ความสัมพันธ์ระหว่างอาการนอนไม่หลับ วิธีการจัดการอาการ และคุณภาพการนอน ของผู้ป่วยโรคไตเรื้อรังระยะสุดท้ายที่ได้รับการฟอกเลือดด้วยเครื่องไตเทียม โรงพยาบาลตำรวจ

Sataporn  klangkan

Authors

Sataporn klangkan Police Nurse College, Police General Hospital, Royal Thai Police

Keywords:

insomnia, management of symptoms, sleep quality, end-stage chronic kidney disease, hemodialysis

Abstract

This study examined the levels of, and relationships among, insomnia symptoms, symptom-management strategies, and sleep quality. The sample comprised 80 patients with end-stage renal disease receiving hemodialysis at the Hemodialysis Unit of the Police General Hospital, purposively selected. The research instruments were: (1) a personal data questionnaire, (2) an insomnia symptom assessment, (3) an insomnia symptom-management questionnaire, and (4) a sleep quality assessment. Five experts examined content validity, and the reliability of the instruments measuring insomnia symptoms, symptom-management strategies, and sleep quality, determined by Cronbach’s alpha coefficient, was .73, .56, and .74, respectively. Data were analyzed using frequencies, percentages, means, standard deviations, and Pearson’s product-moment correlation coefficient.

The results revealed that: (1) the sample had a mean insomnia symptom score at the subthreshold (early-stage) insomnia level (M = 8.31, SD = 2.63); more than half experienced early-morning awakening, resulting most frequently in daytime sleepiness (75%), followed by fatigue (70%); (2) regarding insomnia symptom-management strategies, at the personal level most participants watched television, played games, or used social media before bed (76.3%), at the environmental level they slept in a darkened room with the lights off (82.5%), and at the health level they managed itching before bed (31.1%); (3) for sleep quality, the sample had a mean score of 13.04 (SD = 4.90), indicating poor sleep quality, even though 43.8% went to bed before 8:00 p.m.; and (4) the correlation analysis revealed that insomnia symptoms had the strongest, moderate positive relationship with sleep quality, which was statistically significant at the .05 level (r = .48, p < .05), followed by a positive relationship between insomnia symptoms and symptom-management strategies (r = .36, p < .05), while symptom-management strategies had a low positive relationship with sleep quality, statistically significant at the .05 level (r = .22, p < .05).

Therefore, to address the problem of sleep quality, hemodialysis nurses should assess and screen for insomnia symptoms from the onset of hemodialysis treatment, as well as advise patients to reduce electronic media use before bed and concurrently manage disruptive symptoms such as itching.

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