CAJ | 학술논문

目的：了解分化型甲状腺癌患者行131I 治疗期间的睡眠质量及其影响因素，探讨提高患者睡眠质量的护理措施。方法将106位行大剂量131I 治疗的分化型甲状腺癌患者随机分为干预组及对照组，对照组进行常规护理，干预组在对照组基础上进行护理干预，并对两组的睡眠质量及其影响因素采用匹兹堡睡眠质量指数（PSQI）量表和自行设计的睡眠影响因素调查表进行问卷调查。结果调查显示，出院时干预组与对照组睡眠情况比较，差异有统计学意义（P ≤0.05）。影响睡眠的主要因素依次为心理因素（对癌症的悲观情绪、对疾病预后的担忧、对放射性治疗畏惧心理、隔离治疗期间孤独寂寞感等）、生理因素（颈部伤口不适、甲状腺功能低下、放射性副作用）、环境因素等。结论接受大剂量131I 治疗的甲状腺癌患者普遍存在睡眠障碍，心理、生理和环境因素均可影响其睡眠质量，护理人员应采取针对性措施缓解患者的负性情绪及生理不适，尤其应加强疾病预后及放射性治疗相关知识宣教，同时提供良好的睡眠环境，以提高患者睡眠质量。
목적：료해분화형갑상선암환자행131I 치료기간적수면질량급기영향인소，탐토제고환자수면질량적호리조시。방법장106위행대제량131I 치료적분화형갑상선암환자수궤분위간예조급대조조，대조조진행상규호리，간예조재대조조기출상진행호리간예，병대량조적수면질량급기영향인소채용필자보수면질량지수（PSQI）량표화자행설계적수면영향인소조사표진행문권조사。결과조사현시，출원시간예조여대조조수면정황비교，차이유통계학의의（P ≤0.05）。영향수면적주요인소의차위심리인소（대암증적비관정서、대질병예후적담우、대방사성치료외구심리、격리치료기간고독적막감등）、생리인소（경부상구불괄、갑상선공능저하、방사성부작용）、배경인소등。결론접수대제량131I 치료적갑상선암환자보편존재수면장애，심리、생리화배경인소균가영향기수면질량，호리인원응채취침대성조시완해환자적부성정서급생리불괄，우기응가강질병예후급방사성치료상관지식선교，동시제공량호적수면배경，이제고환자수면질량。
Objective To investigate the possible cause of the sleep disorders of patients with differentiated thyroid cancer after high-dose therapeutic 131I administration and to explore care measures that may improve the sleep quality of those patients. Methods 106 patients with differentiated thyroid cancer treated with high-dose 131 Iodine were randomly and equally divided into intervention and control group. The control group was given routine nursing whereas intervention group received extra nurs-ing intervention in addition to the same routine care as the control group. The Pittsburgh Sleep Quality Index (PSQI) scale was adapted for rating sleep quality and a self-designed questionnaire was used for the analysis of factors may contribute to sleep disorders. Results Our data show that there are significant differences between intervention comparison and control group on discharge (P≤0.05). The main factors affecting sleep are psychological (pessimism over cancer, concerns about prognosis, fear of radioactive therapy, isolation during treatment, etc.), physiological (pain of neck wound, hypothyroidism and side effects of radioactive therapy) or environmental. Conclusion Thyroid cancer patients received high-dose 131 Iodine treatment usually have sleep problems caused by various factors. We should take relevant measures to relieve physical discomforts and negative emo-tions from them and enhance their knowledge about prognosis and radiotherapy in particular; thus we could improve sleep qual-ity of the patients.