自我效能感在老年女性骨质疏松患者恐动症与体力活动间中介效应

Mediating effect of self-efficacy on relationship between kinesiophobia and physical activity among female elderly osteoporosis patients

目的探究老年女性骨质疏松患者恐动症、慢性疼痛自我效能感和体力活动的关系,并分析慢性疼痛自我效能感的中介效应。方法2017年12月-2018年5月,采用一般人口学调查表、汉化版慢性疼痛自我效能感量表(CPSS)、恐动症评分表(TSK)、老年人体力活动量表(PASE),便利抽取辽宁省大连市和锦州市4所三甲医院600名≥60岁老年女性骨质疏松患者进行问卷调查,应用SPSS21.0和AMOS21.0软件对数据进行统计学分析。结果慢性疼痛自我效能感得分与体力活动得分呈显著正相关(r=0.317,P=0.000),恐动症得分与体力活动、慢性疼痛自我效能感得分呈显著负相关(r=–0.251,P=0.000;r=–0.311,P=0.000)。慢性疼痛自我效能感在恐动症与体力活动间起到部分中介效应:卡方与自由度比值(CMIN/DF)=4.510,适配度指数(GFI)=0.957,调整后适配指数(AGFI)=0.920,渐进残差均方和平方根(RMSEA)=0.077,效应值为32.2%。结论增强自我效能感和减少恐动症发生是有效提高老年女性骨质疏松患者体力活动水平的潜在干预措施。

Objective To explore correlations between kinesiophobia, chronic pain self-efficacy and physical activity among female elderly osteoporosis patients and to analyze the mediating effect of chronic pain self-efficacy. Methods Using convenient sampling, we conducted an anonymous questionnaire survey among 600 female osteoporosis patients aged 60 years and above in four tertiary grade A hospitals in Dalian and Jinzhou city from December 2017 to May 2018. Chronic Pain Self-Efficacy Scale(CPSS), Tampa Scale of Kinesiophobia(TSK), and Physical Activity Scale for Elderly(PASE) were adopted in the study. Data analyses were performed with SPSS 21.0 and AMOS21.0. Results There was a significant positive correlation between the score of CPSS and PASE(r = 0.317, P = 0.000). The score of TSK was inversely correlated significantly with the scores of PASE(r =-0.251, P = 0.000) and CPSS(r=-0.311, P = 0.000). Chronic pain self-efficacy played a partial mediation effect on the correlation between kinesophobia and physical activity, with the following parameters for the established structural equation model:minimum chi-square value/degree of freedom(CMIN/DF) = 4.510, goodnessof-fit index(GFI = 0.957), adjusted goodness-of-fit index(AGFI) = 0.920, root mean square error of approximation(RMSEA) = 0.077, and effect ratio = 32.2%. Conclusion Improving chronic pain self-efficacy and preventing kinesophobia are potential intervention measures for promoting physical activity among female elderly osteoporosis patients.