Analysis Of Sleep Quality And Influencing Factors Of Elderly Pregnant Women Based On Symptom Management Theory

Objective:Based on the theory of symptom management,we investigated the current situation of sleep quality of the elderly pregnant women,analyzed the factors that may affect the sleep quality of the elderly pregnant women,and determined the mediating effect of depression between fatigue and sleep quality.Objective to provide effective guidance for improving sleep quality and ensuring physical and mental health of the elderly pregnant women.Methods:The elderly pregnant women who met the inclusion and exclusion criteria and returned to hospital for reexamination 42 days after delivery from December 2019 to October 2020 were selected as the survey objects.Objective to investigate the sleep quality of the elderly pregnant women based on symptom management theory.The research tools used in this study include general demographic data,Pittsburgh sleep quality index,Edinburgh Postpartum Depression Scale,self rating anxiety scale,social support rating scale and fatigue scale.SPSS 23.0 statistical software was used for descriptive statistical analysis,one-way ANOVA,independent sample t-test,Pearson correlation,multiple linear stepwise regression,and process plug-in was used to calculate 95%confidence interval of mediating effect.Results:1.General demographic data of elderly pregnant womenA total of 212 subjects were investigated in this study.The average age of the elderly parturient women was 36.8 years ± 1.63。In terms of educational level,106 students(50%)from high school to junior college accounted for the highest proportion.In terms of family per capita monthly income,179(84.4%)families with more than 3500 yuan accounted for the highest proportion.Most of them lived in cities and towns,170(80.2%).In terms of occupation,86 employees(40.6%)accounted for the largest proportion.In terms of vacation methods,the proportion of paid vacation is higher than that of unpaid vacation.In terms of medical payment,medical insurance accounts for the highest proportion.The proportion of multipara is higher than that of primipara.The proportion of singleton was the highest.In the mode of delivery,cesarean section accounted for the highest proportion(65.1%).In terms of feeding methods,the proportion of pure breast-feeding is higher than other feeding methods.The proportion of non drinkers and smokers was 99.1%and 98.6%respectively.2.Univariate analysis of sleep quality of elderly pregnant womenThe total score of PSQI was 8.87±3.52。The total score of sleep was higher in families with monthly income less than 2000(F=14.013,P<0.001).The total sleep score of unpaid leave was higher than that of paid leave(t=-3.024,P=0.02).The total sleep score of self funded patients was higher than that of those with medical insurance(t=-3.59,P<0.001).The total sleep score of cesarean section was higher than that of natural delivery(F=5.917,P=0.003).The total sleep score of dairy feeding was the highest(F=7.314,P=0.001).Pearson correlation analysis showed that the total score of sleep was positively correlated with depression,anxiety and fatigue(r=0.651,P<0.001);r=0.669,P<0.001;r=0.575,P<0.001),suggesting that the more serious depression,anxiety,fatigue,the higher the total score of sleep,the worse the sleep quality.There was a negative correlation between the total score of sleep and the level of social support(r=-0.349,P<0.001).3.The results of multivariate analysis of sleep quality in elderly pregnant womenThe higher the per capita household monthly income,the lower the total sleep score and the better the sleep quality.Cesarean section was positively correlated with total sleep score.There was a positive correlation between depression score and sleep score,and a positive correlation between anxiety score and sleep score.It suggested that the more serious anxiety and depression,the higher sleep score and the worse sleep quality.Fatigue is positively correlated with the total sleep score.The more serious the fatigue is,the worse the sleep quality is.55.3%of the variance of sleep quality was explained by five variables R2=0.553。4.Mediating effect of depression on fatigue and sleep quality in elderly womenThe results of process plug-in analysis showed that the proportion of mediating effect:indirect effect/total effect(%)=0.3302/0.6335=52.1%.The indirect effect of depression on fatigue and sleep quality was 0.3302,and its contribution rate was 52.1%.The 95%confidence interval was(0.2204-0.4544).Conclusion:1.Poor sleep quality is common in elderly women,and it needs to be improved,which suggests that clinical medical workers should pay attention to the sleep problems of elderly women.2.Anxiety,depression,fatigue,family per capita monthly income and mode of delivery are the influencing factors of sleep quality of elderly pregnant women.It suggests that clinical medical workers should pay attention to the influencing factors of sleep quality of elderly pregnant women and intervene in time,so as to improve the sleep quality of elderly pregnant women.3.There is a mediating role between fatigue and sleep quality in the depression level of the elderly pregnant women.In the sleep quality of the elderly pregnant women,we should not only pay attention to the direct impact of fatigue on sleep quality,but also pay attention to the impact of fatigue on depression level,and improve the sleep problems of the elderly pregnant women through scientific and effective intervention measures.