研究生: |
曾齡慧 |
---|---|
論文名稱: |
社區老人睡眠品質.失眠類型與求助方式之探討-以台北市基督長老教會松年大學為例 |
指導教授: | 姜逸群 |
學位類別: |
碩士 Master |
系所名稱: |
健康促進與衛生教育學系 Department of Health Promotion and Health Education |
論文出版年: | 2002 |
畢業學年度: | 89 |
語文別: | 中文 |
論文頁數: | 163 |
中文關鍵詞: | 睡眠品質 、失眠類型 、求助方式 |
論文種類: | 學術論文 |
相關次數: | 點閱:207 下載:57 |
分享至: |
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
摘 要本研究之主要目的在於瞭解老人的睡眠品質現況,並探討睡眠品質與個人背景因素之關係,以及比較不同失眠類型患者之睡眠品質與求助方式的差異。研究是以台北市基督長老教會所屬的松年大學五十五歲以上全體學員為母群體,採立意取樣,主要利用自填問卷方式進行資料收集,若自覺填答困難者則採面對面訪談以進行收集資料。於90年9月4日進行調查,有效問卷為219份,佔回收的93.6﹪。其重要研究結果歸納如下:一、 睡眠品質不良者(PSQI≧5分)超過七成以上(72.6﹪)而屬於具有良好睡眠品質者(PSQI≦5)僅占將近三成(27.4﹪);整體睡眠品質得分之平均值為7.03分,顯示多數的受訪對象其睡眠品質是屬於「不佳」的情況。其中以「入睡潛伏期過長」是為受訪對象最普遍的睡眠困擾。而使用助眠藥物以幫助睡眠的受訪對象佔三成以上(32.4﹪),研究對象使用處方或非處方安眠藥物的情形相當普遍。二、 不同「年齡」、「規律運動」、「婚姻狀況」以及「居住狀況」之研究對象在睡眠品質上無顯著差異。而「睡眠衛生習慣愈差」、「女性」、「罹患慢性疾病總數愈多」以及「社經地位愈低」之研究對象,其睡眠品質愈差,對於睡眠品質之解釋力為37.4﹪。三、 罹患失眠症之受訪對象約佔三成以上(33.3﹪),以「暫時性失眠症」佔多數(16.9﹪)。睡眠品質之「使用助眠藥物」、「白天功能失常」以及「睡眠品質得分」等部份,「短期失眠症患者」與「慢性失眠症患者」比「暫時失眠症患者」的表現差。四、失眠症患者在經歷睡眠困擾時所採取的求助方式,以採取自我協助方式(98.6﹪)為主,其次為專業方式(61.6﹪),而民俗方式則無人採用。而不同失眠類型研究對象在「自我協助」與「專業方式」之求助方式未有顯著差異。 根據研究結果,提出重視老人的睡眠問題,成立專屬的睡眠問題諮詢管道、針對高危險群提供合適的睡眠衛生教育與相關課程、對於不同失眠類型患者給予適切睡眠衛生教育,以及提供失眠藥物方面之藥物教育等建議,以作為未來老人睡眠衛生教育之參考。 The sleep quality, types of insomnia and help-seeking methods of the elder in senior college of Taipei Presbyterian church A Master Thesis by Lin-Hui Tseng Abstract The main purpose of this study was to investigate the current sleep quality of the elderly, to explore its relationship with demorgraphic characteristics, and to compare the differences on sleep quality and help-seeking methods among different types of insomniacs. The purposive sampling was designed. The data were collected from 234 individuals in senior colleges of Taipei Presbyterian church by self-administrated or interview on September 2000. The following conclusions were drawn from the study.(1) There were 72.6﹪of subjects classified the poor sleepers(PSQI≧5分), and 27.4﹪of subjects classified the good sleepers(PSQI≦5).The average PSQI global score of total subjects was 7.03. The result indicated that sleep quality of most subjects was not good. The most serious problem is the increasing of sleep latency makes hard to sleep. And there were 32.4﹪of subjects used sleeping medications. The finding indicated that the phenomena of subjects’ using prescribed or non-prescribed medications was common.(2) The subjects in the different age, regular exercise, marriage and living conditions were not significantly correlated to their sleep quality. While the worse level of sleep hygiene, female, the more number of chronic diseases and the lower socioeconomic status the subjects were, the worse sleep quality they showed. The sleep hygiene, sex, the number of chronic diseases and the socioeconomic status could explain 37.4﹪variation of sleep quality.(3) Above thirty percentage of subjects(33.3﹪) was insomniac. Most insomniacs were classified short-term insomniacs.(16.9﹪). There were significant differences of using sleeping-medications, daytime dysfunction and the PSQI global score among chronic insomniacs, short-term insomniacs and transient insomniacs.(4) Most insomniacs(98.6﹪) used self-care methods to improve their sleep quality. And no one would use folk methods to do so. There were no significant differences of self-care methods and folk methods among chronic insomniacs, short-term insomniacs and transient insomniacs. Based on the main results of this research, the researcher proposed several suggestions and expected that these suggestions would be useful to sleep health education of the elderly.
