基于保护动机理论的护理干预对轻中度阻塞性睡眠呼吸暂停综合征患者自我管理水平及睡眠质量的影响

doi:10.19983/j.issn.2096-8493.20260085

摘要/Abstract

摘要：

目的: 探讨在轻中度阻塞性睡眠呼吸暂停综合征(OSAS)患者中采取基于保护动机理论(PMT)的护理干预效果。方法: 采用随机数字表法将福建省宁德市医院2022年9月至2024年9月收治的98例轻中度OSAS患者分为对照组(49例,采取常规护理)和观察组(49例,采取基于PMT的护理干预),两组均持续护理14d(涵盖入院第1天至出院当天)。比较两组患者自我管理水平、睡眠质量、生活质量及客观睡眠参数。结果: 护理后观察组自我护理能力测定量表(ESCA)中自我护理技能、自我责任感、自我概念、健康知识水平评分分别为(30.94±3.22)分、(20.33±1.84)分、(25.87±1.92)分、(40.64±2.83)分,均高于对照组[(25.53±3.17)分、(15.96±1.78)分、(19.94±1.46)分、(28.94±2.71)分],差异均有统计学意义(t值分别为8.381、11.949、17.209、20.902,P值均<0.001);护理后,观察组匹兹堡睡眠质量指数量表(PSQI)中入睡时间、催眠药物、睡眠紊乱、睡眠效率、睡眠质量、睡眠时间、日间功能评分分别为(1.10±0.19)分、(1.09±0.12)分、(1.01±0.16)分、(1.02±0.16)分、(1.01±0.12)分、(1.11±0.13)分、(1.13±0.14)分,均低于对照组[(1.68±0.22)分、(1.53±0.15)分、(1.46±0.21)分、(1.44±0.18)分、(1.56±0.18)分、(1.60±0.14)分、(1.62±0.17)分],差异均有统计学意义(t值分别为13.967、16.034、11.932、12.208、17.797、17.953、15.575,P值均<0.001);与对照组相比,观察组护理后生存质量简表(QOL-BREF)中心理领域、生理领域、环境领域、社会关系领域等维度评分分别为(85.53±4.96)分、(82.29±4.18)分、(85.67±4.33)分、(84.94±4.55)分,均高于对照组[(79.94±4.27)分、(75.21±4.04)分、(78.98±4.25)分、(76.62±4.19)分],差异均有统计学意义(t值分别为5.979、8.525、7.719、9.416,P值均<0.001);观察组护理后呼吸暂停低通气指数(AHI)水平为(8.14±2.03)次/h,低于对照组的(12.45±2.41)次/h,最低血氧饱和度(LSaO₂)为(91.05±3.76),高于对照组的(86.33±3.54)%,差异均有统计学意义(t值分别为9.547、6.345,P值均<0.001)。结论: 基于PMT的护理干预可提升轻中度OSAS患者自我管理水平,促进患者睡眠质量有效改善,促进其生活质量提升。

关键词: 睡眠呼吸暂停, 阻塞性, 护理评价研究, 生活质量

Abstract:

Objective: To explore the intervention effect of nursing based on the Protection Motivation Theory (PMT) in patients with mild to moderate obstructive sleep apnea syndrome (OSAS). Methods: A total of 98 patients with mild to moderate OSAS admitted to Ningde Hospital of Fujian Province were enrolled from September 2022 to September 2024. They were divided into the control group (49 cases, receiving routine nursing) and the observation group (49 cases, receiving PMT-based nursing intervention) using the random number table method. Both groups received continuous nursing for 14 days (from the first day of admission to the day of discharge). The self-management level, sleep quality, quality of life and objective sleep parameters were compared between the two groups. Results: After nursing, the scores of self-care skills, self-responsibility, self-concept and health knowledge level in the Exercise of Self-Care Agency Scale (ESCA) of the observation group were (30.94±3.22), (20.33±1.84), (25.87±1.92) and (40.64±2.83) respectively, all higher than those of the control group ((25.53±3.17), (15.96±1.78), (19.94±1.46), (28.94±2.71)), with statistically significant differences (t=8.381, 11.949, 17.209, 20.902, all P<0.001). After nursing, the scores of sleep latency, hypnotic drug use, sleep disturbance, sleep efficiency, sleep quality, sleep duration and daytime dysfunction in the Pittsburgh Sleep Quality Index (PSQI) of the observation group were (1.10±0.19), (1.09±0.12), (1.01±0.16), (1.02±0.16), (1.01±0.12), (1.11±0.13) and (1.13±0.14) respectively, all lower than those of the control group ((1.68±0.22), (1.53±0.15), (1.46±0.21), (1.44±0.18), (1.56±0.18), (1.60±0.14), (1.62±0.17)), with statistically significant differences (t=13.967, 16.034, 11.932, 12.208, 17.797, 17.953, 15.575, all P<0.001). Compared with the control group, the observation group had higher scores in all domains of the Quality of Life-BREF (QOL-BREF) after nursing: psychological domain (85.53±4.96 vs. 79.94±4.27), physical domain (82.29±4.18 vs. 75.21±4.04), environmental domain (85.67±4.33 vs. 78.98±4.25), and social relationship domain (84.94±4.55 vs. 76.62±4.19), with statistically significant differences (t=5.979, 8.525, 7.719, 9.416, all P<0.001). After nursing, the apnea-hypopnea index (AHI) of the observation group was (8.14±2.03) events/h, which was lower than that of the control group ((12.45±2.41) events/h); the lowest oxygen saturation (LSaO₂) was (91.05±3.76) %, which was higher than that of the control group ((86.33±3.54) %). Both differences were statistically significant (t=9.547, 6.345, all P<0.001). Conclusion: PMT-based nursing intervention can improve the self-management level, sleep quality and quality of life of patients with mild to moderate OSAS.

