慢性下腰痛患者健康促进生活方式现状及影响因素分析

Current status and influencing factors of health-promoting lifestyle in patients with chronic low back pain

目的调查慢性下腰痛患者健康促进生活方式现状,探讨其影响因素。方法采用便利抽样方法,选取2019年3—10月在广州市某三级甲等医院就诊的189例慢性下腰痛患者为研究对象,采用一般资料问卷、健康促进生活方式评定量表Ⅱ、社会支持评定量表、下腰痛疾病知识问卷、慢性病自我效能量表对慢性下腰痛患者进行调查,应用单因素分析、Pearson相关分析、多重线性回归分析探讨健康促进生活方式的影响因素。结果189例慢性下腰痛患者健康促进生活方式总分为(118.68±18.61)分,其中条目均分由高至低分别为压力应对(2.59±0.62)分、人际关系(2.47±0.67)分、营养(2.35±0.25)分、自我实现(2.33±0.35)分、运动(2.04±0.35)分、健康责任(1.93±0.19)分;单因素分析显示不同年龄、婚姻状态、共同居住者、文化程度、职业、BMI、有无合并慢性病慢性下腰痛患者健康促进生活方式得分比较,差异均有统计学意义(P<0.05);相关分析显示慢性下腰痛患者健康促进生活方式与社会支持(r=0.358,P<0.01)、自我效能(r=0.418,P<0.01)、疾病知识(r=0.369,P<0.01)均呈正相关。回归分析显示社会支持、疾病知识、自我效能、年龄、文化程度是慢性下腰痛患者是否采取健康促进生活方式的主要影响因素(P<0.05)。结论慢性下腰痛患者健康促进生活方式欠佳,尤其表现在运动和健康责任方面;且健康促进生活方式受社会支持、疾病知识、自我效能影响。应加强科学且专业、个性化的健康指导,提高患者在疾病发展、治疗、控制方面的认知水平,强化患者健康责任和提高运动治疗准确性;同时提供多渠道信息获取方法,鼓励家庭参与,满足患者的健康促进需求,增强其疾病管理自我效能。

Objective To investigate the current status of health-promoting lifestyle in patients with chronic low back pain and explore its influencing factors.Methods Convenience sampling method was adopted to select patients with chronic low back pain who visited a ClassⅢGrade A hospital in Guangzhou from March to October 2019 as the research object(n=189).All patients with chronic low back pain were investigated with the General Information Questionnaire,Health-Promoting Lifestyle ProfileⅡ,Social Support Rate Scale,Low Back Pain Knowledge Questionnaire and the Chronic Disease Self-efficacy Scale.Single factor analysis,Pearson correlation analysis,multiple linear regression analysis were used to explore the influencing factors of health-promoting lifestyle.Results Among 189 patients with chronic low back pain,the total score of health-promoting lifestyle was(118.68±18.61),and scores from high to low were stress management(2.59±0.62),interpersonal support(2.47±0.67),nutrition(2.35±0.25),self-actualization(2.33±0.35),exercise(2.04±0.35),health responsibility(1.93±0.19).Single factor analysis showed that there were statistical differences in health-promoting lifestyle scores among chronic low back pain patients with different ages,marital status,co-resident,education level,occupation,body mass index(BMI)and with or without chronic diseases(P<0.05).Correlation analysis showed that the health-promoting lifestyle of patients with chronic low back pain was positively correlated with social support(r=0.358,P<0.01),self-efficacy(r=0.418,P<0.01)and disease knowledge(r=0.369,P<0.01)with statistical differences.Regression analysis indicated that social support,disease knowledge,self-efficacy,age and educational level were the main factors affecting whether patients with chronic low back pain adopted a health-promoting lifestyle(P<0.05).Conclusions Patients with chronic low back pain have poor health-promoting lifestyles,especially in exercise and health responsibility,and health-promoting lifestyles are affected by social support,disease knowledge and self-efficacy.Scientific,professional and personalized health guidance should be strengthened to improve patients'awareness of disease development,treatment,and control,strengthen patients'health responsibilities and improve the accuracy of exercise therapy.At the same time,we should provide multi-channel information acquisition methods,encourage family participation,meet patients'health promotion needs,and enhance their disease management self-efficacy.