The sleep quality, types of insomnia and help-seeking methods of the elder in
senior college of Taipei Presbyterian church
A Master Thesis
by
Lin-Hui Tseng
Abstract
The main purpose of this study was to investigate the current sleep quality of
the elderly, to explore its relationship with demorgraphic characteristics,
and to compare the differences on sleep quality and help-seeking methods
among different types of insomniacs. The purposive sampling was designed. The
data were collected from 234 individuals in senior colleges of Taipei
Presbyterian church by self-administrated or interview on September 2000. The
following conclusions were drawn from the study.
(1) There were 72.6﹪of subjects classified the poor sleepers(PSQI≧5分),
and 27.4﹪of subjects classified the good sleepers(PSQI≦5).The average PSQI
global score of total subjects was 7.03. The result indicated that sleep
quality of most subjects was not good. The most serious problem is the
increasing of sleep latency makes hard to sleep. And there were 32.4﹪of
subjects used sleeping medications. The finding indicated that the phenomena
of subjects’ using prescribed or non-prescribed medications was common.
(2) The subjects in the different age, regular exercise, marriage and living
conditions were not significantly correlated to their sleep quality. While the
worse level of sleep hygiene, female, the more number of chronic diseases and
the lower socioeconomic status the subjects were, the worse sleep quality they
showed. The sleep hygiene, sex, the number of chronic diseases and the
socioeconomic status could explain 37.4﹪variation of sleep quality.
(3) Above thirty percentage of subjects(33.3﹪) was insomniac. Most
insomniacs were classified short-term insomniacs.(16.9﹪). There were
significant differences of using sleeping-medications, daytime dysfunction and
the PSQI global score among chronic insomniacs, short-term insomniacs and
transient insomniacs.
(4) Most insomniacs(98.6﹪) used self-care methods to improve their sleep
quality. And no one would use folk methods to do so. There were no significant
differences of self-care methods and folk methods among chronic insomniacs,
short-term insomniacs and transient insomniacs.
Based on the main results of this research, the researcher proposed several
suggestions and expected that these suggestions would be useful to sleep
health education of the elderly.
中文部份
APA(1994)著;孔繁錦、孔繁鐘編譯﹙民85﹚:DSM-Ⅳ精神疾病診斷準則手冊。台
北:合記。
方進隆(民80):老人的運動處方。健康教育,67:17-20。
王森德、李世代﹙民88﹚:老年人的睡眠障礙。基層醫學,14﹙4﹚:74—76。
