合肥市医学院校护生睡眠质量与焦虑抑郁共病症状的关联

牛雅倩; 陶舒曼; 杨娅娟; 邹立巍; 李婷婷; 谢阳; 张丹; 翟爽; 曲杨; 陶芳标; 伍晓艳

doi:10.16835/j.cnki.1000-9817.2023.08.015

合肥市医学院校护生睡眠质量与焦虑抑郁共病症状的关联

doi: 10.16835/j.cnki.1000-9817.2023.08.015

牛雅倩¹,
陶舒曼²,
杨娅娟¹,
邹立巍²,
李婷婷³,
谢阳³,
张丹³,
翟爽³,
曲杨³,
陶芳标^{2, 3},
伍晓艳^{2, 3, ,}

1.
安徽医科大学护理学院, 合肥 230601
2.
出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室
3.
安徽医科大学公共卫生学院儿少卫生与妇幼保健学系

基金项目:

国家自然科学基金项目 82173542

安徽医科大学科研水平提升计划资助项目 2022xkjT004

详细信息

作者简介:
牛雅倩(1997-), 女, 河南商丘人, 在读硕士, 主要研究方向为轮班护士健康

通讯作者:
伍晓艳, E-mail: xywuahmu@126.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G444 G478 R193
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- 被引次数: 0
出版历程
- 收稿日期: 2023-05-19
- 修回日期: 2023-06-18
- 网络出版日期: 2023-08-26
- 刊出日期: 2023-08-25

Association between sleep quality and anxiety-depression co-morbid symptoms among nursing students of medical college in Hefei City

1.
School of Nursing, Anhui Medical University, Hefei (230032), China

摘要

摘要: 目的了解护生睡眠质量及焦虑抑郁共病症状的流行现状及关联, 为促进护生心理健康提供科学依据。方法于2019年1月, 在安徽省合肥市3所医科院校中采用整群随机抽样的方法选取护理专业1 716名学生进行基线调查, 于2019年10月对抽样人群进行随访调查, 与基线匹配后有效人数为1 573人。采用抑郁-焦虑-压力量表(DASS-21)评估护生的焦虑抑郁共病症状, 采用匹兹堡睡眠质量指数量表(PSQI)评估护生睡眠质量。结果护生在基线和随访中焦虑抑郁共病检出率分别为16.9%和18.2%, 睡眠质量差的检出率分别为10.1%和10.3%。二元Logistic回归分析结果显示, 基线的睡眠质量得分与基线焦虑抑郁共病症状检出率(OR=1.49, 95%CI=1.40~1.59)及随访焦虑抑郁共病症状检出率(OR=1.22, 95%CI=1.16~1.28)呈正相关, 进一步分析发现, 基线睡眠质量对焦虑抑郁共病症状检出风险的影响主要集中在入睡时间、睡眠效率、睡眠障碍、催眠药物及日间功能障碍维度, 且入睡时间、睡眠障碍及日间功能障碍在随访调查中仍存在这种影响(P值均 < 0.05)。结论护生睡眠质量差可增加焦虑抑郁共病症状的发生风险, 改善护生睡眠质量对促进心理健康有积极作用。
- 睡眠 /
- 焦虑 /
- 抑郁 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To describe the prevalence and association of sleep quality and anxiety-depression co-morbid symptoms among nursing students, in order to provide a reference basis for promoting the development of nursing students' mental health. Methods Using a prospective study design, baseline survey was conducted in January 2019 among a random cluster sample of 1 716 individuals in three medical universities in Hefei, Anhui Province, and a follow-up survey was conducted in October 2019, with a valid number of 1 573 individuals after matching with the baseline survey. The Pittsburgh Sleep Quality Index (PSQI) was used to assess nursing students' sleep quality, and the Depression-Anxiety-Stress Scale (DASS-21) to assess the anxiety-depression co-morbid symptoms. Results The detection rates of anxiety-depression co-morbidities among nursing students at baseline and follow-up survey were 16.9% and 18.2%, respectively, and the detection rates of poor sleep quality among nursing students at baseline and follow-up survey were 10.1% and 10.3%, respectively. The results of the binary Logistic regression model showed that baseline PSQI score were positively associated with the risk of anxiety-depression co-morbid symptoms among nursing students at baseline (OR=1.49, 95%CI=1.40-1.59) and after nine months of follow-up (OR=1.22, 95%CI=1.16-1.28). Furthermore, the influence of baseline sleep quality on the risk of anxiety-depression co-morbid symptoms were mainly concentrated in the five dimensions of sleep time, sleep efficiency, sleep disorders, hypnotic drugs and daytime dysfunction, and such effects of sleep time, sleep disorders and daytime dysfunction still existed in the follow-up investigation. Conclusion Poor sleep quality of nursing students can increase the risk of anxiety-depression co-morbidities. Improving sleep quality of nursing students has a positive effect on improving their mental health.
- Sleep /
- Anxiety /
- Depression /
- Mental health /
- Regression anlaysis /
- Studnets
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 基线不同人口统计学特征护生焦虑抑郁共病症状检出率比较

