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目的:调查癌症住院患者癌因性失眠(CRI)发生情况,并分析其影响因素。方法:采用连续取样法选择癌症住院患者130例,回收有效问卷114例。采用自制调查问卷调查患者一般情况,包括年龄、性别、肿瘤类型、病程、治疗情况等,以及是否使用激素、镇痛药、安眠药等,合并慢性病情况。采用匹兹堡睡眠质量指数量表(PSQI)评估患者睡眠情况,采用数字疼痛量表(NRS)评估患者疼痛情况。比较不同肿瘤类型、不同治疗方式患者的睡眠情况,分析发生CRI的影响因素。结果:114例PSQI分值为(10.54±5.795)分;治疗期间发生CRI 76例,发生率66.7%;使用安眠药物者仅7例(6.1%)。不同肿瘤类型患者PSQI分值差异不显著(P>0.05);接受化疗、放疗、同步放化疗的患者PSQI分值分别显著或非常显著高于未接受化疗、未接受放疗、未接受同步放化疗者(P<0.05,P<0.01);接受靶向治疗的患者PSQI分值显著低于未接受靶向治疗者(P<0.05)。多重线性回归分析结果显示,CRI与化疗、放疗及疼痛评分显著相关(P<0.05)。结论:失眠在癌症患者中常见,但并未引起临床足够重视;化疗、放疗及疼痛是肿瘤住院患者发生CRI的影响因素。
Objective: To investigate the incidence of cancer-related insomnia (CRI) in cancer inpatients and analyze the influencing factors. Methods: 130 cases of cancer inpatients were selected by continuous sampling and 114 valid questionnaires were collected. The self-made questionnaire was used to investigate the general condition of the patients, including age, sex, tumor type, course of disease, treatment, etc., and whether or not to use hormones, analgesics, sleeping pills and so on. The Pittsburgh Sleep Quality Index Scale (PSQI) was used to assess patient sleep and the patient’s pain was assessed using the Digital Pain Scale (NRS). Compare different types of tumors, different treatment of patients with sleep conditions, analysis of the impact of CRI factors. RESULTS: The PSQI score of 114 patients was (10.54 ± 5.795) points. There were 76 CRI cases occurred during the treatment, with a rate of 66.7%. Only 7 patients (6.1%) used hypnotic medications. PSQI scores of patients with different tumor types had no significant difference (P> 0.05). PSQI scores of patients receiving chemotherapy, radiotherapy and concurrent chemoradiotherapy were significantly higher than those without chemotherapy, without receiving radiotherapy and without receiving concurrent chemoradiation (P <0.05, P <0.01). PSQI scores of patients receiving targeted therapy were significantly lower than those who did not receive targeted therapy (P <0.05). Multiple linear regression analysis showed that CRI was significantly associated with chemotherapy, radiotherapy and pain scores (P <0.05). Conclusion: Insomnia is common in cancer patients, but it has not caused enough attention in clinic. Chemotherapy, radiotherapy and pain are the influencing factors of CRI in hospitalized patients.