Objective To investigate the current status of fear of disease progression and sleep quality among laryngeal cancer patients, and analyze the correlation between them. Methods Laryngeal cancer patients who were hospitalized in West China Hospital of Sichuan University between March 2021 and February 2022 were selected for this cross-sectional survey. Sociodemographic and disease-related data questionnaires, Chinese version of Fear of Progression Questionaire Short Form, and Pittsburgh Sleep Quality Index (PSQI) Scale were used to investigate the laryngeal cancer patients who met the inclusion criteria, and the correlation between fear of disease progression and PSQI score in laryngeal cancer patients was analyzed by Spearman correlation analysis. Multiple linear stepwise regression analysis was used to analyze the effects of sociodemographic and disease-related characteristics on the total score of fear of disease progression in laryngeal cancer patients, and the effects of sociodemographic, disease-related characteristics and total score of fear of disease progression on the total score of PSQI of laryngeal cancer patients. Scores were expressed as median (lower quartile, upper quartile). Results A total of 312 copies of questionnaires were distributed and 309 valid copies were recovered, with an effective recovery rate of 99.0%. The total score of fear of disease progression in the laryngeal cancer patients was 22.00 (16.00, 30.00), including 12.00 (8.00, 17.00) in physiological health dimension, and 10.00 (7.00, 14.00) in social and family dimension. The total score of PSQI was 5.00 (3.00, 8.50). The correlations of the physiological health dimension score, the social and family dimension score, and the total score of fear of disease progression with the total score of PSQI in laryngeal cancer patients were positive with statistical significance (rs=0.294, P<0.001; rs=0.234, P<0.001; rs=0.287, P<0.001). Multiple linear stepwise regression analyses showed that the total score of fear of disease progression in laryngeal cancer patients was affected by the stage of disease, occupation, primary caregiver and treatment plan (P<0.05), and the total score of PSQI of laryngeal cancer patients was affected by level of education, treatment plan and the total score of fear of disease progression (P<0.05). Conclusions The fear of disease progression in laryngeal cancer patients has a significant negative correlation with the sleep quality. Meanwhile, alleviating the level of fear of disease progression may improve sleep quality.
Objective To investigate the effect of anti-seizure medications (ASMs) pregabalin (PGB) monotherapy on sleep structure and quality of patients with focal epilepsy. MethodsAdult patients whom newly diagnosed focal epilepsy were collected and treated with PGB monotherapy. The main outcome measures were the changes of polysomnography and video-electroencephalography (PSG-VEEG), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) in epilepsy patients with PGB and baseline. Results PGB improved significantly sleep structural parameters, including increased total sleep time (P<0.001), decreased sleep latency (P<0.001), improved sleep efficiency (P<0.001), reduced wake time after sleep onset (P<0.001), increased sleep maintenance efficiency (P<0.001) and proportion of N3 sleep stage (P<0.001). In the group with poor sleep efficiency, 86.7% of patients achieved sleep efficiency>85% after PGB treatment. The difference was statistically significant (P<0.01). PGB reduced significantly PSQI score (P<0.001) and ISI score (P<0.001). No significant change in ESS score was observed (P>0.05). ConclusionsPGB could enhance slow-wave sleep (SWS), increase sleep quality and improve insomnia in patients with epilepsy without causing daytime sleepiness.