Table 1. Anxiety-depression co-morbidity sysptoms rates among nursing students with different demographic characteristics at baseline

人口统计学指标	人数	焦虑抑郁共病症状	χ²值	P值
性别
男	255	53(20.8)	3.25	0.07
女	1 318	213(16.2)
家庭居住地
农村	981	173(17.6)	3.09	0.21
城镇	373	65(17.4)
市区	219	28(12.8)
独生子女
是	379	63(16.6)	0.03	0.86
否	1 194	203(17.0)
父亲文化程度
小学及以下	387	64(16.5)	0.06	0.97
初中	749	128(17.1)
高中及以上	437	74(16.9)
母亲文化程度
小学及以下	759	137(18.1)	1.36	0.51
初中	515	82(15.9)
高中及以上	299	47(15.7)
家庭经济条件
差	393	89(22.6)	15.44	＜0.01
中	1 102	171(15.5)
好	78	6(7.7)
学习负担
重	610	131(21.5)	14.89	＜0.01
一般	945	133(14.1)
轻	18	2(11.1)
健康状况
好	960	120(12.5)	50.98	＜0.01
一般	567	125(22.0)
差	46	21(45.7)
吸烟
否	1 504	247(16.4)	5.80	0.02
是	69	19(27.5)
饮酒
否	1 289	196(15.2)	14.77	＜0.01
是	284	70(24.6)
睡眠质量
好	1 414	182(12.9)	162.42	＜0.01
差	159	84(52.8)
注：()内数据为检出率/%。

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表 2 基线护生睡眠质量与基线焦虑抑郁共病症状的关联(n=1 573)

Table 2. Association of sleep quality and baseline anxiety-depression co-morbidity sysptoms among baseline nursing students(n=1 573)

自变量	模型1		模型2
自变量	OR值(95%CI)	P值	OR值(95%CI)	P值
PSQI总分	1.53(1.44~1.63)	＜0.01	1.49(1.40~1.59)	＜0.01
睡眠质量	1.30(1.00~1.70)	0.05	1.21(0.92~1.59)	0.18
入睡时间	1.29(1.07~1.56)	0.01	1.32(1.09~1.61)	0.01
睡眠时间	1.12(0.91~1.36)	0.29	1.06(0.86~1.30)	0.58
睡眠效率	1.38(1.16~1.64)	＜0.01	1.36(1.14~1.64)	＜0.01
睡眠障碍	3.85(2.72~5.45)	＜0.01	3.74(2.62~5.34)	＜0.01
催眠药物	2.22(1.39~3.54)	＜0.01	2.21(1.36~3.60)	0.01
日间功能障碍	2.42(1.82~3.21)	＜0.01	2.28(1.70~3.05)	＜0.01
注：模型1为未调整协变量的结果，模型2为调整了家庭经济条件、学习负担、健康状况、吸烟及饮酒等协变量后的结果。

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表 3 基线护生睡眠质量与随访焦虑抑郁共病症状的关联(n=1 573)

Table 3. Association of sleep quality and follow-up anxiety-depression co-morbidity sysptoms among baseline nursing students(n=1 573)

自变量	模型1		模型2
自变量	OR值(95%CI)	P值	OR值(95%CI)	P值
PSQI总分	1.24(1.18~1.31)	＜0.01	1.22(1.16~1.28)	＜0.01
睡眠质量	1.10(0.87~1.39)	0.45	1.06(0.83~1.35)	0.64
入睡时间	1.20(1.01~1.42)	0.04	1.22(1.02~1.45)	0.03
睡眠时间	1.08(0.90~1.29)	0.41	1.04(0.87~1.25)	0.66
睡眠效率	1.71(1.00~1.38)	0.06	1.16(0.98~1.37)	0.08
睡眠障碍	1.70(1.28~2.25)	＜0.01	1.61(1.21~2.15)	＜0.01
催眠药物	1.35(0.92~1.98)	0.12	1.30(0.88~1.90)	0.19
日间功能障碍	1.51(1.19~1.92)	＜0.01	1.46(1.14~1.86)	＜0.01
注：模型1为未调整协变量的结果，模型2为调整了家庭经济条件、学习负担、健康状况、吸烟及饮酒等协变量后的结果。

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