探討灼傷病患住院間睡眠品質與疼痛的關係
Relationship Between Sleep Quality and Pain Intensity in Hospitalized Burn Patients
中文摘要
睡眠困擾與疼痛對住院期間灼傷病患而言是常見的問題，故本研究利用縱貫性 研究設計，針對灼傷病患住院第一週內，睡眠品質與疼痛及其相關影響因素進 行探討。本研究共收集了46 位病患，依研究目的，除收集人口學資料外，還應 用灼傷創傷量表、數字評估量表進行睡眠及疼痛測量，進行連續七天的調查研究 並以SPSS 13.0 統計軟體分析資料。
研究結果發現，（1）病患主觀自訴睡眠品質為 5.98±3.43 分，睡眠時數為 6.47±1.84 小時，半夜清醒次數，每天平均出現 2.69 ± 1.87 次，且一週內其每天 的睡眠品質、睡眠時數、半夜清醒次數無顯著差異；（2）影響到睡眠的因素有 性別、年齡、婚姻狀態、社經地位及創傷壓力；（3）病患 Background pain 平均為 3.82±1.44 分，其一週內前四天的 Background pain 的程度高於第七天的疼痛程度；
Procedure pain 平均為 7.11±1.79 分，於一週內其每天 Procedure pain 的程度無顯 著差異；每天Demoral 的使用量為 81.88mg；（4）影響到疼痛的因素有性別、
宗教信仰的有無、燒傷面積、Demoral 的使用量及創傷壓力；（5）在睡眠與疼痛 關係上發現，睡眠時數與Background pain、Procedure pain 呈負相關，半夜清醒 次數與Background pain 呈正相關。
故本研究結果支持灼傷病患因灼傷所產生的疼痛會影響到睡眠品質，而其睡眠 品質的好壞亦會影響到灼傷疼痛，且創傷壓力亦會影響到睡眠品質及疼痛。因此 建議在臨床照護上，除了建立一套疼痛與睡眠品質的評估模式外，應將灼傷創 傷壓力納入評估範圍內，依據評估結果，給予適當有效的醫療處置及護理措施，
以提升其護理照護品質。
英文摘要
Sleep disturbance and pain are commonly seen problem in hospitalized burn patients. The longitudinal study was designed to investigate the relationship between sleep quality and pain intensity, and relatant factor in this first week of hospitalization. Forty-six patients were interviewed continue seven days, collect information about demography, post-burned traumatic stress scale, numeric rating scale for sleep quality and pain intensity. Data analyze used SPSS 13.0 statistic computer.
The results present: (1) patients subjective sleep quality average were 5.98±3.43, reported sleeping average 6.47±1.84 hour, with frequent awakenings 2.69 ± 1.87 times per night and the sleep quality, sleeping hours and frequent awakenings were no significantly within week. (2) the sleep influence factor had sex, age,
marry status, social-economy status and post-burned traumatic stress.(3) patients background pain average 3.82±1.44, and the pain intensity were higher in the first four days then seven day; the procedure pain average 7.11±1.79, and be no significantly within week. Demoral dosage were 81.88mg per day. (4)the pain intensity influence factor had sex, religious belief, burn surface area, Demoral dosage and post-burned traumatic stress. (5) Relationship between sleep quality and pain intensity presented, sleeping hours were negative correlated with background pain and procedure pain, frequent awakenings were positive correlated with background pain.
The results of this study support pain intensity with burned were influence sleep quality, and sleep quality were influence pain intensity with burned too. This results suggest that building a assessment model for sleep quality and pain intensity ,and increase assessing post-burned traumatic stress. Provide effective management and nursing intervention for burned patients to promote better nursing quality.