行政院衛生署(民83):國民保健執行計劃報告-健康體能促進。
朱嘉華、方進隆﹙民88﹚:運動與睡眠品質之探討。中華體育,11﹙2﹚:98—108。
江東亮、蘇春蘭﹙民79﹚:農民保險政策對農民醫療消費行為的影響。中華衛誌,10﹙2﹚
:79-88。
江東亮﹙民88﹚:醫療保健政策-台灣經驗。台北:巨流。
李柏之﹙民74﹚:大學生求助態度與求助行為及其相關變項。國立台灣大學心理學研究所
碩士論文。
李宇宙(民89):身心疾病之睡眠障礙。臺灣醫學,4(6):673-680。
邱思慈(民83):運動行為與老年健康。國民體育季刊,23(2):63-65。
邱獻章﹙民88﹚:失眠的診斷與治療。中化藥訊,41:4—7。
吳就君﹙民80﹚:台灣地區居民社會醫療行為研究。公共衛生,8﹙1﹚:25-49。
吳宏蘭(民82):某教學醫院參加健康檢查者之運動及攝鈉行為之探討。臺灣師範大學衛
生教育研究所碩士論文。
吳意玲﹙民82﹚:國中學生的困擾行為、因應策略與求助行為之研究。國立政治大學教育
學研究所碩士論文。
林嘉玲(民89):自費安養機構老人睡眠品質及其相關因素之探討。國立臺灣大學護理系
研究所碩士論文。
林信男(民89):睡眠障礙症之藥物治療。臺灣醫學,4(6):687-693。
戎瑾如、蕭淑貞(民83):老人健康功能評估問卷及量表之簡介。醫學繼續教育,4(1)
:86-92。
保版隆著、丹雲譯(1998):失眠症:擺脫失眠症之困擾。台北:益群。
夏一新、何瑞麟﹙民82﹚:老年人睡眠障礙﹙下﹚。醫學繼續教育,3﹙2﹚:260—267。
徐長庚、曾國華﹙民88﹚:失眠藥物治療的探討。中化藥訊,41:1—3。
陳榮華﹙民75﹚:行為改變技術。台北:五南。
黃昆輝(民67):我國大學入學考試報考者與錄取者社經背景比較分析。教育研究所,20
:321-322。
黃惠滿﹙民77﹚:家屬對精神病的確認及求助行為。國立台灣大學護理學研究所碩士論文
。
童淑琴(民80):工作場所健康促進計劃之實驗研究-以臺電總公司體適能計劃為例。臺
灣師範大學衛生教育研究所碩士論文。
陳美妃、王秀紅﹙民84﹚:老年婦女睡眠品質及其相關因素。護理研究,3﹙4﹚:323
—333。
陳仙子﹙民88﹚:社區成人健康教育需求與求助行為之相關研究。國立高雄師範大學成人
教育研究所碩士論文。
張小鳳﹙民78﹚:走過女性一生。台北:大眾。
Bourke,D.H.著;張美惠、葉翠雰&陳泰滄譯(民81):睡出時間來(原書名:睡眠管理手
冊)。台北:新自然主義。
張苙雲﹙民87a﹚:醫療與社會:醫療社會學的探索。台北:巨流。
張苙雲﹙民87b﹚:「逛醫師」的邏輯:求醫歷程的分析。台灣社會學刊,21:59-87。
楊文山﹙民81﹚:台灣地區民眾求醫行為之分析。榮總護理,9﹙2﹚:121-125。
楊遵聲﹙民82﹚:談「睡眠障礙」。醫院藥學,10:142—146。
楊慧玲(民83):雙極性情感性疾患對睡眠衛生與失眠症狀之主觀評估。國立台灣大學護
理學研究所碩士論文。
鄒秀菊﹙民82﹚:敬老院老人睡眠品質與健康狀況之探討。國防醫學院護理研究所碩士論
文。
Thorson, J.A.著(1995);潘英美譯(民88):老人與社會。臺北:五南。
劉珍芳(民85):大學新生睡眠品質與飲食因子之關係探討。國防醫學院公共衛生研究所
碩士論文。
蔡美月(民85):台北市某活動中心六十歲以上老人運動行為及其影響因素之研究。臺灣
師範大學衛生教育研究所碩士論文。
蔡春美、吳就君﹙民88﹚:藥癮患者求助行為之研究。公共衛生,26﹙2﹚:91-101。
鄭淑利、蔡欣玲&高淑芬﹙民86﹚:老人失眠之治療與護理。長庚護理,8﹙3﹚:66-71
。
蕭淑貞、鄧蓮修、楊麗敏(民82):睡前放鬆運動在急性精神科病房應用之探討。護理研
究,1(1):16-21。
簡錦標、廖倩誼&陳正誠﹙民83﹚:台北市某精神科醫院病人家屬的求醫行為與精神疾病
有關態度之研究。健康教育,73:44-54。
蘇東平(民89):睡眠障礙症之診斷分類及臨床評估。臺灣醫學,4(6):665-672。
英文部份
Adams, K.(1980):A time for rest and a time for play.Nursing Mirror,150
(1):17-18.
American Psychiatric Association(1987):Diagnostic and statistical
manual of mental disorder(3rd).APA.297-314.
Atchley, R.A.(1994):Social forces and aging(7th).(Chap 6)
.Belmont, CA:Wadsworth Pub.
Ancoli-Israel,S & Roth, T.﹙1999﹚:Characteristics of insomnia in the
United States:Results of the 1991 national sleep foundation survey.Ⅰ.Sleep
,22﹙Supple 2﹚:S347-S358.
Blair,S.N.(1984):How to assess exercise habits and physical fitness
.Behavioral health:a handbook of health enhancement and disease prevention
.NewYork,NY:John Wiley and Sons:424-477。
Buysee,D.J., Reynold,C.F., Monk,T.H.,Berman,S.R.&Kupfer,D.J.﹙1988﹚:The
Pittsburge Sleep Quality Index:A new instrument for psychiatric practice and
research.Psychiatric Research,28:193-213.
