愛滋病毒感染者的睡眠品質、憂鬱、焦慮與自尊

Sleep Quality, Depression, Anxiety, and Self-Esteem in People Living With HIV/AIDS (PLWHA)

背景：愛滋病毒感染已成為慢性疾病，感染者的心理健康與睡眠問題值得關注。目的：瞭解愛滋病毒感染者的睡眠品質、憂鬱、焦慮與自尊等心理健康因素，及睡眠品質與這些心理健康因素之相關性。方法 本研究為橫斷性、描述性、相關性之研究，以匹茲堡睡眠品質量表、美國流行病學研究中心憂鬱量表、曾氏焦慮量表與Rosenberg自尊量表的結構式問卷收集2013-2014年間於南台灣某醫學中心共146 位愛滋病毒感染者的睡眠品質、憂鬱、焦慮與自尊資料。結果 60.3%的愛滋病毒感染者睡眠品質不佳、50%具憂鬱傾向、36.3%具焦慮傾向，其睡眠品質、憂鬱、焦慮問題皆高於一般人。睡眠品質不佳和憂鬱（r = .40, p < .001）與焦慮（r = .53 , p < .001）呈現顯著性相關。多變項分析顯示愛滋病毒感染者睡眠品質顯著的預測因子為年齡、自覺疾病影響生活、焦慮與憂鬱。愛滋病毒感染者的CD4（cluster of differentiation 4）淋巴球數量、HIV病毒量和是否正在接受抗病毒藥物治療與睡眠品質、憂鬱、焦慮，以及自尊皆無顯著相關。結論／ 實務應用：本研究顯示約有一半以上的愛滋病毒感染者睡眠品質不佳或具憂鬱傾向，部分感染者有焦慮傾向。因為睡眠品質與心理健康和CD4淋巴球數量、HIV病毒量，以及是否接受抗反轉錄病毒藥物治療無相關性，建議對愛滋病毒感染者進行心理健康及睡眠品質評估，以提供全人照護。

Background: HIV has become a chronic disease. Therefore, the mental health and sleep quality of people living with HIV/AIDS (PLWHA) have become increasingly important issues of concern. Purpose: To explore the sleep quality, depression, anxiety, and self-esteem of PLWHA and the correlation between sleep quality and various related mental-health factors. Methods: A cross-sectional, descriptive, correlational study was conducted at a medical center in southern Taiwan in 2013-2014. Data on the sleep quality, depression, anxiety, and self-esteem of 146 PLWHA cases were collected using a structural questionnaire (the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, Zung’s Self-Administered Anxiety Scale, and Rosenberg Self-Esteem Scale). Results: Three-fifths (60.3%) of the cases had poor sleep quality, 50% were inclined toward depression, and 36.3% were inclined toward anxiety, indicating that sleep quality, depression, and anxiety levels in these cases were worse than the general population. Moreover, significant correlations were identified between poor sleep quality and the variables of depression (r = .40, p < .001) and anxiety (r = .53, p < .001). Multiple variate analysis revealed that older age, subjective feelings that HIV significantly influenced personal life, anxiety, and depression were all significant predictors of sleep quality. No significant correlations were found between CD4 (cluster of differentiation 4) lymphocyte count, HIV viral load, or receiving antiretroviral therapy and the variables of sleep quality, depression, anxiety, or self-esteem. Conclusions/Implications for Practice: About half of the PLWHA cases in the present study exhibited poor sleep quality and tendencies toward depression and anxiety. Moreover, sleep quality and mental health factors were found to be not correlated with CD4 lymphocyte count, HIV viral load, or receiving antiretroviral therapy. Therefore, early evaluation of the sleep quality and mental health of people living with HIV/AIDS is recommended in order to provide holistic care.