心理护理联合认知行为干预改善老年患者睡眠障碍的研究

谢萍香　王桃

[摘要]目的 探讨心理护理联合认知行为干预对老年患者睡眠障碍的影响。方法 选取2014年6月～2016年2月住院的120例睡眠障碍的老年患者，随机分成对照组和实验组，每组60例。两组患者均进行常规护理措施，实验组患者同时加强心理护理、认知行为干预。比较两组患者在入院时，护理干预4、8周后的匹兹堡睡眠质量指数量表（PSQI）评分。结果 与入院时比较，两组患者干预4、8周后的PSQI评分逐渐降低，组内比较差异有统计学意义（P=0.000）；入院时，两组的PSQI评分差异无统计学意义（P>0.05），护理干预4、8周后，实验组的PSQI评分低于对照组（P<0.05）。干预后，实验组的睡眠质量、睡眠时间、睡眠效率、睡眠障碍、催眠药物等评分均显著低于对照组（P<0.05）。结论 心理护理联合认知行为干预对老年睡眠障碍患者改善睡眠质量发挥重要作用，且效果显著，具有较高的临床实用性和推广性。

[关键词]心理护理；认知行为干预；老年患者；睡眠障碍；护理

[中图分类号] R473.74 [文献标识码] A [文章编号] 1674-4721（2017）06（a）-0156-03

[Abstract]Objective To study the influence of psychological nursing combined with cognitive behavioral intervention on sleep disorders in elderly patients.Methods 120 elderly patients with sleep disorders and in the hospital from June 2014 to February 2016 were selected，and they were randomly divided into control group and experimental group，and there were 60 cases in each group.Two groups of patients were given the routine nursing measures，while the experimental group was given psychological nursing and cognitive behavior intervention.Pittsburgh sleep quality index （PSQI） score on admission and after 4，8 weeks nursing intervention between two groups were compared.Results Compared with on admission，PSQI score after 4，8 weeks nursing intervention in the two groups decreased and there was a statistical difference in the same group （P=0.000）.There was no statistical difference of PSQI score between two groups （P>0.05），after 4，8 weeks nursing intervention，PSQI score of the experimental group was lower than that of the control group （P<0.05）.After intervention，the score of sleep quality，sleep time，sleep efficiency，sleep disorder and hypnotic drugs in the experimental group were significantly lower than those in the control group （P<0.05）.Conclusion Psychological nursing combined with cognitive behavioral intervention plays an important role in improving sleep quality in elderly patients with sleep disorders，and has a significant effect，and has a higher clinical practicability and popularization.

[Key words]Psychological nursing；Cognitive behavioral intervention；Elderly patients；Sleep disorder；Nursing

睡眠是人的生理需要，良好的睡眠质量让人身心愉悦，但调查结果显示：93%的老年住院患者有不同程度的失眠，其中入睡困难是老年患者失眠的主要类型[1]。老年患者由于生理、心理、住院环境、疾病影响引起睡眠障碍，从而影响生活质量，诱发、加重躯体疾病[2]；有的患者甚至由于長期失眠而出现精神紧张、抑郁或者焦虑等负性情绪而造成不良事件的发生。例如：夜间频繁起床而增加摔伤等意外事件发生[3]。目前，改善老年患者睡眠障碍是老年科护理工作中重要内容，也是实现“健康老龄化”的途径之一[4]。因此，对老年患者睡眠障碍实施心理护理联合认知行为干预具有显著效果。心理护理能有效疏导患者情绪，改善患者睡眠；而认知行为干预（cognitive behavioral therapy，CBT）着重改善患者错误认知，并结合行为训练，来改善患者的不依从行为[5]。本……