Current States Of Sleep Quality Among Nursing Students At Home And The Application Of Acupoint Massage With Mindfulness

Objective1.A cross-sectional study was conducted to understand the current situation of sleep quality of nursing undergraduates at home and the interaction mechanism of emotion state,cognitive orientation and mindfulness level,and to formulate practical programs suitable for current teaching.2.The short-term acupoint massage with mindfulness and mindfulness training courses online are used to teach all home nursing students,and add a random music control group,to analyze the impact of different teaching implementations on their sleep quality,so as to provide new ideas for seeking a new,simple,scientific and efficient sleep hygiene psychology teaching practice program.Methods1.Status survey:Based on the teaching cloud platform of Psychiatric Nursing on February 23rd to 24th,2020,all 292 junior nursing students were selected with cluster sampling method from one university in Shanxi conducting an online questionnaire survey.The Self-designed general information questionnaire,Pittsburgh sleep quality index,Self-Rating anxiety scale,Self-rating depression scale,Cognitive Appraisal qrientation test and Five-factor Mindfulness questionnaire were used to understand the current situation of nursing undergraduates’sleep quality and related main psychological variables,and construct a mediation and moderation model to explore the mechanism of sleep quality.2.Intervention survey:（1）Preparation of the teaching plan:The expert team in Chinese medicine and Psychology discussed and revised it,including"theme cognitive education+practice course".Among them,the key intervention meridians and acupoints of the Mindfulness acupoint massage course are:（1）Foot Shaoyang gallbladder meridian:Fengchi,Huantiao,Fengshi,Yanglingquan（from top to bottom）;（2）Foot Jueyin Liver meridian:Taichong,Xingjian,Zhangmen,Qimen（bottom to top）;（3）Hand Taiyin lung meridian:Chize,Kongju,Taiyuan,thenar（from top to bottom）.（2）Intervention:All junior nursing students were divided randomly into experimental group H1（100）,experimental group H2（100）and control group H0（101）for daily teaching.In each group,30 nursing students with PSQI≥5assessed early were observed.Control group H0 received self-help random music listening before going to bed.Experimental group H1 received online acupoint massage with mindfulness course at 20:00-20:30;Experimental group H2 received online mindfulness practice course at 20:30-21:00,and asked self-practice the next morning.All members are asked to work and rest regularly（8 in the morning and11 in the evening）,and each group leader supervises the implementation.The intervention courses are respectively presided over by the author and a clinical psychologist,assisted by a graduate student.The period is 15 days.Actively encouraged sharing experiences before and after the exercise,and repeatedly emphasizing the core of exercisest in answering questions.Follow-up exercises are led by each group leader on the same time in turn,supervised by the author.At 15days（the end of the course）,1 month（follow-up）,and 2 months（follow-up）,the Pittsburgh Sleep Quality Index was used for evaluation.For statistical analysis,the comparison of repeated measures between groups and time points used generalized mixed linear models,and multiple comparisons were performed afterwards.Results1.Status survey:（1）Most of the nursing students surveyed had activities before going to bed,only 17.1%went to bed directly,and 44.9%of them did not sleep until dawn,and the most common work and rest were late to bed and late to wake up.The score of PSQI was（3.54±2.74）,poor sleep quality accounted for 9.25%,and the detection rate of poor sleep was 30.82%.The score of anxiety was（35.43±6.41）,and a total of 26.37%of those with anxiety and tendency;the score of depression was（42.04±8.06）,a total of 62.33%of those with depression and tendency.The score of cognitive orientation was（15.34±2.67）,and the mindfulness score was（123.38±11.21）.（2）Anxiety and depression play a partial and complete mediation between cognitive tendency and sleep quality respectively.The effect index are:the mediating effect of anxiety is-0.07,accounting for 28.19%of the total effect;the mediating effect of depression is-0.14,accounting for 61.38%of the total effect.Mindfulness can play a regulatory role between anxiety/depression and sleep quality（B₁=-0.01,T₁=-3.19;B₂=-0.003,T₂=-2.68,P<0.01）.2.Intervention survey:（1）Comparison of factors between groups before intervention:There were no significant differences in the general data,sleep quality,anxiety and depression,cognitive tendency and mindfulness scores（P>0.05）.The pre-test baseline was comparable.（2）Comparison of sleep quality during the whole process of intervention:Using the generalized linear mixed model combined with its further pairwise comparison and the change trend graph,comprehensively analyzes.First of all,in terms of overall sleep quality（PSQI score）,the improvement trend of the mindfulness acupoint massage intervention among three groups was more obvious.Secondly,all factors of sleep quality:（1）In the dimensions of subjective sleep quality,time to fall asleep,sleep time,and daytime dysfunction,the improvement trend of the mindfulness acupoint massage intervention was more obvious.（2）In the dimensions of sleep efficiency and sleep disorder,the improvement trend of the random music control intervention was more obvious.The sleep quality of the three groups of nursing students all improved significantly.（3）Comparison between groups after intervention:After the course,there was a statistical difference only in the Sleep disorders among teaching implementations in the three groups（P<0.01）,and the improvement effect of the group H1 was the best.After 1month,there was significant difference only in the Sleep time among groups（P<0.01）.The improvement effect and trend of the group H1 and the control group were the same,and both were better than the group H2.After 2 months,there were significant differences in the PSQI score and the Sleep time among groups（P<0.05）.The intervention effects of the group H1 and the control group were equivalent,but the improvement trend of the group H1 is better.（4）Subjective feedback of three groups:The group H1（Mindfulness acupoint massage）:paying attention to the current massage acupoint feelings with a mindful attitude,and the sensation of the acupoints starts from severe pain,tingling,gradually to numbness,relief and comfort.It verifies the incisive principle of the theory in Chinese medicine,"Pain is relieved with improved blood circulation".For example,"Improve the awareness of body sensations,the original weak and cold constitution has become the body gradually warming up","Being serious and not distracting can help improve concentration","after massage,I fell asleep"and so on.The group H2（Mindfulness training）helps to improve the awareness of one’s own feelings and emotional thoughts,discover one’s inner healing power,and make one’s mind calm and happy.The group H0（Random music）can help the body and mind relax,fast sleep.All three methods received a lot of positive feedback from students.Conclusion1.During the epidemic period,nursing undergraduates who occupy the home had certain sleep quality problems.Their mood was generally in a negative and depressed state,and their overall cognitive state and mindfulness were at a medium level.Cognitive orientation can directly predict sleep quality,and it can also indirectly influence sleep quality through the mediating role of emotion（anxiety,depression）.It can help improve the current sleeping quality of nursing undergraduates by setting up a correct cognitive view,strengthening the guidance of positive beliefs and behavior training.2.Mindfulness,as a psychological trait ability,plays a moderating role in the relationship between anxiety/depression and sleep quality.3.In the context of short-term teaching intervention,the improvement trend of Mindfulness acupoint massage for sleep quality was more obvious,with a certain continuity,better than mindfulness and random music practice.In the whole teaching,the sleep quality of nursing undergraduates in the three groups has been significantly improved,especially during the 15-day period of course leadership.