消防员的睡眠质量和创伤后应激障碍水平及其相关关系研究

Research on the Sleep Quality and Posttraumatic Stress Disorder Levels of Firefighters and Their Correlation

摘要: 目的：了解现役消防员的睡眠质量和创伤后应激障碍(posttraumatic stress disorder, PTSD)的流行现状，探究二者之间的相关关系。方法：应用横断面研究方法，采用方便抽样与整群抽样结合的方法选取重庆市现役消防员为研究对象进行问卷调查。采用《创伤后应激障碍自评量表–平民版》(PCL-C)评估消防员的PTSD患病情况及症状特征；采用匹兹堡睡眠指数(Pittsburgh Sleep Quality Index, PSQI)评估睡眠质量，结合一般情况调查问卷，分析消防员的睡眠质量和PTSD的流行现况，采用二元logistic回归及偏相关分析研究消防员睡眠质量与PTSD的相关关系。结果：1021名消防员中，PTSD患病率4.6%。PTSD阳性组中“反复发生令人不安的梦境”、“入睡困难或易醒”症状的阳性率分别为85.1%和100.0%，存在睡眠质量问题的共病率为72.3%。年龄、大专及以上学历是消防员睡眠障碍的危险因素，中等强度及高强度锻炼是睡眠障碍的保护因素(P < 0.05)，消防员总体睡眠质量及日间功能障碍与PCL-C得分呈中度正相关(P < 0.01)。结论：研究表明，消防员PTSD患者普遍具有睡眠障碍的现象，应重视消防员睡眠质量问题。

Abstract: Objective: To understand the sleep quality of active duty firefighters and the prevalence of posttraumatic stress disorder (PTSD), and to explore their correlation. Methods: Convenience sampling and cluster sampling were used to select the active duty firefighters in Chongqing as the research objects. Evaluate the prevalence and symptom characteristics of PTSD in firefighters using the PTSD Checklist Civilian Version (PCL-C). The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, and a general survey questionnaire was used to analyze the prevalence of PTSD and sleep quality among firefighters. Binary logistic regression and partial correlation analysis were conducted to investigate the relationship between sleep quality and PTSD among firefighters. Results: Among 1021 firefighters, the prevalence of PTSD was 4.6%. The positive rates of symptoms such as “recurrent disturbing dreams” and “difficulty falling asleep or easily waking up” in the PTSD positive group were 85.1% and 100.0%, respectively. The comorbidity rate of sleep quality problems and PTSD was 72.3%. Age and college education or above are risk factors for sleep disorders in firefighters, while moderate and high-intensity exercise are protective factors for sleep disorders (P < 0.05). Overall sleep quality and daytime dysfunction in firefighters are moderately positively correlated with PCL-C scores (P < 0.01). Conclusions: Studies have shown that PTSD patients among firefighters generally exhibit sleep disorders, and sleep problems among firefighters should be taken seriously.