老年急性脊椎骨折患者疾病不确定感影响因素分析

Influencing factors of illness uncertainty in elderly patients with acute vertebral fracture

1目的分析老年急性脊椎骨折患者疾病不确定感的影响因素,为患者的综合健康教育提供依据。2方法收集临床186例急性脊椎骨折患者为研究对象,分别在伤后3周和3个月以问卷调查方式收集和评测患者疾病不确定感、疼痛程度、残疾程度、日常生活能力以及一般临床资料,应用Logistic回归分析老年急性脊椎骨折患者疾病不确定感的影响因素。3结果 3周和3个月时患者的疾病不确定感为中等水平,但3周时患者的疾病不确定感评分显著高于3个月。Logistic回归分析显示影响3周时患者疾病不确定感的主要因素为骨折类型、变形程度、疼痛等(OR值分别为OR=4.886,4.428和4.024;均P<0.05);影响3个月时患者疾病不确定感的主要因素为行动能力、残疾程度、自我照顾行为等(OR值分别为OR=4.032,3.382,3.366;均P<0.05);高文化程度是疾病不确定感的保护因素(OR=0.610或0.599,P<0.05)。4结论老年急性脊椎骨折患者存在疾病不确定感,且其随疾病病程改变。

Objective To analyze influencing factors of illness uncertainty in elderly with acute vertebral fracture,providing the basis for comprehensive health education of patients.Methods We se- lected totally 186 cases of elderly patient with acute vertebral fracture as subject. Illness uncertainty, pain, disability, daily life and clinical index Were evaluated after 3 weeks and 3 months respectively.The influencing factors of illness uncertainty in elderly with acute vertebral fracture were analyzed by Logis- tic regression.Results The uncertainty degree of acute vertebral fracture is in medium after 3 weeks and 3 months respectively, but scores of illness uncertainty of the 3 weeks were significantly higher than that of 3 months ; Logistic regression analysis showed that the main influencing factors of illness uncer- tainty in 3 weeks included the fracture type,deformation degree and pain degree（OR=4.886,4.428 and 4.024;all P 〈0.05）;white influencing factors of illness uncertainty included action ability, disability de- gree and caring behavior oneself （OR= 4.032,3.382 and 3.366;all P 〈0.05）;high culture degree was protective factors of illness uncertainty（OR-0.610 or 0.599, P 〈0.05）.Conclusion The patient with acute vertebral fracture s had the illness uncertainty and the illness uncertainty changed with disease progression.Medical staff should determine its source and take measures to reduce uncertainty.