目的 探讨原发性失眠患者日间功能损害及其影响因素。 方法 选取2010年3月－12月符合美国《精神障碍诊断与统计手册》第4版诊断标准的原发性失眠者62例，另选择性别、年龄匹配的健康睡眠者53例。失眠组和对照组均采用匹茨堡睡眠质量指数量表（PSQI）评估1个月的主观睡眠质量，多导睡眠监测（PSG）评估客观睡眠质量，并通过“主观睡眠时间/客观睡眠时间×100%”计算睡眠知觉，PSG监测后受试者完成一系列日间功能评定，包括Epworth嗜睡量表（ESS）评价嗜睡程度、Flinders疲劳量表（FFS）评价疲劳程度、贝克抑郁量表（BDI）和状态-特质焦虑量表（STAI）评估情绪状态。 结果 ① 与对照组相比，失眠组主客观睡眠质量均较差；PSQI分数更高[（14.37 ± 2.44）、（2.74 ± 1.79）分，P＜0.001）]；睡眠知觉差[（49.76 ± 33.29）、（99.36 ± 12.79）分，P＜0.001）]。② 失眠组FSS、BDI、SAI、TAI分数明显高于对照组，ESS分数低于对照组（P值均＜0.05）。③ PSQI总分与ESS呈负相关（r=−0.17，P＜0.01），与FSS、BDI、SAI、TAI分数呈正相关（r=0.54，r=0.66，r=0.70，r=0.87）（P值均＜0.01）。客观睡眠时间与ESS（r=−0.01，P=0.138）、FSS（r=−0.02，P=0.019）、BDI（r=−0.03，P=0.022）、SAI（r=−0.03，P=0.086）、TAI（r=−0.04，P=0.015）分数均无明显相关性。 结论 原发性失眠者主观睡眠质量与多项日间功能损害相关，这为有效的治疗失眠和改善日间症状提供理论依据。
Objective To explore the relationship between depression and quality of life in schizophrenic patients, and the mediating role of sleep quality and weakness. Methods We selected inpatients with schizophrenia from 4 secondary and above psychiatric hospitals in Chengdu for questionnaire survey by convenient sampling method between March and July 2022. The questionnaires included general demographic data, disease-related questionnaire, Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Fried Frailty Phenotype (FFP) and Schizophrenia Quality of Life Scale (SQLS). Results A total of 594 patients were included, including 373 males (62.8%) and 221 females (37.2%). The univariate analysis of the factors affecting the quality of life of the patients showed that there was no significant difference in the age, sex, only child or not, education level, course of schizophrenia, and combined medication (P>0.05), except for the family history of mental disorders (P<0.05). SQLS score was positively correlated with SDS score (r=0.635, P<0.001), PSQI score (r=0.402, P<0.001) and FFP score (r=0.327, P<0.001). The mediation of sleep quality and weakness on depression and quality of life are significant, and chain-mediated effect of depression and quality of life was significant. Conclusion The depression level of schizophrenia patients can not only directly affect their quality of life, but also indirectly affect their quality of life through the mediation of sleep quality, weakness and chain mediation of sleep quality and weakness.
ObjectiveTo observes the postoperative transformation of subjective and objective sleep quality and related influencing factors in patients with rheumatic valvular heart disease (RVHD) who were found with central sleep apnea (CSA) after cardiac valve replacement.MethodsA total of 262 patients undergoing cardiac valve replacement were screened for CSA by overnight polysomnography and 21 patients with CSA were enrolled and followed up successfully in the 3th, 6th and 12th month of postoperation from April 2010 to January 2013. The Pittsburgh Sleep Quality Index, Epworth Sleepiness, polysomnography and cardiac function were evaluated in preoperation and postoperation (in the 3th, 6th and 12th month).ResultsNew York Heart Association class ［preoperation and postoperation: (3.7±0.5), (2.3±0.6), (1.7±0.6), (1.6±0.7), F=81.124, P<0.05］ continuously decreased, left ventricular ejection fraction ［preoperation and postoperation: (58.5±6.8)%, (60.0±7.4)%, (60.9±5.6)%, (64.4±4.0)%, F=7.182, P<0.05］ steadily increased, six-minute walk distance ［preoperation and postoperation: (271.5±76.6), (422.1±71.9), (445.1±56.2), (454.5± 63.5) m, F=67.134, P<0.05］ constantly increased. During postoperative follow-up, sleep apnea-hypopnea index ［preoperation and postoperation: (26.2±13.4), (12.0±11.5), (8.6±7.5), (7.4±5.5)/h, F=20.548, P<0.05, central sleep apnea index ［preoperation and postoperation: (19.6±10.3), (0.5±1.5), (0.3±1.3), (0.2±0.7)/h, F=72.926, P<0.05］ and oxygen desaturation index ［preoperation and postoperation: (20.1±16.6), (10.8±9.5), (8.5±7.2), (6.1±5.1)/h, F=9.646, P<0.05］ sustained improved. Aroual index ［preoperation and postoperation: (23.1±12.1), (2.7±3.8), (3.5±4.8), (2.2±2.1)/h, F=58.370, P<0.05］ presented overall downward trend. Pittsburgh Sleep Quality Index scale ［preoperation and postoperation: (11.1±3.2), (8.2±3.3), (6.0±3.8), (4.4±2.5), F=27.670, P<0.05］ were constantly improved. Epworth Sleepiness scale ［preoperation and postoperation: (13.3±5.7), (6.9±4.5), (8.2±4.8), (6.1±3.7), F=15.994, P<0.05］ showed overall reduction.ConclusionThe sleep quality of patients with RVHD and CSA is improved after cardiac valve replacement, of which the trend is in keep with postoperative recovery of cardiac function.
