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系統識別號 U0026-0812200915263547
論文名稱(中文) 早產兒出院前及返家初期睡眠清醒型態差異之初探
論文名稱(英文) Comparison of sleep-wake patterns in premature infants before and after discharge: A pilot study
校院名稱 成功大學
系所名稱(中) 護理學系碩博士班
系所名稱(英) Department of Nursing
學年度 97
學期 2
出版年 98
研究生(中文) 劉美娟
研究生(英文) Mei-chuan Liu
學號 t2694112
學位類別 碩士
語文別 中文
論文頁數 60頁
口試委員 指導教授-張瑩如
召集委員-林其和
口試委員-柯乃熒
中文關鍵字 早產兒  睡眠清醒型態  腕動計 
英文關鍵字 actigraphy  sleep-wake pattern  premature infant 
學科別分類
中文摘要 臨床上早產兒的父母經常主訴早產兒出院返家後經常有異於住院期間的睡眠清醒型態,如難以入睡、日夜顛倒、夜間哭鬧不安或持續的睡眠難以叫醒,並影響進食等情形。此不單只影響父母親或主要照顧者的生活作息,也常導致父母親擔憂早產兒的健康而產生焦慮不安。故本研究主要探討早產兒出院前及返家初期睡眠清醒型態的特性及其差異,期盼能讓父母親或主要照顧者對早產兒的睡眠清醒型態有所認識,除了作為調適其親職角色的重要參考外,也提供護理人員實證資料,提供合乎早產兒個別性需求的護理指導,並協助增強照顧者的自信心,協助早產兒順利適應居家生活。
本研究採用描述性比較性的研究設計,以南部某醫學中心嬰兒病房目的取樣的10位早產兒作為研究對象,在早產兒出院前7天及返家後7天內(共14天) ,以腕動計及早產兒活動日誌收集睡眠及清醒型態分佈的資料,所收集的資料以描述性統計、配對t檢定及皮爾森積差相關係數檢定進行資料分析。
結果顯示(1)早產兒出院前每日平均睡眠時間佔全日的73.3%,返家初期的平均睡眠時間占全日的68.3%,出院前後的睡眠清醒比例約為7:3。(2)返家初期每日及日間的睡眠清醒週期時間較出院前縮短,而週期次數則增加,每日及日夜睡眠及清醒時間,夜間的睡眠清醒週期時間和週期數則無差異。(3)出院前及返家初期全日有超過90%的時間處於黑暗及昏暗的環境光線之中,光線的調控是沒有日夜的差別,早產兒出院前睡眠清醒型態與光線沒有顯著相關,返家初期睡眠時間與光亮及明亮光線呈顯著負相關,清醒時間與黑暗及昏暗光線呈顯著負相關,與光亮及明亮光線呈顯著正相關。
本研究所發現之早產兒出院前後睡眠清醒型態分佈及其與光線之關係的結果,可以作為指導早產兒父母親的參考依據,以增加其認知及減輕焦慮。
英文摘要 Clinically, a main complaint from parents of a premature infant is that the premature infant often has a different sleep-wake pattern from when it is hospitalized. For example, a premature infant will have difficulty falling asleep, often sleep in the day and cry at night or sleep for long hours and cannot be waken so it often puts off eating time. This does not only affect the parents or caregiver but also lead the parents to worry about the health of their baby and give rise to anxiety. This study was focus on the characteristics of the sleep-wake pattern of a premature infant before and after discharge and the differences between the two. It is hoped that results will help the parents or caregiver with clear to know of the sleep-wake pattern of their baby. Besides serving as important reference while parents try to adjust their role, it provides nursing staff with empirical data so that they can differentiate care offered to each premature infant to suit individual needs and help strengthen the confidence of the caregiver, assisting premature infants in getting used to home life successfully.
