠
    chronic kidney disease
    sleep quality
    insomnia
    Date: 2013
    Issue Date: 2014-03-03 15:31:13 (UTC+8)
    Abstract: 研究目的 對於慢性腎臟病患者而言,睡眠困擾是十分常見的問題。過去相關研究中,研究對象較偏重於已進入透析治療的患者,且大多著重於探討人口學及臨床變項,而忽略了心理及行為因素(例如睡前激發狀態、睡眠衛生行為)的影響。本研究試圖改善過去研究之不足,釐清心理及行為因子在慢性腎臟病患者的睡眠問題中所扮演之角色。
    研究方法 本研究採橫斷性調查研究,於腎臟科門診及血液透析室招募第三期到第五期(eGFR<60 ml/min/1.73m2)的慢性腎臟病患者。最終納入分析的個案共有152人,其中77人為未達尿毒症的慢性腎臟病患者,75人為穩定接受血液透析治療(3個月以上)的尿毒症患者。受試者需完成匹茲堡睡眠品質量表、失眠嚴重度量表、睡眠衛生行為量表、睡前激發狀態量表、醫院焦慮與憂鬱量表,並且回答和不寧腿症候群、疼痛及皮膚癢程度相關的問題,此外,本研究亦從病歷紀錄中抄錄相關的檢驗數値以及共病情形。
    研究結果 未透析患者約有29.9%睡眠品質不佳、23.4%有失眠問題;而血液透析患者約有57.3%睡眠品質不佳、28.0%有失眠的問題。血液透析患者和未透析患者相比,其睡眠品質顯著較差,且失眠較為嚴重。迴歸分析結果顯示,MMSE得分較低、共病較多、疼痛程度較高、和焦慮相關行為較多可預測較差的睡眠品質,而焦慮與憂鬱情緒較高、焦慮相關行為較多、和認知激發程度較高可預測較嚴重的失眠。未透析患者的睡眠問題主要是受到和激發相關的行為或認知活動的影響,而血液透析患者的睡眠則較容易受到疾病和症狀相關因素的影響。
    結論 疾病與臨床因素、身體症狀、以及睡眠心理及行為相關因素對於慢性腎臟病患者的睡眠有所影響,但對於未透析和已透析的患者,其影響因素和影響程度可能不同。
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    Description: 碩士
    國立政治大學
    心理學研究所
    98752019
    102
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