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接受冠状动脉搭桥手术的男性患者的焦虑、抑郁与睡眠

Anxiety, depression and sleep in male patients undergoing coronary artery bypass surgery.

作者信息

Edéll-Gustafsson U M, Hetta J E

机构信息

Department of Medicine and Care, Faculty of Health Sciences, Linköping, Sweden.

出版信息

Scand J Caring Sci. 1999;13(2):137-43.

Abstract

The aim of this study was to examine the prevalence of depression and anxiety following coronary artery bypass surgery (CABG) and to see how those patients with depression and anxiety differ in sleeping pattern. The individual reaction to sleep loss was tested as a predictor of certain emotional symptoms in the follow-up period. Thirty-eight males, between 45 and 68 years, were interviewed prior to, and 1 month after, surgery, and received a questionnaire at the 6-month follow-up. Eighty per cent scored moderate anxiety prior to surgery and six patients were depressed. An anxiety-prone individual reactivity persisted in the same patients in 38.9% (n = 14) following CABG, with significantly more sleep disturbances, firedness, energy deficits, immobility, and lower degree of quality of life (QoL). Sad/depressed mood or cognitive/behavioural fatigue symptoms as reactions to sleep loss were predictors of sleep problems and daytime sequelae, whereas a higher postoperative NYHA class was predicted by cognitive/behavioural fatigue and dysphoria reactions. Being less refreshed by sleep on final awakening prior to surgery related to 44.5% of the variance in QoL outcome 6 months following surgery. In conclusion, an anxiety-prone individual reactivity is significantly associated with sleep disturbances. Reactions to sleep loss prior to surgery are associated with emotional distress after surgery.

摘要

本研究的目的是调查冠状动脉搭桥手术(CABG)后抑郁和焦虑的患病率,并观察那些患有抑郁和焦虑的患者在睡眠模式上有何不同。对睡眠剥夺的个体反应作为随访期间某些情绪症状的预测指标进行了测试。38名年龄在45至68岁之间的男性在手术前和手术后1个月接受了访谈,并在6个月随访时收到一份问卷。80%的患者在手术前中度焦虑,6名患者抑郁。38.9%(n = 14)的患者在CABG后仍存在易焦虑的个体反应性,伴有明显更多的睡眠障碍、疲劳、能量不足、活动减少和较低的生活质量(QoL)。悲伤/抑郁情绪或认知/行为疲劳症状作为对睡眠剥夺的反应是睡眠问题和日间后遗症的预测指标,而较高的术后纽约心脏协会(NYHA)分级则由认知/行为疲劳和烦躁反应预测。术前最后一次醒来时睡眠后恢复不佳与术后6个月QoL结果中44.5%的差异相关。总之,易焦虑的个体反应性与睡眠障碍显著相关。术前对睡眠剥夺的反应与术后情绪困扰相关。

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