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研究生:葉紘維
研究生(外文):Yeh, Hung-Wei
論文名稱:結合腕戴式裝置與活動睡眠分析之術後住院病人恢復表現評估
論文名稱(外文):Assessment of recovery performance in postoperative inpatients based on the wrist-worn device and activity-sleep analysis
指導教授:梁勝富梁勝富引用關係
指導教授(外文):Liang, Sheng-Fu
口試委員:蕭富仁王淵弘曾稼志郭至恩
口試日期:2023-07-28
學位類別:碩士
校院名稱:國立成功大學
系所名稱:醫學資訊研究所
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
論文種類:學術論文
論文出版年:2023
畢業學年度:111
語文別:英文
論文頁數:42
中文關鍵詞:術後表現腕動計穿戴式裝置客觀睡眠指標客觀活動量測
外文關鍵詞:postoperative performanceactigraphywearable deviceobjective activity measurementobjective sleepiness indicator
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病患術後恢復一直是醫師在動完手術後非常關心的項目,目前已經有許多研究對患者術後的活動量、夜間睡眠以及術後恢復情形的關係性進行了調查,簡而言之,良好的恢復表現可以體現在整日活動模式及夜間睡眠上面,並形成正向循環。然而目前評估方法僅使用PSQI或心跳、血壓或血糖等等生命體徵來評估,並缺乏對於住院患者術後的活動模式的評估。多數患者即使生命體徵穩定,也不一定擁有正常的日夜活動以及休息模式。
在這項研究中,我們透過腕帶式穿戴裝置,收集了80名使用達文西手術後的住院患者,每人連續4天,一共320天的日夜活動及夜間睡眠資料,以及每日的PSQI主觀睡眠問卷,這些數據被用來觀察術前到術後3天的客觀活動、睡眠表現,以及主觀睡眠表現的變化情況,並且這些結果能夠在穿戴式裝置中完成計算,並透過行動裝置來控制設備並顯示結果。
腕帶式穿戴裝置能用來觀察手術前後的變化情形後,活動時間及活動強度都會在手術當天顯著下降,並隨著時間恢復,並於三日後可恢復到原先的68%,非靜態活動時間可增加2.7小時,其中使用DES的麻醉患者以及進行腹腔手術的患者在術後有較強的活動強度表現。而主客觀的睡眠表現則呈現相反的方式變化,PSQI主觀問卷認為在手術當天會睡的最差,而客觀量測則認為在手術當天會睡得最好且隨時間慢慢變差,但兩者都會在術後第二天回到基準。
在這項研究中, 所提出的觀察方法反映了患者在日間活動量與夜間睡眠的相關性與差異。日間活動有共同的趨勢,且能反映在客觀指標上。夜間睡眠客觀表現會與主觀相反,會因患者在夜間沒有活動產生判斷誤差,但可將這些資料進行標記,為醫師提供重要信息,進行精準定位治療。
Postoperative recovery has always been a major concern for physicians after surgery, and many studies have been conducted to investigate the relationship between patients' postoperative activity level, nighttime sleep, and postoperative recovery. In short, a good recovery can be reflected in the pattern of daytime activity and nighttime sleep, and form a positive cycle. However, the current assessment methods only use PSQI or vital signs such as heart rate, blood pressure, or blood glucose, and there is a lack of assessment of the postoperative activity patterns of hospitalized patients. Most patients, even if their vital signs are stabilized, do not necessarily have normal day and night activity and rest patterns.
In this study, we collected daytime activity and nighttime sleep data and daily PSQI subjective sleep questionnaires from 80 post-surgical hospitalized patients with da Vinci, each of whom had 4 consecutive days of sleep, for a total of 320 days, using a wrist-worn device, and these data were used to observe the changes in objective activity, sleep performance, and subjective sleep performance from the preoperative period to the 3-day postoperative period. These results can be calculated in the wearable device and the results can be controlled and displayed by the mobile device.
Wristband device can be used to observe changes before and after the surgery., the activity time and activity intensity decreased significantly on the day of surgery and recovered over time to 68% of the original level after three days, and the non-static activity time increased by 2.7 hours. The anesthetized patients who used DES those who underwent laparotomy had a stronger activity performance postoperatively. Subjective and objective sleep performance varied in opposite ways, with the subjective PSQI questionnaire suggesting the worst sleep on the day of surgery, and the objective measures suggesting the best sleep on the day of surgery with a gradual deterioration over time. However, both will return to the baseline on the second day after surgery.
In this study, the proposed observations reflect the correlation and differences between patients' daytime activity levels and nighttime sleep. There is a common trend in daytime activity, which is reflected in objective indicators. The objective performance of nocturnal sleep is contrary to the subjective one, and it is subject to errors of judgment due to the patient's inactivity during the night, but it is possible to mark this data, which provides important information for the physician and allows for precise targeting of the treatment.
摘要 I
Abstract II
致謝 IV
Content V
List of Table VII
List of Figures VIII
Chapter 1 Introduction 1
1.1 Background 1
1.2 Motivation 2
Chapter 2 Method 4
2.1 Subjects 4
2.2 Experimental Design 5
2.3 System architecture 6
2.3.1 Hardware implementation 6
2.3.2 Firmware implementation 8
2.4 Data measurement 11
2.4.1 Objective measurement 11
2.4.2 subjective measurement 18
2.4.3 Statistical analysis 19
Chapter 3 Result 20
3.1 Activity 20
3.1.1 Duration of daytime activity 20
3.1.2 intensity of daytime activity 23
3.2 sleep index 26
3.2.1 sleep stage index 26
3.2.2 Average count during sleep 28
3.3 Pittsburgh Sleep Quality Index 29
3.4 Mutual Comparison 30
3.4.1 Daytime Activity and Nighttime Sleep 30
Chapter 4 Discussion 32
4.1 Daytime Activity Performance 32
4.2 Nighttime Sleep Performance 35
Chapter 5 Conclusion 40
Reference 41
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