摘要
目的探讨全髋关节置换术(total hip arthroplasty,THA)术后患者运动恐惧发展轨迹及影响因素。方法采用方便抽样法,选取2023年2月—6月武汉市3所三级甲等医院THA术后患者作为研究对象。在患者术后1~2 d(T1)发放一般情况调查表、恐动症Tampa评分量表、运动自我效能量表、骨科社会支持量表、广泛性焦虑障碍量表、患者健康问卷抑郁量表和疼痛视觉模拟评分表,术后1周(T2)、1个月(T3)、3个月(T4)时,再次采用上述量表进行调查,评估其运动恐惧水平及生理、心理状况。采用潜类别增长模型对运动恐惧轨迹进行分类,并分析不同类别运动恐惧的影响因素。结果共纳入263例THA术后患者,其运动恐惧轨迹分为4个潜在类别,分别为C1高运动恐惧持续组29例、C2中运动恐惧改善组41例、C3低运动恐惧改善组131例、C4无运动恐惧组62例。无序多分类logistic回归分析显示,相较于C4无运动恐惧组,THA患者运动恐惧轨迹类别发展为C1高运动恐惧持续组的影响因素为年龄[比值比(odds ratio,OR)=1.081,95%置信区间(confidence interval,CI)(1.025,1.140)]、有合并症[OR=6.471,95%CI(1.831,22.872)]、T1~T4时间点运动自我效能评分均分[OR=0.867,95%CI(0.808,0.931)]和T1~T4时间点疼痛评分均分[OR=7.981,95%CI(1.718,37.074)],发展为C2中运动恐惧改善组的影响因素为年龄[OR=1.049,95%CI(1.010,1.089)]、文化程度[OR=0.244,95%CI(0.085,0.703)]和T1~T4时间点疼痛评分均分[OR=8.357,95%CI(2.300,30.368)],发展为C3低运动恐惧改善组的影响因素为T1~T4时间点的运动自我效能评分均分[OR=0.871,95%CI(0.825,0.920)]和疼痛评分均分[OR=4.167,95%CI(1.544,11.245)]。结论THA术后患者的运动恐惧呈现不同的变化轨迹,护士应重视对高龄、文化程度低、合并慢性疾病、运动自我效能低下、疼痛水平高的患者运动恐惧的评估和干预。
Objective To investigate the development trajectories of kinesiophobia and their influencing factors in patients after total hip arthroplasty(THA).Methods Patients after THA from three tertiary hospitals in Wuhan from February to June 2023 were selected by convenience sampling method.The general situation questionnaire,Tampa Scale for Kinesiophobia,Self-Efficacy for Exercise Scale(SEE),Groningen Orthopaedic Social Support Scale,Generalized Anxiety Disorder,Patient Health Questionnaire,and Visual Analogue Scale(VAS)were distributed 1-2 d after surgery(T1),which were used again 1 week(T2),1 month(T3),and 3 months(T4)after surgery,to evaluate the level of kinesiophobia and the physical and psychological conditions of the patients.The latent category growth model was used to classify the kinesiophobia trajectories of patients after THA,and the influencing factors of different categories of kinesiophobia trajectories were analyzed.Results A total of 263 patients after THA were included.The kinesiophobia trajectories of patients after THA were divided into four potential categories,including 29 cases in the C1 high kinesiophobia persistent group,41 cases in the C2 medium kinesiophobia improvement group,131 cases in the C3 low kinesiophobia improvement group,and 62 cases in the C4 no kinesiophobia group.Multicategorical logistic regression analysis showed that compared to the C4 no kinesiophobia group,the influencing factors for the kinesiophobia trajectory in THA patients to develop into the C1 high kinesiophobia persistent group were age[odds ratio(OR)=1.081,95%confidence interval(CI)(1.025,1.140)],chronic comorbidities[OR=6.471,95%CI(1.831,22.872)],the average SEE score at T1-T4 time points[OR=0.867,95%CI(0.808,0.931)],and the average VAS score at T1-T4 time points[OR=7.981,95%CI(1.718,37.074)],the influencing factors for the kinesiophobia trajectory to develop into the C2 medium kinesiophobia improvement group were age[OR=1.049,95%CI(1.010,1.089)],education level[OR=0.244,95%CI(0.085,0.703)],and the average VAS scor
作者
赖婷
吴明珑
胡凯利
胡嘉欣
周欣可
LAI Ting;WU Minglong;HU Kaili;HU Jiaxin;ZHOU Xinke(Department of Nursing,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,P.R.China;Department of Orthopedics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,P.R.China;School of Nursing,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,P.R.China)
出处
《华西医学》
CAS
2024年第10期1571-1578,共8页
West China Medical Journal
基金
湖北省卫生健康委科研项目(WJ2023F002)。
关键词
全髋关节置换术
运动恐惧
纵向研究
轨迹
潜类别增长模型
影响因素
Total hip arthroplasty
kinesiophobia
longitudinal study
trajectory
latent category growth model
influencing factors
