正念认知干预对膝关节置换术后患者恐动心理及自我效能的影响

Effect of mindfulness-based cognitive intervention on fear of movement and self-efficacy in patients underwent total knee arthroplasty

目的探讨正念认知干预对膝关节置换术(TKA)后患者恐动心理及自我效能的影响。方法选取2018年1月—2022年4月在漯河市中心医院接受TKA治疗的122例患者作为研究对象,采用随机数字表法分为对照组与观察组,每组61例。对照组患者采用常规护理干预,观察组患者采用正念认知干预。2组患者均持续干预4周,于术后6个月复诊。比较2组患者干预前后的恐动症坦帕评分(TSK)、康复自我效能量表(SER)评分、疼痛数字量表(NRS)评分及干预后护理满意度。结果2组患者干预前TSK评分比较,差异无统计学意义(P>0.05);2组患者干预后TSK评分均低于干预前,且观察组患者低于对照组,差异均有统计学意义(P<0.05)。2组患者干预前SER量表中的身体锻炼自我效能、应对自我效能维度评分及SER总分比较,差异均无统计学意义(P>0.05);2组患者干预后身体锻炼自我效能、应对自我效能维度评分及SER总分均高于干预前,且观察组患者均高于对照组,差异均有统计学意义(P<0.05)。2组患者干预前NRS评分比较,差异无统计学意义(P>0.05);2组患者干预后NRS评分均低于干预前,且观察组患者低于对照组,差异均有统计学意义(P<0.05)。观察组患者护理满意度为95.08%(58/61),高于对照组的83.61%(51/61),差异有统计学意义(χ^(2)=4.219,P=0.040)。结论正念认知干预用于TKA术后患者护理中,有助于减轻患者恐动心理,促进患者康复自我效能的养成,减轻患者疼痛程度,提高患者护理满意度,值得在临床上推广应用。

Objective This paper aims to investigate the effect of mindfulness-based cognitive intervention on fear of movement and self-efficacy in patients receiving total knee arthroplasty(TKA).Methods A total of 122 patients who received TKA in Luohe Central Hospital from January 2018 to April 2022 were selected as the study participants.They were assigned to the control group and the observation group using a random number table,with 61 cases in each group.Patients in the control group received routine nursing intervention;patients in the observation group,mindfulness-based cognitive intervention.Patients in both groups continued to intervene for 4 weeks and returned 6 months after surgery.Tampa Scale of Kinesiophobia(TSK),Self-Efficacy for Rehabilitation Outcome Scale(SER),Numerical Rating Scale(NRS)were compared between the two groups before and after intervention.Degree of satisfaction with nursing was compared between the two groups after intervention.Results No significant difference was observed in TSK score before intervention between the two groups(P>0.05).TSK score in both groups was significantly decreased after intervention,and the observation group was significantly lower than the control group(P<0.05).No significant differences were found in the subscale(self-efficacy of physical exercise and coping)and total scores of SER between the two groups before intervention(P>0.05);subscale(self-efficacy of physical exercise and coping)and total scores of SER between the two groups after intervention showed a significant increase,and the observation group was significantly higher than the control group(P<0.05).No significant difference was found in the NRS scores before intervention between the two groups(P>0.05);the NRS scores after intervention in the two groups showed a significant decrease,and the NRS scores in the observation group were significantly lower than those in the control group(P<0.05).The degree of satisfaction with nursing in the observation group was significantly higher than that in the control group,[95.08%(58/61)vs.83.61%(51/61);χ^(2)=4.219,P=0.040].Conclusion Mindfulness cognitive intervention in the nursing of patients after TKA is beneficial to reduce the fear of movement,promote the development of rehabilitation self-efficacy,lower the degree of pain,and raise the degree of satisfaction with nursing.These advantages hold promise for a wider application clinically.