Key words: Sleep apnea, obstructive, Nursing evaluation research, Quality of life

中图分类号:

R714.253

连钗兰, 李海燕. 基于保护动机理论的护理干预对轻中度阻塞性睡眠呼吸暂停综合征患者自我管理水平及睡眠质量的影响[J]. 结核与肺部疾病杂志,2026, 7(5): 624-629. doi: 10.19983/j.issn.2096-8493.20260085

Lian Chailan, Li Haiyan. The effect of a nursing intervention based on protection motivation theory on self-management levels and sleep quality in patients with mild to moderate obstructive sleep apnea syndrome[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(5): 624-629. doi: 10.19983/j.issn.2096-8493.20260085

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参考文献 15

[1]	田润琦, 段鹏, 苏峰, 等. 介入封堵术有效改善阻塞性睡眠呼吸暂停综合征合并卵圆孔未闭患者近期预后[J]. 川北医学院学报, 2024, 39(7):960-964. doi:10.3969/j.issn.1005-3697.2024.07.023.
[2]	王绪林, 张建文, 李平乐, 等. 改良鼻咽通气道用于阻塞性睡眠呼吸暂停综合征患者无痛胃镜检查的临床效果观察[J]. 中国内镜杂志, 2022, 28(10):11-16. doi:10.12235/E20210769.
[3]	卢镇章, 陶晶, 刘日钊, 等. 加速康复外科在阻塞性睡眠呼吸暂停综合征患者同期多平面手术围手术期的应用价值研究[J]. 中国耳鼻咽喉头颈外科, 2021, 28(5):305-309. doi:10.16066/j.1672-7002.2021.05.011.
[4]	吕秀芹, 彭霞, 王宁宁, 等. 保护动机理论护理干预对改善PE患者自护能力、母婴结局的效果[J]. 中国计划生育学杂志, 2025, 33(11):2555-2560. doi:10.3969/j.issn.1004-8189.2025.11.029.
[5]	中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 成人阻塞性睡眠呼吸暂停基层诊疗指南(实践版·2018)[J]. 中华全科医师杂志, 2019, 18(1):30-35. doi:10.3760/cma.j.issn.1671-7368.2019.01.008.
[6]	刘延锦, 余溯源, 郭丽娜, 等. 汉化修正版自我护理能力评估量表用于成年人群中的信效度研究[J]. 重庆医学, 2018, 47(33):4266-4269. doi:10.3969/j.issn.1671-8348.2018.33.017.
[7]	刘志喜, 石倩萍, 杨洪霞, 等. 匹兹堡睡眠质量指数量表在护理人群中的信效度评价[J]. 汕头大学医学院学报, 2020, 33(3):173-176. doi:10.13401/j.cnki.jsumc.2020.03.011.
[8]	徐迪, 端琼丽, 潘玲, 等. WHOQOL-BREF用于评价HIV感染者生活质量的信、效度研究[J]. 中华疾病控制杂志, 2022, 26(5):576-582. doi:10.16462/j.cnki.zhjbkz.2022.05.015.
[9]	赵醇, 戴玲丽, 冯慧, 等. 有氧联合抗阻运动对阻塞性睡眠呼吸暂停综合征患者心率及运动能力的影响[J]. 中华物理医学与康复杂志, 2021, 43(8):724-728. doi:10.3760/cma.j.issn.0254-1424.2021.08.013.
[10]	张曙光, 李静. 基于保护动机理论的护理干预对轻中度阻塞性睡眠呼吸暂停综合征患者的影响[J]. 国际护理学杂志, 2022, 41(4):743-747. doi:10.3760/cma.j.cn221370-20200705-00193.
[11]	蒋新艳, 孟海兵, 邓飞娜, 等. 多元化环境干预对学龄前阻塞性睡眠呼吸暂停综合征患儿术前焦虑及麻醉诱导依从性的影响[J]. 护理学报, 2023, 30(20):68-72. doi:10.16460/j.issn.1008-9969.2023.20.068.
[12]	赵婷, 路康, 张艳艳, 等. 健脾益气化瘀方联合鼻腔冲洗治疗阻塞性睡眠呼吸暂停综合征疗效及对炎性因子的影响[J]. 现代中西医结合杂志, 2024, 33(11):1545-1549. doi:10.3969/j.issn.1008-8849.2024.11.015.
[13]	Huang Z, Huang D, Liu F, et al. Modified oropharyngeal muscle training and scientific vocalization are effective in treating mild-to-moderate obstructive sleep apnea hypoventilation syndrome in adults[J]. Acta Otolaryngol, 2023, 143(11-12):989-995. doi:10.1080/00016489.2023.2288283.
[14]	王海燕, 朱亚珍, 潘友让, 等. 治疗性沟通联合常规护理对阻塞性睡眠呼吸暂停综合征患者睡眠质量和心理状况的影响[J]. 中华全科医学, 2023, 21(12):2160-2164. doi:10.16766/j.cnki.issn.1674-4152.003313.
[15]	曹霞, 周小丽, 薛明月, 等. 基于智能手环的呼吸功能训练对阻塞性睡眠呼吸暂停综合征患者的影响研究[J]. 实用心脑肺血管病杂志, 2023, 31(8):119-123,127. doi:10.12114/j.issn.1008-5971.2023.00.121.

