老年患者脊柱压缩性骨折术前疾病不确定感状况及其影响因素

Preoperative Uncertainty in Illness in Elderly Patients with Spinal Compression Fracture and Its Influencing Factors

目的观察老年脊柱压缩性骨折患者术前疾病不确定感状况,分析患者疾病不确定感的影响因素。方法回顾性分析2020年1~12月期间郑州市骨科医院接受手术治疗的124例老年脊柱压缩性骨折患者病历资料,全部患者均于术前接受疾病不确定感评价,采用疾病不确定感量表(MUIS)评估,评估结果资料完整,统计评估结果并分组,分为疾病不确定感高组和疾病不确定感低组,查阅患者病历资料,设计基线资料填写表填写两组基线资料并比较,将可能因素纳入,经单因素与多因素分析找出影响疾病不确定感的因素。结果查阅资料统计发现,124例老年脊柱压缩性骨折患者中,有25例患者疾病不确定感高,占20.16%;疾病不确定感高组和疾病不确定感低组受教育程度、不良心理状态、家庭月收入、疾病接受度及自我效能比较差异有统计学意义(P<0.05),组间其他资料比较差异无统计学意义(P>0.05);经Logistic回归分析结果显示,受教育程度低、不良心理状态、家庭月收入<3000元、疾病接受度差及自我效能差均是老年脊柱压缩性骨折患者术前疾病不确定感高的影响因素(OR>1,P<0.05)。结论受教育程度低、不良心理状态、家庭月收入<3000元、疾病接受度差及自我效能差均会提高老年脊柱压缩性骨折患者术前疾病不确定感,临床应重视伴有上述因素患者早期合理干预,以减轻疾病不确定感,促进手术顺利实施。

Objective To observe the preoperative uncertainty in illness in elderly patients with spinal compression fracture,to analyze the influencing factors of uncertainty in illness of patients.Methods The medical records of 124 elderly patients with spinal compression fractures who received surgical treatment in Zhengzhou Orthopedic Hospital from January 2020 to December 2020 were retrospectively analyzed,all patients were evaluated with uncertainty in illness before operation,Mishel Uncertainty in Illness Scale(MUIS)was used to evaluate,the data of assessment results were complete,the evaluation results were counted and divided them into groups,namely a high uncertainty in illness group and a low uncertainty in illness group,the medical records of patients were consulted,the baseline data of the two groups were filled in and compared,the possible factors were taken into account,single factor and multi factor analysis were used to find out the influencing factors of uncertainty in illness.Results After consulting the statistics of data found that among 124 cases of elderly patients with spinal compression fracture,25 cases had high uncertainty in illness,accounting for 20.16%;there were statistical significant differences in the comparison of education level,bad mental state,family monthly income,disease acceptance and self-efficacy between the high uncertainty in illness group and low uncertainty in illness group(P<0.05),there was no statistical significant difference in the comparison of other data between the two groups(P>0.05);through Logistic regression analysis,the results showed that low education level,bad psychological state,family monthly income<3000 yuan,poor disease acceptance and poor self-efficacy were the influencing factors of high preoperative uncertainty in illness in elderly patients with spinal compression fracture(OR>1,P<0.05).Conclusion Low education level,bad psychological state,family monthly income<3000 yuan,poor acceptance of disease and poor self-efficacy can improve the preoperative uncertainty in illness of elderly patients with spinal compression fracture,in order to reduce the uncertainty in illness and promote the smooth implementation of operation,the early reasonable intervention of patients with the above factors should be paid attention to in clinic.