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研究生:余珮蓉
研究生(外文):Pei-Jung Yu
論文名稱:芳香療法對改善糖尿病合併神經痛患者睡眠品質之成效探討
論文名稱(外文):The Effects of Aromatherapy for Improvement of Sleep Quality in Diabetes with Neuropathy
指導教授:邱愛富邱愛富引用關係
指導教授(外文):Ai-Fu Chiou
學位類別:碩士
校院名稱:輔仁大學
系所名稱:護理學系碩士班
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:137
中文關鍵詞:芳香療法糖尿病合併神經痛睡眠品質血糖值
外文關鍵詞:AromatherapyDiabetes with NeuropathySleep qualityBlood sugarfuturetaiwanafterdata
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本研究目的在探討芳香療法對改善糖尿病合併神經痛患者的睡眠品質及血糖值之成效。本研究採實驗性研究設計,以立意取樣方式選取44位北部某ㄧ區域醫院新陳代謝科門診之糖尿病合併神經痛患者,並隨機分配至實驗組22名和控制組22名。實驗組患者接受芳香療法的介入,控制組則只給予常規護理指導,共為期六週。資料收集以結構性問卷進行訪談,以匹茲堡睡眠品質量表及SureStepTM血糖機為研究工具,取得芳香療法介入前的前測、第一次後測(介入後二週)、第二次後測(介入後四週)及第三次後測資料(介入後六週)作為實驗組與控制組成效之比較。所得資料以SPSS for Windows12.0套裝軟體進行資料處理與分析,主要使用的統計方法包括獨立t檢定(Independent t test)、配對t檢定( Pair sample t test)、卡方檢定(Chi-square test)、皮爾森積差相關係數(pearson product-moment correlation)及重複測量(Repeated measure ANOVA 及General Linear Mixed-effect Model)之時間與組別交叉比較。
研究結果顯示:(一)糖尿病合併神經痛患者的睡眠品質不佳;(二)實驗組糖尿病合併神經痛患者在芳香療法的介入後第二週即改善其睡眠潛伏期,第四週提升個人主觀睡眠品質及改善睡眠困擾;(三)於芳香療法的介入後第六週,實驗組病患的夜間實際睡眠時數增加,並獲得其白天功能障礙及整體睡眠品質之改善;(四)芳香療法對實驗組糖尿病合併神經痛患者在第二週即可降低其血糖值;(五)睡眠品質與血糖值無統計上顯著相關性。本研究證實芳香療法可有效改善糖尿病合併神經痛患者的睡眠品質和血糖值。建議可將此芳香療法納入糖尿病合併神經痛患者睡眠品質不佳之病患常規照護中,未來可以提供臨床護理人員對有睡眠問題病患,無侵入性、安全且有效的照護,進而改善病患生活品質。
The purpose of this experimental study was to examine the effects of aromatherapy on improvement of sleep quality in diabetes patients with neuropathy. Forty-four diabetes patients with neuropathy were randomly assigned to the experimental group (n=22) and the control group (n=22) at a hospital in northern Taiwan. Patients in the experimental group received the aromatherapy intervention for 6 weeks, while those in the control group received only regular nursing care. The instruments included Pittsburg Sleep Quality Index and SureStepTM of blood glucose meters. Data were collected on pre-test, two weeks, four weeks, and six weeks after the aromatherapy intervention. The frequency, percentage, chi-square, independent t test, paired t test, Pearson product-moment correlation, repeated measure ANOVA and general linear mixed-effect models were used for data analysis.
The results of this study indicated: 1. Sleep quality of diabetes patients with neuropathy is poor. 2. Sleep latency of patients in the experimental group was improved at 2nd week after they received aromatherapy; In addition, perceived sleep quality and sleep disturbance of patients was also improved at 4th week after aromatherapy. 3. At 6th week after aromatherapy, patients in the experimental group had increased their sleep duration, reduced their daytime dysfunction, and improved their sleep quality. 4. Level of blood sugar was decreased at 2nd week after aromatherapy on diabetes patients in the experimental group. 5. There was no significant correlation between blood sugar and sleep quality.
This experimental study proves that aromatherapy can ameliorate both blood sugar and sleep quality of diabetes with neuropathy patients. Suggestion is made to take aromatherapy as a combined therapy in routine care for diabetes with neuropathy patients. It is supported that aromatherapy can be a safe, noninvasive, effective approach for clinical nursing member to care patients with sleep disturbance for a better quality in the future.
