老年全膝关节置换术患者希望水平及影响因素分析

Level of hope and its influencing factors in elderly patients with total knee anthroplasty

目的调查老年全膝关节置换术(TKA)患者希望水平并分析其影响因素,为提高TKA术后患者的希望水平及生活质量提供依据。方法采用整群随机抽样法,选取哈尔滨市某2所三级甲等综合医院2017年1月-2018年7月收治的308例首次接受人工双侧TKA患者为研究对象,使用Herth希望量表、贝克抑郁量表第2版、社会支持量表进行问卷调查。结果老年TKA患者希望水平总分为(29.96±8.72)分,其中希望水平处于中等至高等的患者所占比例为76.62%(236/308);抑郁总分(19.20±11.75)分,处于轻度抑郁水平。不同性别、居住地、文化程度、婚姻状况、家庭人均月收入患者希望水平差异具有统计学意义(P<0.05);多元逐步回归分析结果显示:年龄、性别、家庭人均月收入、抑郁、消极应对方式、主观支持、客观支持是老年TKA患者希望水平的影响因素(P<0.05)。结论TKA术后患者处于中等希望水平,医护人员应关注影响患者希望水平的相关因素,采取有针对性的护理干预措施,给予患者心理指导、提供社会支持,进一步提高TKA患者的希望水平。

Objective To investigate the hope level of elderly patients undergoing total knee arthroplasty (THA) and analyze its influencing factors, so as to provide evidence for improving the hope level and quality of life of patients after THA. Methods A cluster random sampling method was used to select 308 patients with bilateral THA for the first time who were admitted to two ClassⅢ Grade A general hospitals in Harbin from January 2017 to July 2018. Questionnaire surveys were conducted using Herth Hope Scale, the Second Edition of Beck Depression Scale and Social Support Scale. Results The total score of hope level in elderly THA patients was (29.96±8.72). Among them, 76.62%(236/308) had moderate to high level of hope and the total score of depression was (19.20±11.75) which was at a moderate level. There were significant differences in the hope level of patients with different gender, place of residence, educational level, marital status and family per capita monthly income (P< 0.05). The results of multiple stepwise regression analysis showed that age, sex, family income per capita, depression, negative coping style, subjective support and objective support were the influencing factors of elderly THA patients' hope level (P < 0.05). Conclusions The THA patients' hope are at a medium level. Medical staff should pay attention to the relevant factors affecting the level of hope, adopt targeted nursing intervention measures, give psychological guidance to patients, provide social support, and further improve the level of hope of the THA patients.