อิทธิพลของความเครียด ความปวด และกิจกรรมการพยาบาลต่อคุณภาพการนอนหลับในผู้ป่วยเด็กโรคมะเร็งที่ได้รับเคมีบำบัด

Abstract

The purpose of this descriptive study was to investigate the predictive power of stress, pain, and nursing care activities on sleep quality in children with cancer receiving chemotherapy. Seventy-three children with cancer aged 8-15 years were purposively selected during their admission for chemotherapy in 2 tertiary hospitals in Songkhla and Suratthani provinces. Data were obtained using 1) the General data questionnaire 2) the Childhood Cancer Stressor Inventory (CCSI) 3) the Numeric Pain Rating Scale 4) the Nursing Care Activities Recording Form, and 5) the Children's Sleep Habits Questionnaire (CSHQ). The internal consistency reliability of the CCSI part I was tested using Kuder Richardson 20, and that of part II and total score using Cronbach's alpha coefficient. The reliabilities were .80, 71, and .84, respectively. The reliabilities of the Numeric Pain Rating Scale, and the CSHQ were tested using test-retest stability, and the Nursing Care Activities Recording Form using interrater reliability. The reliabilities were 1, .98, and 95, respectively. Descriptive statistics, Pearson's product moment correlation and stepwise multiple linear regression were used to analyze the data. The findings revealed that: 1. Stress, pain, and nursing care activities were significantly moderately negatively correlated with sleep quality (r=-45, p < .001, r = -31, p < .01, and r = -.62, p < .001, respectively) 2. Stress, pain, and nursing care activities could explain 53 percent of the variance in sleep quality (R = .53, F(3,69)=25.91, p < .001). Nursing care activities had the greatest influence on sleep quality followed by stress and pain (B = -51, p < .001, B = -30, p < .01, and ẞ = -23, p < .01, respectively) The results indicate that stress, pain, and nursing care activities can predict sleep quality. Nurses should have strategies to provide nursing care to reduce these factors, in turn enhancing the sleep quality of children with cancer receiving chemotherapy.