Fatigati Angela, Alrawashdeh Mohammad, Zaldonis Jenna, Dabbs Annette DeVito
University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
Prog Transplant. 2016 Mar;26(1):62-9. doi: 10.1177/1526924816632123.
Sleep quality affects health and self-management in chronic illness. Limited research has examined patterns and predictors of sleep quality and its impact on self-management and health-related quality of life (HRQOL) among lung transplant recipients (LTRs).
The aims of this study were to identify the patterns, predictors, and impact of poor sleep quality on self-management behaviors and HRQOL the first year after lung transplantation.
Secondary analysis of 75 LTRs who participated in a randomized controlled trial. Pittsburgh Sleep Quality Index (PSQI) was administered at baseline, 2, 6, and 12 months after transplant; 12-month PSQI was dichotomized categorizing good versus poor sleepers. Predictors were measured at the time of transplant; self-management and HRQOL were measured at 12 months. Logistic regression identified predictors of poor sleep. Correlations examined poor sleep quality, self-management behaviors, and HRQOL.
Sleep quality was relatively stable during the first year, and 24 of the 75 (32%) of the sample met criteria for poor sleep quality at 12 months. The only multivariate predictor of poor sleep was female gender (odds ratio = 3.421; P = .026); the mental component of HRQOL was the only outcome associated with poor sleep (r = -.348; P < .01).
Nearly one-third of LTRs reported persistent poor sleep through year 1. More females reported poor sleep quality, and sleep quality was inversely related to mental HRQOL by 12 months. Knowledge of these relationships may help identify LTRs at the greatest risk for poor sleep and guide strategies to promote sleep and optimize HRQOL.
睡眠质量会影响慢性病患者的健康和自我管理。关于肺移植受者（LTR）睡眠质量的模式、预测因素及其对自我管理和健康相关生活质量（HRQOL）的影响，相关研究有限。
本研究旨在确定肺移植后第一年睡眠质量差的模式、预测因素及其对自我管理行为和HRQOL的影响。
对75名参与随机对照试验的LTR进行二次分析。在移植后的基线、2个月、6个月和12个月时进行匹兹堡睡眠质量指数（PSQI）评估；将12个月时的PSQI分为睡眠良好组和睡眠不佳组。在移植时测量预测因素；在12个月时测量自我管理和HRQOL。采用逻辑回归确定睡眠不佳的预测因素。研究睡眠质量差、自我管理行为和HRQOL之间的相关性。
第一年睡眠质量相对稳定，75名样本中有24名（32%）在12个月时符合睡眠质量差的标准。睡眠不佳的唯一多变量预测因素是女性（比值比=3.421；P = 0.026）；HRQOL的心理成分是与睡眠不佳相关的唯一结果（r = -0.348；P < 0.01）。
近三分之一的LTR在第一年报告持续睡眠不佳。更多女性报告睡眠质量差，且到12个月时睡眠质量与心理HRQOL呈负相关。了解这些关系可能有助于识别睡眠不佳风险最高的LTR，并指导促进睡眠和优化HRQOL的策略。
