CAJ | 학술논문

目的：了解腹膜透析患者睡眠相关疲乏的感受和经历。方法采用目的抽样法，于2012年12月—2013年8月选取在郑州大学第一附属医院行腹膜透析治疗的患者13例为本研究对象。应用质性研究方法，对13例因睡眠质量差而致疲乏的腹膜透析患者进行深度访谈，采用 Colaizzi 描述性现象学研究法分析资料。结果腹膜透析患者睡眠相关疲乏的感受可提炼出三个主题：（1）患者对疲乏的感知：心理和身体疲乏，嗜睡；（2）疲乏的结果：产生愧疚、担心、易怒、恐惧、孤独等消极情绪，影响患者的活力、创造力和集中注意力，虚弱；（3）自我适应疲乏的能力和策略：与疲劳斗争，变得顺从和冷漠，接受和适应疲劳。结论持续的疲乏状态使腹膜透析患者产生不同的心理和生理感知，困顿和嗜睡的消极状态限制了患者的活动、对身体功能的感知和正常的社会活动，并产生相应的心理负担。为了应对疲乏，患者必须要与之斗争，最终接受或者是变得顺从冷漠。医护人员需要更加关注患者的疲乏问题，及时评估患者睡眠质量和日常活动能力，采取针对性措施改变患者对疲乏的认知，减少其疲乏程度，提高睡眠质量。
목적：료해복막투석환자수면상관피핍적감수화경력。방법채용목적추양법，우2012년12월—2013년8월선취재정주대학제일부속의원행복막투석치료적환자13례위본연구대상。응용질성연구방법，대13례인수면질량차이치피핍적복막투석환자진행심도방담，채용 Colaizzi 묘술성현상학연구법분석자료。결과복막투석환자수면상관피핍적감수가제련출삼개주제：（1）환자대피핍적감지：심리화신체피핍，기수；（2）피핍적결과：산생괴구、담심、역노、공구、고독등소겁정서，영향환자적활력、창조력화집중주의력，허약；（3）자아괄응피핍적능력화책략：여피로두쟁，변득순종화랭막，접수화괄응피로。결론지속적피핍상태사복막투석환자산생불동적심리화생리감지，곤돈화기수적소겁상태한제료환자적활동、대신체공능적감지화정상적사회활동，병산생상응적심리부담。위료응대피핍，환자필수요여지두쟁，최종접수혹자시변득순종랭막。의호인원수요경가관주환자적피핍문제，급시평고환자수면질량화일상활동능력，채취침대성조시개변환자대피핍적인지，감소기피핍정도，제고수면질량。
[AbstraCt] ObjeCtive To understand the experience of tiredness related to poor sleep in peritoneal dialysis( PD) patients. Methods A qualitative method was used to conduct in _ depth interviews with 13 PD patients receiving peritoneal dialysis in the First Affiliated Hospital of Zhengzhou University from December,2012 to August,2013 recruited by purposive sampling. Data were analyzed by Colaizzi phenomenotogical research method. Results The tiredness feelings fell into 3 themes, including patientsˊ perception of fatigue:mental and physical tiredness,sleepiness;the results of the fatigue:having such negative emotions as shame,concern,irritability,anxiety and loneliness,inactive,less creative and less concentrated, fragile;self fatigue _ adapting abilities and strategies:fighting for tiredness,being more obedient and indifferent,accepting and adapting to fatigue. ConClusion Constant tiredness makes PD patients have different feelings and physiological perception. Negative responses like perplexity and sleepiness confine their physical activity,awareness of their physical function and normal social activity,causing them under corresponding psychological burden. In their fight for tiredness,they finally accept or become obedient and indifferent. The medical workers should pay more attention to the problem of tiredness,evaluate their sleep quality and daily activities in time,take appropriate measures to change patientsˊ awareness of PD so as to help them reduce their tiredness and improve their sleep quality.