腰椎退行性病变术后患者积极度与出院准备度的相关性分析

Correlation between patient activation and discharge readiness in patients with degenerated lumbar disorders after surgery

目的调查腰椎退行性病变术后患者积极度与出院准备度的现状,并分析二者的关系。方法采用便利抽样法,选取2018年1—12月在广东省中医院珠海医院骨三科诊疗的183例腰椎退行性病变术后患者。采用患者积极度量表(PAM)和出院准备度量表(RHDS)进行调查,并采用Pearson相关性分析和多重线性回归分析二者的关系。结果183例患者的标准化PAM得分为(53.06±16.14)分,其中86例(47.0%)得分≤47分,37例(20.2%)得分为47.1-55.1分,48例(26.2%)得分为55.2-67.0分,12例(6.6%)得分≥67.1分。183例患者的RHDS得分为(92.10±10.43)分,标准化得分为(7.68±1.87)分。PAM各维度得分均与RHDS各维度得分呈正相关(r=0.203-0.588,P<0.05),且自我疾病管理意识、疾病相关知识、术后预防能力和坚持健康生活的信念均为出院准备度的独立影响因素(P<0.05),共可解释32.9%的方差变异量。结论腰椎退行性病变术后患者的积极度及出院准备度仍有待改善,良好的患者积极度有助于提升出院准备度。临床医护人员应注重培养患者积极度,以提升患者在出院前的自我管理能力。

Objective To investigate the current status of current status of patient activation and discharge readiness in patients with degenerated lumbar disorders after surgery and to analyze their correlation.Methods By the convenient sampling method,a total of 183 patients with degenerated lumbar disorders after surgery who were treated in Third Department of Orthopedics in Guangdong Province Hospital of Traditional Chinese Medicine,Zhuhai Hospital from January 2018 to December 2018 were selected.Patient Activation Measure(PAM)and Readiness for Hospital Discharge Scale(RHDS)were used to investigate them,and Pearson correlation analysis and multiple linear regression analysis were used to analyze the relationship between them.Results The standardized PAM scores of 183 patients were(53.06±16.14).Of which,86 patients(47.0%)scored less than or equal to 47,37 patients(20.2%)scored 47.1 to 55.1,48 patients(26.2%)scored 55.2 to 67.0,12 patients(6.6%)scored more than or equal to 67.1.The RHDS score of 183 patients was(92.10±10.43)and the standardized score was(7.68±1.87).PAM scores in all dimensions were positively correlated with RHDS scores in all dimensions(r=0.203-0.588,P<0.05).Moreover,self-consciousness of disease management,knowledge of disease,postoperative prevention ability and belief in adhering to healthy life were all independent influencing factors of discharge readiness(P<0.05),which could explain 32.9%of variances.Conclusions The patient activation and discharge readiness of patients with degenerated lumbar disorders after surgery still need to be improved,and good patient activation helps improve discharge readiness.Clinical medical staff should focus on cultivating patient activation so as to improve their self-management ability before discharge.