This study used a descriptive and comparative design. Ten premature infants from a sick baby room of medical center in Southern Taiwan were enrolled. Seven days before discharge and during the first seven days after they went home (a total of fourteen days), data of the sleeping and waking patterns were collected by the actigraphy and premature infant activity diary. Data was analyzed using descriptive statistics, Paired t-test, and Pearson’s correlation.
Results show that (1) before discharge, the premature infants slept 73.3% of time per day and after discharge, they slept 68.3% of time per day. The sleep-wake ratio before and after discharge was round 7:3. (2) The sleep-wake cycle per day and during daytime after discharge was shorter than before and the number of cycles increased. However, the daily and day-night sleep-wake hours, the duration of each sleep-wake cycle at night, and the number of cycles did not show any difference. (3) Before and after discharge, the premature infants spent over 90% of time in a dark and dimmed environment. The light did not show difference of day and night. Before discharge, the sleep-wake pattern of the premature infants did not show significant relevance with lighting but the sleeping time after discharge was in a significantly negative relationship with light and bright light.
Results of the present study about the sleep-wake pattern serve as empirical data for clinical nursing staff and guidance in terms of premature infant sleeping problems at home. Meanwhile, related data on the sleep-wake pattern and illumination can be the criteria for providing a premature infant with an environment with distinct day and night differences before they are discharged from the hospital.
論文目次 中文摘要……………………………………………………………Ⅰ
英文摘要……………………………………………………………Ⅲ
誌謝…………………………………………………………………Ⅴ
目錄…………………………………………………………………Ⅵ
圖表目錄……………………………………………………………Ⅷ
附錄…………………………………………………………………Ⅷ
第一章 緒論
第一節 研究動機……………………………………………………1
第二節 研究目的……………………………………………………3
第三節 研究問題……………………………………………………3
第二章 文獻回顧
第一節 早產兒睡眠清醒型態發展及測量…………………………4
第二節 光線對早產兒睡眠的影響…………………………………11
第三節 其他干擾早產兒睡眠的因素………………………………13
第四節 研究架構……………………………………………………17
第三章 研究方法
第一節 研究設計……………………………………………………20
第二節 研究對象與場所……………………………………………20
第三節 研究工具……………………………………………………21
第四節 研究對象之倫理考量………………………………………24
第五節 資料收集……………………………………………………26
第六節 資料分析與處理……………………………………………27
第四章 研究結果
第一節 研究對象基本資料…………………………………………28
第二節 早產兒出院前及返家初期睡眠清醒型態之分佈…………30
第三節 早產兒出院前及返家初期睡眠清醒型態之差異…………33
第四節 早產兒返家初期睡眠清醒型態與光線之關係……………34
第五章 討論
第一節 早產兒出院前及返家初期睡眠清醒型態之分佈…………39
第二節 早產兒出院前及返家初期睡眠清醒型態之差異…………40
第三節 早產兒出院前及返家初期睡眠清醒型態與光線之係關…41
第六章 結論與建議
第一節 結論…………………………………………………………43
第二節 臨床應用……………………………………………………44
第三節 研究限制……………………………………………………44
第四節 未來研究方向………………………………………………46
第七章 參考文獻……………………………………………………47
圖表目錄
圖2-1 研究架構……………………………………………………17
表4-1 研究對象基本資料…………………………………………29
表4-2 早產兒出院前及返家初期全日之睡眠狀況………………31
表4-3 早產兒出院前及返家初期全日睡眠與清醒型態之分佈…32
表4-4 早產兒出院前及返家初期在不同光線下的曝露時間……35
表4-5 早產兒出院前及返家初期全天光線強度與睡眠清醒
型態之分佈…………………………………………………37
表4-6 早產兒出院前及返家初期光線與睡眠清醒型態之
Pearson 相關係數…………………………………………38
附錄
附錄一 人體試驗委員會同意臨床試驗證明書……………………57
附錄二 個案及主要照顧者基本資料表……………………………58
附錄三 早產兒活動日誌……………………………………………60
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