| Objectives1.To investigate the sleep quality,negative emotion and coping style of maintenance hemodialysis patients with MHD.2.To explore the influencing factors of sleep quality,negative emotion and coping style in patients with MHD.3.To analyze the correlation among sleep quality,negative emotion and coping style in MHD patients.MethodsThis research was based on descriptive study by using questionnaire survey.From April to August 2017,a questionnaire survey was conducted among 200 MHD patients in the blood purification centers of ministerial,provincial,municipal and private hospitals in Changsha by stratified random cluster sampling.The questionnaires included self-designed general information questionnaire,Pittsburgh Sleep Quality Index(PSQI),Diagnostic criteria of restless legs for dialysis,Irritability,Depression and Anxiety(IDA),Medical Coping Modes Questionnaire(MCMQ).Data input and Statistical Analysis with SPSS18.0.T test,ANOVA and logistic regression analysis were used for measurement data,and chi-square test was used for counting data.Pearson correlation was used for statistical analysis.The significant level of statistical test was significantly higher than that of control group(P<0.05).Results1.The PSQI score of MHD patients was 8.97±4.11.The incidence of sleep disorder was 65%.PSQI total score and every dimension score are higher than the national norm(P<0.05).The sleep quality of person under 40 years old(7.04±3.96)was better than that of over 60 years old(9.63±4.43),by chi-square test X2 was 6.378,the difference was statistically significant(P<0.05).The sleep quality of the MHD patients who have work(7.27 ±4.50)was better than that of the non-workers(9.17±4.03,P<0.05),and the difference was significant by chi-square test(X2=4.15,p<0.05).The sleep quality of MHD patients without tea drinking(8.63±4.22)was better than that of tea drinkers(9.15±4.06),and the difference was statistically significant(P<0.05).The sleep quality of MHD patients with the shortest dialysis age was 9.37±4.47 and the longest was 9.53±3.57.There was significant difference in X2 was 8.160 by chi-square test(P<0.05).The sleep quality of MHD patients having Itch of skin within one month(9.44±3.81)was worse than that of non-occurrence Itch of skin patients(8.51±4.35).The difference is statistically significant(P<0.05)by chi-square test X2 was 8.711.The MHD patients with restless leg syndrome(10.25±3.60)had worse sleep quality than those without it(8.45±4.21),By chi-square test X2 is 8.639,the difference was statistically significant(P<0.05).2.The negative emotion score of MHD patients was 15.51±7.43.The incidence of depression was the highest(40.5%)in negative emotion,followed by anxiety(7.0%).The extroverted irritation score of MHD patients with age<40 years old(3.25±2.22)is higher than that of MHD patients>60 years old(2.48±2.06).Analysis of variance(ANOVA)showed significant difference(P<0.05).Compared with the total scores of depression,anxiety,introverted irritation,extroversion irritation and negative emotion,the F value of ANOVA is 2.723,4.168,2.758,5.000,5.697 respectively,the difference is significant(P<0.05).The highest scores(6.21±3.01 and 4.86±2.68)of depression and anxiety were the MHD patients with the shortest dialysis age,the F value of ANOVA was 3.829±3.420,the difference is statistically significant(P<0.05).The scores of depression in MHD patients who were not in work was 6.14±2.95 higher than those in workers(4.32±2.63),and the difference was statistically significant(P<0.05).The depression of MHD patients who slept in one person(7.04±3.01)and negative emotion(17.32±7.56)were significantly higher than those not slept in one person.T value of t test were 6.116,3.781,the difference was statistically significant(P<0.05).In MHD patients who did not use EPO,the scores of depression(7.2±3.10)and extroversion irritation(3.95±2.75)are higher than those of users,and T value were 2.139 and 0.075 respectively,and the difference was statistically significant(p<0.05).3.Patients with MHD have lower score in encounter(17.94±3.36)and avoidance(13.47±3.13)than those of the national norm while the surrender(11.60±3.63)score higher than the national norm,the T value were-6.481,-4.387,10.838 respectively,the difference was statistically significant(P<0.05).MHD patients with age under 40 years old in avoidance dimensions scores was the highest,Kruskal-Wallis by H test,H value was 9.537,the difference was statistically significant(P<0.05).4.There was a positive correlation between the total score of IDA and the total score of PSQI in patients with MHD.The correlation coefficient between IDA and PSQI was 0.311.The subjective sleep quality,sleep delay,sleep duration,sleep efficiency,sleep disorder,hypnotic drugs,daytime function and total PSQI score were all positively correlated with depression.The correlation coefficients of binary variables were 0.298,0.273,0.181,0.243,0.287,0.142,0.304,0.394 respectively.The subjective sleep quality,daytime function,sleep disorder and total score of PSQI were all positively correlated with anxiety,and the correlation coefficient of binary variables were 0.177,0.325,0.239,0.196 respectively.The correlation coefficient between avoidance and daytime function was 0.195,and the correlation coefficient between surrender and sleep disorder was 0.273.Depression was negatively correlated and positively correlated with the face and surrender respectively,and the correlation coefficients of binary variables were-0.254 and 0.35,respectively.And anxiety and avoidance were positively correlated,the correlation coefficients of binary variables was 0.154.The correlation coefficients of the above binary variables was statistically significant(P<0.05).Conclusions1.MHD patients had poor sleep quality,and 65%of MHD patients had sleep disorders.Age,working status,tea drinking,skin itching in the last month,dialysis age and the presence of restless leg syndrome were the main factors affecting sleep quality.2.Depression was the most common negative emotion in MHD patients.Depression was mainly effected by income level,dialysis age,working status,sleep habit,whether or not to use EPO.3.MHD patients were more likely to adopt the passive coping style of surrender and avoidance than normal people.4.There was a positive correlation between sleep disorder and negative emotion and negative coping in MHD patients,that was,the worse the sleep quality,the more likely MHD patients were to develop negative emotion and tend to choose negative coping style.There was a positive correlation between negative emotion and negative coping while a negative correlation between positive coping. |
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