Division of Cardiovascular Medicine, Taipei Medical University Shuang-Ho Hospital, Taipei County, Taiwan.
J Cardiovasc Nurs. 2011 Mar-Apr;26(2):99-105. doi: 10.1097/JCN.0b013e3181ed7d12.
Although it is well established that symptom burden in heart failure (HF) often leads to poor health-related quality of life (QOL), the contributions of quality of sleep and daytime sleepiness to the overall perception and satisfaction with life in the HF population have yet to be determined. We thus tested the hypothesis that quality of sleep and daytime sleepiness are significant predictors of QOL as measured by the World Health Organization Quality of Life-BREF (WHOQOL-BREF) in patients with HF.
Included were 88 medically stable patients with echocardiographically documented HF. This cross-sectional study used a correlational design, and data were collected using self-report questionnaires including the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), Epworth Sleepiness Scale, and WHOQOL-BREF Taiwan version. Multiple linear regression analyses were used to address the study hypotheses.
With the exception of the environmental domain (P = .078), poor sleepers had significantly lower scores in physical (P < .001), psychological (P = .001), and social (P = .040) domains of the WHOQOL-BREF. Multivariate regression analysis revealed that age, CPSQI, perceived health status, and comorbidities significantly predicted the physical QOL (adjusted R2 = 0.59, P < .001). For the psychological QOL, only perceived health status and CPSQI score remained in the regression model (adjusted R2 = 0.28, P = .016). For the environmental QOL, perceived health status and Epworth Sleepiness Scale were the only predictors remaining in the model (adjusted R2 = 0.17, P < .001). The findings from this study add support to the evidence that in medically stable persons with HF, poor sleep independently predicts the overall perception and satisfaction with life, in particular, in the physical and psychological domains of QOL, whereas daytime sleepiness independently predicts the environmental QOL.
尽管已有充分证据表明心力衰竭（HF）患者的症状负担常常导致较差的健康相关生活质量（QOL），但睡眠质量和白天嗜睡对 HF 人群整体生活感知和满意度的贡献仍有待确定。因此，我们检验了以下假设，即睡眠质量和白天嗜睡是 HF 患者生活质量（采用世界卫生组织生活质量简表（WHOQOL-BREF）进行测量）的重要预测指标。
纳入了 88 例经超声心动图证实的 HF 患者。本横断面研究采用相关设计，使用自报告问卷收集数据，包括匹兹堡睡眠质量指数（CPSQI）中文版、Epworth 嗜睡量表和 WHOQOL-BREF 台湾版。采用多元线性回归分析来验证研究假设。
除环境领域（P=0.078）外，睡眠质量差的患者在 WHOQOL-BREF 的生理（P＜0.001）、心理（P=0.001）和社会（P=0.040）领域的得分明显较低。多变量回归分析显示，年龄、CPSQI、感知健康状况和合并症显著预测生理 QOL（调整后的 R2=0.59，P＜0.001）。对于心理 QOL，仅感知健康状况和 CPSQI 评分保留在回归模型中（调整后的 R2=0.28，P=0.016）。对于环境 QOL，感知健康状况和 Epworth 嗜睡量表是保留在模型中的唯一预测因素（调整后的 R2=0.17，P＜0.001）。这项研究的结果进一步证实，在 HF 稳定期患者中，睡眠质量差独立预测整体生活感知和满意度，特别是在 QOL 的生理和心理领域，而白天嗜睡独立预测环境 QOL。
