| Background: People spend one-third of their life time in sleep, the relationship between sleep and health has always been concerned by people. With the development of modern medicine, the research of psychological disorders has been turned from severe disorder to mild disorder. As the increase of medical expense and the declining efficiency of study and work, people pay more and more attention on the quality of sleep. The quality of sleep is associated with not only mental disorders, peptic ulcer, cardiovascular disease, the abuse of psychoactive substances, but also the increasing risk of death and accident. The period of senior high school is a critical time to the psychosomatic development. As a special group, senior high school students undertake much pressure in many aspects, such as the pressure of study and life. It is urgent to solve the problem of sleep disorders of high school students. Meanwhile, the prevalence of depression and anxiety is high, so it is important to study the quality of sleep, depression and anxiety of senior high school students.Objective: To investigate current situation of the sleep quality, anxiety and depression in senior high school students, and to identify the deference between urban and rural senior high students on sleep quality, anxiety and depression, as well as their relevant factors.Methods: By cluster sampling, a total of 1407 students from one urban senior high school in Jinan and one rural senior high school in Qufu were investigated. The standardized rating scale of mental health included self-rating depression scale (SDS), self-rating anxiety scale (SAS), The Pittsburgh Sleep Quality Index (PSQI). The basic information and related factors were also recorded. All the data were inputted into the SPSS database and then analyzed. The analysis method included descriptive analysis, t-test, chi-square test, Pearson linear correlation analysis, Spearman rank correlation analysis and multiple stepwise regression analysis.Results: A total 1383 senor high students completed the investigation. Among them 685 (49.5%) students were from the urban high school, and 698 (50.5%) from rural high school.The detection rate of sleep disorders in high school students was 14.61% in total, and 14.01% in urban students and 15.19% in rural students respectively; The total score of PSQI was 4.21±3.02, and the urban students 3.87±3.12 and the rural students 4.55±2.89, with a significant deference between the two area students (P<0.001). The minimum of actual sleep time was 4.15 hours, and the maximum was 8.26 hours, with an average of 7.41±0.71 hours in total, 7.34±1.56 hours of urban students, and 7.47±0.93 hours of rural students.The overall detection rate of anxiety was 20.31%, and the urban and rural areas were 27.30% and 13.47% respectively. The rate was significantly higher in cities than in rural areas (P <0.001). The total standard score of anxiety was 42.33±9.37, and the cities 43.81±10.10, and the rural areas 40.86±8.35. The score was higher in cities than in rural areas, and the difference was significant (P <0.001).The overall detection rate of depression was 37.02%, and the urban and rural areas were 42.77% and 31.38% respectively. The rate was higher in urban than in rural, and the difference was significant (P <0.001). The total standard scores of depression was 46.34±11.17, and the cities 47.86±12.06 and the rural areas 44.88±10.03. The score was higher in cities than in rural areas, and the difference was significant (P <0.001).The family factors to effect sleep quality, anxiety or depression of senor high students were parental health condition, father-child relationship, mother-child relationship, parental relations, consistency style of upbringing, family learning environment and atmosphere around the family, et al (p <0.05 or p <0.01). The main factors for rural students were father health condition, parental relationship, family learning environment and atmosphere around the family (<0.05 or p <0.01), and the main factors for urban students were parental health condition, parental relations, consistency upbringing, atmosphere around the family, father-son relationship and mother-child relationship (p <0.05 or p<0.01).Health condition, personality characteristics, academic record, physical training, self-confidence and willpower, et al influenced the sleep quality, anxiety and depression of senior high school students (p <0.05 or p <0.01). The main elements for students in rural areas were health condition, academic record, sports training, adaptive capacity, self-confidence and willpower (p <0.05 or p <0.01); for rural students, health condition, academic record and self-confidence (p <0.05 or p<0.01).The school factors to effect sleep quality, anxiety and depression of high school students were learning burden, classmate relationship, assignment performance and school environment, et al.(p <0.05 or p <0.01). For students from rural area were learning burden, assignment performance, learning time, classmate relationship, teacher-student relationship and school environment (p <0.05 or p <0.01); and for students from urban area were assignment performance, school climate, study plan and learning burden (p <0.05 or p <0.01). Conclusion:1. The detection rates of sleep disorder, anxiety and depression are high in senior high students. The detection rate of sleep disorder is higher in rural students than in urban students; however anxiety and depression are on the contrary.2. The factors to effect sleep quality, anxiety and depression include family factors, personal oneself factors and school-related factors, such as parental health condition, parent-child relationship, family learning environment, personality characteristics, individual health condition, self-confidence, learning burden, classmate relationship, assignment performance and school environment, et al. The influence factors have some different between the urban and rural students... |
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