ประสบการณ์อาการนอนไม่หลับ วิธีการจัดการอาการ และคุณภาพการนอนหลับในผู้ป่วยโรคไตเรื้อรังระยะสุดท้ายที่ได้รับการล้างไตทางช่องท้องแบบต่อเนื่อง

Abstract

The purposes of the study were to examine insomnia experiences, symptom management strategies and quality of sleep in end stage renal disease (ESRD) patients undergoing continuous ambulatory peritoneal dialysis (CAPD), and to analyze the relationship between insomnia experiences and quality of sleep. Purposive sampling was used to recruit 100 participants in a dialysis unit. Data were collected using (1) Demographic Characteristics (2) Laboratory Tests (3) Insomnia Severity Index (ISI) (4) Response to Insomnia Symptoms (RIS) (5) Insomnia Management Strategies (IMS) and (6) Pittsburgh Sleep Quality Index (PSQI). Content validity of all measurements was examined by 3 experts. Cronbach's alpha coefficient of ISI, RIS, IMS and PSQI were 85, 74, 73 and 72, respectively. The data were statistically analyzed according to frequency, percentage, mean, standard deviation and Pearson's correlation coefficient. The results revealed that participants were aged between 23 and 80 years (M = 55.11, SD = 12.50). Sixty-seven percent of participants were female. Total insomnia experience was at a moderate level (M = 20.04, SD = 4.01). The perceptions of insomnia most frequently found in the participants were difficulty falling asleep (100%), difficulty staying asleep (100%) and waking up too early (98%). The most commonly used management strategies of each component were as follows: (1) sleep when sleepy (100%), which they perceived as mild level efficacy (75%) (2) sleeping in the bedroom without noise (95%), which they perceived as mild level efficacy (68.42%) and (3) using hypnotic/anxiolytic medications (36%), which they perceived as most level efficacy (66.67%). One hundred participants had poor sleep quality and overall of quality of sleep showed a poor level (M = 1451, SD = 3.36) In addition, the results showed that insomnia experience was significant positively correlated with quality of sleep (r = .64, p < .01). The results of this study provide evidence to help nurses and health care providers assess insomnia symptoms, manage insomnia, and promote quality of sleep in ESRD patients undergoing CAPD.