Buysee,D.J., Reynold,C.F., Monk,T.H., Hoch,C.C., Yeager,A.L., Kupfer, D.J.﹙
1991﹚:Quantification of subjective sleep quality in healthy elderly men and
women using the Pittsburgh Sleep Quality Index﹙PSQI﹚.Sleep ,14﹙4﹚:331-
338.
Becker,P.M.&Jamieson,A.O.﹙1992﹚:Common sleep disorders in the elder
:diagnosis and treatment.Geriatrics,47﹙3﹚:41-52.
Campell,S.S., Gillin,J.C.& Krip, D.F.﹙1986﹚:Ambulatory recording of rest /
activity .temperature and light exposure in normal elderly and Alzheimer’s
disease.Sleep Res,5:264.
Ellis,B.W., Johns,M.W., Lancaster,R., Raptopoulos,P., Angelopoulos, N.&
Priest, R.G.(1981): The St. Mary’s hospital sleep questionnaire:A study
of reliability.Sleep,4(1):93-97.
Engle-Frieman, M.& Bootzin, R.R.﹙1992﹚:An evaluation of behavior
treatments for insomnia in the older adults.Journal of Clinical Psychology,48
﹙1﹚:77-90.
Naylor, E., Penev, P.D., Orbeta, L.,Janssen, I., Ortiz, R., Colecchia, E.F.,
Keng, M., Finkel S.& Zee,P.C.(2000):Daily social and physical activity
increases slow-wave sleep and daytime neuropsychological performance in the
elderly.Sleep,23(1):87-95.
Foley, D.J., Monjan, A.A., Brown, S.L., Simonsick, E.M., Wallance, R.B.&
Blazer, D.G.﹙1995﹚:Sleep complaints among elderly persons:an
epidemiological study of three communities.Sleep,18﹙6﹚:425-432.
Foley, D.J., Monjan, A., Simonsick, E.M., Wallance, R.B.&Blazer, D.G.﹙1999﹚
:Incidence and remission of insomnia among elderly adults:an epidemiological
study of 6800 persons over three years.Sleep,22﹙supple 2﹚:S366-S372.
Gionet, N. J.& Godin, G.(1989):Self-reported exercise behavior of
employee:a validity study.Journal of Occupation Medicine,31(2):969-973。
Hilton, B.A.﹙1976﹚:Quantity and quality of patient’s sleep and sleep
disturbing facters on a respiratory intensive care unit.Journal of Advanced
Nursing,1﹙3﹚:453-468.
Hayter, J.(1985):To nap or not to nap.Geriatric Nursing,5(2):104-106.
Hoch, C.C., Reynolds, C.F., Kupfer, D.J. & Berman, S.R.﹙1988﹚:Stability of
EEG sleep and sleep quality in healthy seniors.Sleep ,11:521-527.
Hauri, P.& Linde, S.﹙1990﹚:No More Sleepless Nights.New York:Wiley.
Habte-Gabr, E.,Wallace,R.B.,Colsher,P.L.,Hulbert,J.R.,White,L.R.,&Smith,I.M.(
1999):Sleep patterns in rural elders:Demographic, health and
psychobehavioral correlates.Epidemiol,44(1) :5-13.
Johnson, J.E.(1988):Bedtime routines:Do they influence the sleep of
elderly women?The Journal of Applied Gerontology,7(1):97-110.
Johnson, J.E.(1991):A comparative study of the bedtime routines and sleep
of older adults.Journal of Community Health Nursing.8(3):129-136.
Jimenez, C.J., Perez, T.A., Prieto, F.S.& Navia-Osorio, P.M.(1989)
:Behavioral habits and affective disorders in old people.Journal of Advanced
Nursing,14:356-364.
Kleiman, A. ﹙1975﹚:Medicine and psychiatric anthropology and the study of
traditional forms of medicine in modern Chinese culture. Bulletin of the
Institute of Ethnology Academia Sincia,39:107-123.
Krieger N,W.(1997):Measuring social class in US public health research
:concepts.Methodologies and guidelines.Annual Reviews of Public Health,18
:341-378。
Lacks, P,.Bertelson, A.D., Gans, L.&Kunkel, J.(1983):The effectiveness of
three behavioral treatments for different degrees of sleep onset insomnia
.Behavior Therapy,14:593-605.
Lacks, P.& Robert, M.(1986):Knowledge and practice of sleep hygiene
techniques in insomniacs and good Sleepers.Behav. Res.Ther,24(3):365-358
.
Lacks, P.(1987):Behavioral treatment for persistent insomnia.Oxford
.Pergamon Press.