组别	自我护理技能		自我责任感		自我概念		健康知识水平
组别	护理前	护理后	护理前	护理后	护理前	护理后	护理前	护理后
对照组(49例)	18.86±2.24	25.53±3.17^a	10.61±1.33	15.96±1.78^a	15.73±1.27	19.94±1.46^a	22.85±2.13	28.94±2.71^a
观察组(49例)	18.89±2.27	30.94±3.22^a	10.65±1.42	20.33±1.84^a	15.79±1.33	25.87±1.92^a	22.89±2.16	40.64±2.83^a
t值	0.066	8.381	0.144	11.949	0.228	17.209	0.092	20.902
P值	0.948	<0.001	0.886	<0.001	0.820	<0.001	0.927	<0.001

组别	入睡时间		催眠药物		睡眠紊乱		睡眠效率		睡眠质量		睡眠时间		日间功能
组别	护理前	护理后	护理前	护理后	护理前	护理后	护理前	护理后	护理前	护理后	护理前	护理后	护理前	护理后
对照组 (49例)	2.35± 0.24	1.68± 0.22^a	2.40± 0.25	1.53± 0.15^a	2.28± 0.23	1.46± 0.21^a	2.30± 0.25	1.44± 0.18^a	2.35± 0.22	1.56± 0.18^a	2.24± 0.21	1.60± 0.14^a	2.37± 0.25	1.62± 0.17^a
观察组 (49例)	2.32± 0.21	1.10± 0.19^a	2.38± 0.17	1.09± 0.12^a	2.25± 0.20	1.01± 0.16^a	2.27± 0.22	1.02± 0.16^a	2.31± 0.19	1.01± 0.12^a	2.20± 0.17	1.11± 0.13^a	2.34± 0.22	1.13± 0.14^a
t值	0.659	13.967	0.463	16.034	0.689	11.932	0.631	12.208	0.963	17.797	1.036	17.953	0.631	15.575
P值	0.512	<0.001	0.644	<0.001	0.493	<0.001	0.530	<0.001	0.338	<0.001	0.303	<0.001	0.530	<0.001

组别	心理领域		生理领域		环境领域		社会关系领域
组别	护理前	护理后	护理前	护理后	护理前	护理后	护理前	护理后
对照组(49例)	72.26±3.39	79.94±4.27^a	68.98±3.24	75.21±4.04^a	70.07±3.35	78.98±4.25^a	69.93±3.57	76.62±4.19^a
观察组(49例)	72.45±3.43	85.53±4.96^a	69.07±3.53	82.29±4.18^a	70.16±3.47	85.67±4.33^a	69.98±4.10	84.94±4.55^a
t值	0.276	5.979	0.132	8.525	0.131	7.719	0.064	9.416
P值	0.783	<0.001	0.896	<0.001	0.896	<0.001	0.949	<0.001

组别	AHI(次/h)		LSaO₂(%)
组别	护理前	护理后	护理前	护理后
对照组(49例)	18.52±3.15	12.45±2.41^a	82.15±4.22	86.33±3.54^a
观察组(49例)	18.48±3.08	8.14±2.03^a	82.23±4.18	91.05±3.76^a
t值	0.064	9.547	0.095	6.345
P值	0.949	<0.001	0.924	<0.001