致謝…………………………………..……………………………………….. I
中文摘要……………………………………………..………………...……….. III
英文摘要…………………………………..………………………...………….. V
目錄……………………………………………..…………………...………….. VI
圖目錄…………………………………………………………….…………….. VIII
表目錄…………………………………………………………….…………….. VIIII
附錄……………………………………………..………………………...…….. XI
第一章 緒論
第一節 研究動機與重要性…………………………………..…………….. 1
第二節 研究目的……………………………………………..…………….. 5
第二章 文獻查證
第一節 睡眠生理及評估……………………………………..…………….. 6
第二節 糖尿病病患睡眠品質及其影響因素………………..…………….. 12
第三節 芳香療法……………………………………………..…………….. 21
第三章 研究方法
第一節 研究架構……………………………………………..…………….. 29
第二節 研究假設……………………………………………..…………….. 30
第三節 名詞界定……………………………………………..…………….. 31
第四節 研究設計……………………………………………..…………….. 32
第五節 研究場所與對象……………………………………..…………….. 33
第六節 研究工具信效度檢定………………………………..…………….. 34
第七節 研究步驟……………………………………………..…………….. 36
第八節 倫理關注……………………………………………..…………….. 41
第九節 資料處理與統計分析………………………………..…………….. 42
第四章 研究結果
第一節 糖尿病合併神經痛患者基本資料與睡眠品質之分布與差異. …... 44
第二節 芳香療法介入前各變項間之相關性…………………………..….. 52
第三節 芳香療法介入前實驗組與控制組病患睡眠品質及血糖值之差異 .. 70
第四節 芳香療法介入後實驗組與控制組病患睡眠品質及血糖值之差異 .. 73
第五節 睡眠品質與血糖值之相關性………………….……..…………….. 86

第五章 討論
第一節 糖尿病合併神經痛患者之睡眠品質…………………………..….. 88
第二節 芳香療法介入糖尿病合併神經痛患者睡眠品質之成效…..….…. 93
第三節 芳香療法介入糖尿病合併神經痛患者生理血糖值之成效..…..… 99
第四節 睡眠品質與血糖值之相關性………………………….. ….....…… 100
第六章 結論與建議
第一節 結論…………………………………………………………..…….. 102
第二節 護理上的應用………………………………………………..…….. 103
第三節 研究限制與建議…………………………………………..……….. 105
參考文獻
中文部分………………………………………………………………..…… 106
英文部分……………………………………………………………..……… 111
圖目錄
圖3-1 研究概念架構圖…………………………………………..……..……... 29
圖3-2 薰衣草薰香介入措施步驟………………………………..……..……... 39
圖3-3 芳香療法介入對糖尿病合併神經痛患者睡眠成效之研究流程……... 33
圖4-1 實驗組與控制組前測、第一次後測、第二次後測及第三次後測,匹
茲堡睡眠量表之個人主觀睡眠品質之差異…………..……..……....... 78
圖4-2 實驗組與控制組前測、第一次後測、第二次後測及第三次後測,匹
茲堡睡眠量表之睡眠潛伏期之差異…………..……..…….............. 79
圖4-3 實驗組與控制組前測、第一次後測、第二次後測及第三次後測,匹
茲堡睡眠量表之睡眠困擾之差異…………..……..................... 80
圖4-4 實驗組與控制組前測、第一次後測、第二次後測及第三次後測,匹
茲堡睡眠量表之白天功能障礙之差異…………..……..……........... 81
圖4-5 實驗組與控制組前測、第一次後測、第二次後測及第三次後測,匹
茲堡睡眠量表之白天功能障礙之差異…………..……..……............ 82
圖4-6 實驗組與控制組前測及第三次後測,匹茲堡睡眠量表之睡眠時數之
變化……………………………………………………..……..………... 85
圖4-7 實驗組與控制組前測及第三次後測,匹茲堡睡眠量表之睡眠效率之
變化…………………………..…………………………..……..………. 85
圖4-8 實驗組與控制組前測及第三次後測,匹茲堡睡眠量表之整體睡眠品
