全膝关节置换术患者恐动症及影响因素分析

Factors influencing kinesiophobia in patients with total knee arthroplasty

目的有关全膝关节置换术(TKA)患者恐动症的相关报道较少。文中旨在调查全膝关节置换术患者恐动症的发生情况并分析其影响因素,为恐动症干预方案的制定提供理论依据。方法便利抽样选取2016年3至12月郑州大学第一附属医院骨科行TKA治疗的298例全膝关节置换术患者,采用一般资料调查问卷、恐动症TSK评分表、膝关节自我效能量表、简易应对方式问卷及社会支持评定量表对其进行问卷调查,并通过单因素和Logistic回归分析其影响因素。结果 298例患者中恐动症发生率31.88%。Logistic回归分析表明疼痛年限(OR=5.546,95%CI:2.143~14.353)、文化程度(OR=0.145,95%CI:0.067~0.314)、自我效能(OR=0.606,95%CI:0.470~0.780)、积极应对(OR=0.784,95%CI:0.683~0.900)、客观支持(OR=0.807,95%CI:0.691~0.943)和支持利用度(OR=0.570,95%CI:0.461~0.705)是全膝关节置换术患者恐动症的影响因素。结论应重视全膝关节置换术患者的恐惧运动情况,更应该重视疼痛年限、文化程度、客观支持等影响因素,鼓励患者早期康复功能锻炼,以减少恐动症的发生,促使膝关节功能的快速康复。

Objective Currently,there are few articles about kinesiophobia in patients with total knee arthroplasty（ TKA） in China. This study aims to investigate the incidence of kinesiophobia and its influencing factors in TKA patient,and provide evidence for the intervention of kinesiophobia. Methods A total of 298 TKA patients from our hospital were investigated by general information questionnaire,Tampa Scale of Kinesiophobia（ TSK）,Knee Self-Efficacy Scales,Simplified Coping Style Questionnaire and Social Support Rating Scale. Single-factor analysis and logistic regression analysis were conducted to explore influencing factors. Results The score of TSK was 38.50±13.52,and 31.88% of TKA patients reported kinesiophobia. Logistic regression analysis showed that duration of pain（ OR = 5.546,95%CI： 2.143-14.353）,education level（ OR = 0.145,95%CI： 0.067-0.314）,self efficacy（ OR = 0.606,95% CI： 0. 470-0. 780）,positive response（ OR = 0. 784,95% CI：0.683-0. 900）,objective support（ OR = 0. 807,95% CI： 0.691-0.943） and utilization of social support（ OR = 0. 507,95% CI：0.461-0.705） were factors influencing kinesiophobia in TKA patients.Conclusion Attention should be paid to the kinesiophobia in TKA patients,especially those influencing factors including duration of pain,education level,and objective support. Health care providers should encourage early stage rehabilitation exercise to improve the postoperative knee function of TKA patients.