老年髋部骨折固定术后患者正念水平与自我感受负担及家庭康复的关系

Correlation of mindfulness level with self-perceived burden and family rehabilitation in elderly patients with hip fracture fixation

目的分析老年髋部骨折固定术后患者正念水平与自我感受负担及家庭康复的关系。方法应用正念注意觉知量表(Mindful Attention Awareness Scale,MAAS)、自我感受负担量表(Self-perceived Burden Scale,SPBS)和医从性量表等评价患者正念水平、自我感受负担及医从性,结合患者髋关节功能(Harris评分)及日常生活能力(Barthel指数)变化情况对168例老年髋部骨折固定术后患者进行评定,正念水平与自我感受负担及家庭康复的关系采用Pearson相关性分析。结果高正念水平组患者家庭康复状况优于低正念水平组(P<0.05)。多元Logistic回归分析结果表明:性别、年龄、合并影响骨代谢的慢性疾病、伤后手术时间、跌倒风险水平、SPBS、家庭功能因素、正念水平是老年髋部骨折固定术后患者家庭康复的影响因素。高正念水平患者依从性行为如吸烟、饮酒、饮食、康复锻炼、用药和体位保护等方面优于低正念水平组,差异有统计学意义(P<0.05)。正念水平总评分以及观察、描述、对内在经验的非评判性、对内在经验的非反应性及觉知的行为与SPBS总评分呈负相关(P<0.01)。结论老年髋部骨折固定术后患者正念水平越高,其自我感受负担越轻、遵医行为越好,有利于提高家庭康复效果。

Objective To investigate the mindfulness level and its correlation with selfperceived burden and family rehabilitation in elderly patients with hip fracture fixation.Methods Mindful Attention Awareness Scale,Compliance Scale and Self-perceived Burden Scale（SPBS）were used as evaluating tools to analyze the mindfulness level,compliance and selfperceived burden for totally 168 cases of elderly patients with hip fracture fixation;and its correlation with self-perceived burden and family rehabilitation in elderly patients with hip fracture fixation combining the patients′hip function（Harris Scale）and Daily Life Ability（Barthel index）were analyzed by Pearson.Results The family rehabilitation condition in the high mindfulness level group was obviously higher than in low mindfulness level group（P〈0.05）.Logistic regression analysis showed that gender,age,chronic diseases affecting bone metabolism,operation time,the level of fall risk,SPBS and the family function were the influencing factors for patients with hip fracture fixation.The compliance behaviors such as smoking,drinking and diet,medication,rehabilitation exercise and posture protection in high mindfulness level group were obviously better than in low mindfulness level group（P〈0.05）.Pearson analysis showed that total mindfulness score and each single item score were negative correlated with SPBS（all P〈0.01）.Conclusion The mindfulness level of elderly hip fracture fixation is higher,the self perceived burden is lighter and compliance higher, which is advantageous to family rehabilitation.