McGile, A.& Russel, S.M.(1962):The subjective assessment of normal sleep
patterns.Journal of Mental Science,108:642-654.
Morgan, K., Dallosso, H., Ebrahim, S., Arie, T.& Featen, D.H.﹙1988﹚
:Characteristics of subjective insomnia in the elderly living at home.Age
Aging,17:1-7.
Monk, T.H., Reynolds Ⅲ, C.F., Machen, M.A.,&Kupfer, D.J.﹙1992﹚:Daily
social rhythms in the elderly and their relation to objectively Recorded Sleep
.Sleep,15﹙4﹚:322-329.
Nau, S.D.&Walsh, J.K.(1983):Sleep hygiene of insomnia patients.Sleep Res
,12:268.
Nehlig, A., Daval, J.L.&Debry, G.(1992):Caffeine and the central nervous
system:mechanism of actions 、biochemical metabolic and psychostimulant
effects.Brain Res-Brain Res Rev,17:139-170.
National Center on Sleep Disorders Research﹙2000﹚.Insomnia:assessment and
management in primary care.Sleep,22﹙Supple 2﹚:S402-S408.
Nalor,E.,Penev,P.D., Orbeta,L., Jassen,I., Ortiz,R., Colecchia,E,F., Keng,M.,
Finkel,S., Zee,P.C.﹙2000﹚:Daily social and physical activity increases slow-
wave sleep and daytime neuropsychological performance in the elderly.Sleep,23
﹙1﹚:87—95.
Pressman, M.R. & Fry, J.M.﹙1988﹚:What is normal sleep in the elder?
Clinics in Geriatrics Medicine,4﹙1﹚:71-81.
Parrott, A.C. & Hindmarch, I(1978):Factor analysis of a sleep evaluation
questionnaire.Psychological Medicine,8:325-329。
Rogestein, Q.R.﹙1980﹚:Insomnia and sleep disturbances in the aged:sleep
and insomnia in the elderly.Journal of Geriatric Psychiatry,13:153-171.
Robert, A.﹙1990﹚:Systems of life – senior systems.Nursing Times,181﹙46﹚
:61-64.
Rosenthal, L.,Roehrs, T.,Zwyghuizen, D.A.,Plath, D.& Roth, T(1991)
:Alerting effects of caffeine after normal and restricted sleep
.Neuropsychopharmacology,4:103-108.
Roth, T.& Ancoli-Israel, S.﹙1999﹚:Daytime consequences and correlates of
insomnia in the United States:results of the 1991 national sleep foundation
survey.Ⅱ.Sleep ,22﹙Supple 2﹚:S354-S358.
Southwell, P.R.,Evans, C.R. & Hunts, J.N.(1972):Effects of a hot milk
drink on movement during sleep.British Medical Journal,2:429-431。
Schoicket, S L.,Bertelson, A.D.& Lacks, P.(1988):Short-term stimulus
control treatment for sleep maintenance insomnia?Behavior Therapy,19:183-
190.
Shaver,J.L.F., Giblin,E. & Paulsen,V.﹙1991﹚:Sleep quality subtypes in
midlife women.Sleep,14﹙1﹚:18—23.
Singh,N., Celement,K.M. & Fiatarone,M.A.﹙1997﹚: Sleep deprivation and
daytime activities:a randomized controlled trial of the effect of exercise on
sleep.Sleep,20﹙2﹚:95—101.
Simon, G.E.&Vonkorff,M.﹙1997﹚:Prevalence、burden and treatment of insomnia
in primary care.Am J Psychiatry,154:1417—1423.
Shochat,T., Umphress,J., Israel,A.G. & Ancoli-Israel,S.﹙1999﹚:Insomnia in
primary care patients.Sleep,22﹙Supple 2﹚:S359—S365.
Walsh, J.K.& Engelhardt, C.L.(1999):The directed economic costs of
insomnia in the United States for 1995.Sleep,22﹙Supple 2﹚:S386-393.
Wilcox,S.& King, A.C.﹙1999﹚:Sleep complaints in the older women who are
family caregivers.Journal of Gerontology:Psychological Sciences,54B﹙3﹚
:189-198.
Zung,W.W.K.&Zung,E.M.(1986):Use of the Zung Self-rating Depression Scale
in the elderly.Clinical Gerontology,5:137-148。
Zammit,G.K., Weiner,J., Sillup,G.P.& McMillan,C.A.﹙1999﹚:Quality of life
in people with insomnia.Sleep,22﹙Supple 2﹚:S379—S385.