全髋关节置换术后患者反刍性沉思水平及其影响因素分析

Analysis of rumination level and its influencing factors in patients after total hip arthroplasty

目的调查全髋关节置换术后患者的反刍性沉思现状,分析其影响因素,为进一步制定干预措施提供参考依据。方法选取2019年3—11月在广州市2所三级甲等医院骨科接受治疗的245例全髋关节置换术后患者,采用一般情况调查表、事件相关性反刍性沉思问卷、社会支持评定量表及希望水平量表进行调查。采用t检验、方差分析、Pearson相关性分析、多元线性回归分析对全髋关节置换术后患者的反刍性沉思水平进行分析。结果全髋关节置换术后患者侵入性和目的性反刍性沉思总分为(14.56±4.57)分、(13.29±4.48)分;多元线性回归分析显示,文化程度、Harris髋关节评分、社会支持及希望水平是侵入性反刍性沉思的主要影响因素(F=26.533,P<0.001;R^2=0.326,调整R^2=0.314);文化程度、家庭人均月收入、社会支持及希望水平是目的性反刍性沉思的主要影响因素(F=41.964,P<0.001;R^2=0.534,调整R2=0.522)。结论全髋关节置换术后患者反刍性沉思处于中等偏下水平,临床医务人员应根据患者情况采用个体化干预,重视社会支持和希望水平对其反刍性沉思的影响,引导患者向积极认知加工转变,最终促进患者的术后康复。

Objective To investigate the status of rumination in patients after total hip arthroplasty,analyze its influencing factors,and provide reference for further development of intervention measures.Methods A total of 245 patients after total hip arthroplasty who were treated in the orthopaedics department of two tertiary Class A hospitals in Guangzhou from March to November 2019 were selected and investigated using the general situation questionnaire,Event Related Ru-mination Inventory,Social Support Rating Scale and Herth Hope Index.The t-test,analysis of variance,Pearson correla-tion analysis and multiple linear regression analysis were used to analyze the rumination level in patients after total hip ar-throplasty.Results The scores of intrusive rumination and deliberate rumination of patients after total hip arthroplasty were(14.56±4.57)and(13.29±4.48).Multivariate linear regression analysis showed that education level,Harris hip score,social support,and level of hope were the main influential factors for invasive rumination(F=26.533,P<0.001;R^2=0.326,adjusted R^2=0.314);Educational level,monthly household income,social support,and level of hope were the main influencing factors of deliberate rumination(F=41.964,P<0.001;R^2=0.534,adjusted R^2=0.522).Conclusion The rumination of patients after total hip arthroplasty are at a moderately low level.Clinical medical staff should adopt individualized intervention according to the patient's situation,pay attention to the impact of social support and hope levels on their rumination,guide patients to change to positive cognitive processing,and ultimately promote the postoperative rehabilitation.