Objective To explore the influencing factors of sleep quality of the elderly in Chengdu community and put forward corresponding nursing strategies. Methods The elderly in four communities in Chengdu were selected by convenient sampling method from January to June 2021. The elderly in the community were investigated and analyzed by general information questionnaire, Interpersonal Relationship Integrative Diagnostic Scale (IRIDS) and Pittsburgh Sleep Quality Index (PSQI). Multiple linear stepwise regression was used to analyze the factors affecting the sleep quality of the elderly. Results A total of 232 elderly were investigated and 211 were finally included. The total score of PSQI in the elderly was positively correlated with the score of interpersonal conversation disturbance (r=0.297, P<0.05) and the score of treating people disturbance (r=0.208, P<0.05). The results of multiple linear stepwise regression analysis showed that physical exercise, monthly amount of money, education and four dimensions of interpersonal troubles were the main influencing factors of sleep quality in the elderly. Conclusions The community elderly in this study had better sleep quality. Physical exercise, monthly amount of money, education and four dimensions of interpersonal troubles were all important factors affecting the sleep quality of the elderly. Community nursing staff should pay more attention to the sleep quality of the elderly, put forward measures to improve the related factors leading to sleep disorders, encourage the elderly to take physical exercise. They should also provide psychological counseling and interpersonal communication skills for the elderly with interpersonal troubles and help expand the communication platform to improve sleep quality of the elderly in the community.
Objective To evaluate the effectivity of dexmedetomidine on the early postoperative quality of recovery in patients undergoing ambulatory knee arthroscopy under general anesthesia. Methods Patients scheduled for knee arthroscopy at the Day Surgery Center of the First Affiliated Hospital of Anhui Medical University between June and September 2024 were selected. According to the computer-generated random allocation, patients were randomly divided into the dexmedetomidine group (Dex group) and the saline control group (NS group). The Dex group received a continuous infusion of dexmedetomidine at a rate of 0.04 µg/(kg·h) until discharge, whereas the NS group was administered a comparable volume of saline. The primary outcome measure was the EuroQol Five-Dimensional Five-Level (EQ-5D-5L) score for health-related quality of life measured at the postoperative 24 hours. Secondary outcome measures included the Athens Insomnia Scale score on the night of surgery and the incidence of adverse reactions such as nausea and vomiting within 24 hours postoperatively. Results A total of 60 patients were included, with 30 patients in each group. There were statistically significant differences in the EQ-5D-5L health scores at the postoperative 24 hours (0.857±0.081 vs. 0.721±0.098) and the Athens Insomnia Scale scores [2.00 (2.00, 3.00) vs. 4.00 (3.00, 5.25)] on the night of surgery between the Dex group and the NS group (P<0.05). The difference in the incidence of postoperative nausea and vomiting between the two groups was not statistically significant [1 case (3.3%) vs. 5 cases (16.7%); χ2=1.667, P=0.197]. No adverse reactions such as bradycardia, hypotension, urinary retention, respiratory depression, dizziness and lethargy occurred in both groups. Conclusion Dexmedetomidine can significantly improve the early postoperative quality of life and sleep in patients undergoing ambulatory knee arthroscopy, thereby facilitating early postoperative quality of recovery.
ObjectivesTo assess the efficacy of non-drug interventions on improving sleep quality in ICU patients by network meta-analysis.MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on non-drug interventions on improving sleep quality in ICU patients from inception to December, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, network meta-analysis was performed by using the Stata 13.0 software.ResultsA total of 12 RCTs, involving 1 223 patients and 9 non-pharmacological interventions (music therapy, comprehensive nursing intervention, TCM emotions, music therapy+TCM emotions, Chinese medicine pillow therapy, ear acupressure, eye mask+earplugs+music, eye mask+earplugs, regular care) were included. The results of Pittsburgh sleep quality index (PSQI) showed that eye mask+earplugs, eye masks, and comprehensive nursing interventions were superior to conventional care in improving sleep quality in ICU patients, and the rankings were: eye mask+earplugs>eye mask>comprehensive nursing intervention, music therapy+TCM emotional>Chinese medicine emotional>music therapy>general care. The results of Richards-Campbell sleep scale (RCSQ) showed that eye mask+earplugs+music, Chinese medicine pillow therapy, and auricular pressure beans were superior to conventional care, and the rankings were: eye mask+earplugs+music>Chinese medicine pillow therapy>music therapy>ear acupressure beans>general care.ConclusionsThe evidence shows that in improving the sleep quality of ICU patients, eye mask + earplug, eye mask, comprehensive nursing intervention, music therapy + TCM emotional characteristics may all be effective intervention methods. It is suggested that more non-drug interventions should be carried out in the future for enhancing the sleep quality of ICU patients.