質之變化………………….………………………………..……..…….. 86
表目錄
表3-1研究設計………………………………………………..……..………… 32
表4-1糖尿病合併神經痛患者(N=44)基本資料之分析..……..……….… 47
表4-2糖尿病合併神經痛患者(N=44)匹茲堡睡眠品質量表問卷之分佈 .... 50
表4-3糖尿病合併神經痛患者(N=44)睡眠困擾發生情形……..…………... 51
表4-4 糖尿病合併神經痛患者(N=44)年齡與睡眠品質相關性(皮爾森
積差相關係數)………………………………………..……..………… 53
表4-5 糖尿病合併神經痛患者(N=44)教育程度、職業、飲食習慣、身
體質量指數及更年期症狀與整體睡眠品質相關性………...………… 54
表4-6 糖尿病合併神經痛患者(N=44)教育程度、職業、飲食習慣、身
體質量指數及更年期症狀與主觀睡眠品質相關性………...………… 55
表4-7 糖尿病合併神經痛患者(N=44)教育程度、職業、飲食習慣、身
體質量指數及更年期症狀與睡眠潛伏期相關性………...…………… 56
表4-8 糖尿病合併神經痛患者(N=44)教育程度、職業、飲食習慣、身
體質量指數及更年期症狀與睡眠時數相關性………...……………… 57
表4-9 糖尿病合併神經痛患者(N=44)教育程度、職業、飲食習慣、身
體質量指數及更年期症狀與睡眠效率相關性………...……………… 58
表4-10糖尿病合併神經痛患者(N=44)教育程度、職業、飲食習慣、身體質量指數及更年期症狀與睡眠困擾相關性………...…………..................… 59
表4-11糖尿病合併神經痛患者(N=44)教育程度、職業、飲食習慣、身
體質量指數及更年期症狀與白天功能障礙相關性………...……… 60
表4-12糖尿病合併神經痛患者(N=44)性別、婚姻狀況、生活型態、夜
間頻尿、藥物使用及心理狀態與整體睡眠品質相關性………...…… 61
表4-13 糖尿病合併神經痛患者(N=44)性別、婚姻狀況、生活型態、夜
間頻尿、藥物使用及心理狀態與主觀睡眠品質相關性………...…… 62
表4-14 糖尿病合併神經痛患者(N=44)性別、婚姻狀況、生活型態、夜
間頻尿、藥物使用及心理狀態與睡眠潛伏期相關性………...……… 63
表4-15糖尿病合併神經痛患者(N=44)性別、婚姻狀況、生活型態、夜
間頻尿、藥物使用及心理狀態與睡眠時數相關性………...……… 64
表4-16 糖尿病合併神經痛患者(N=44)性別、婚姻狀況、生活型態、夜
間頻尿、藥物使用及心理狀態與睡眠效率相關性………...………… 65
表4-17 糖尿病合併神經痛患者(N=44)性別、婚姻狀況、生活型態、
夜間頻尿、藥物使用及心理狀態與睡眠困擾相關性………...……… 66
表4-18 糖尿病合併神經痛患者(N=44)性別、婚姻狀況、生活型態、夜
間頻尿、藥物使用及心理狀態與白天功能障礙相關性………...…… 67
表4-19糖尿病合併神經痛患者(N=44)芳香療法介入前睡眠潛伏期與睡
眠困擾之相關(皮爾森積差相關係數)……………..……..…………. 69
表4-20 糖尿病合併神經痛患者(N=44)匹茲堡量表睡眠品質及血糖值前
測之比較…………..……..………………………..……..…………... 72
表4-21糖尿病合併神經痛患者(N=44)之個人主觀睡眠品質、睡眠潛伏期、睡眠潛困擾、白天睡眠困擾及血糖值重覆測量ANOVA分析結果………….……………..... 77
表4-22 以Mix-effect GLMs比較兩組病患之個人主觀睡眠品質…………... 78
表4-23 以Mix-effect GLMs比較兩組病患之睡眠潛伏期……… …..…….... 79
表4-24 以Mix-effect GLMs比較兩組病患之睡眠困擾………………..…... 80
表4-25 以Mix-effect GLMs比較兩組病患之白天功能障礙………………... 81
表4-26 以Mix-effect GLMs比較兩組病患之血糖值…………………..…... 82
表4-27糖尿病合併神經痛患者(N=22)實驗組病患前後測睡眠時數、睡
眠效率及整體睡眠品質之差異………………..……..…………......... 84
表4-28糖尿病合併神經痛患者(N=22)控制組病患前後測睡眠時數、睡
眠效率及整體睡眠品質之差異………………..……..…………......... 84
表4-29 糖尿病合併神經痛患者(N=44)芳香療法介入前匹茲堡睡眠品質
與血糖值之相關(皮爾森積差相關係數)…..……..………….......... 88
附表一 國內介入性措施對睡眠品質成效探討之相關研究報告.......... 127
附表二 芳香療法於臨床應用之國內外相關研究報告.................. 128
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