重度创伤性骨折患者术后复发恐惧与疾病不确定感的相关性分析

Correlation between fear of recurrence and uncertainty of illness in patients with severe traumatic fracture after operation

目的探讨重度创伤性骨折患者术后复发恐惧与疾病不确定感的相关性。方法选取2018年1月至2020年10月上海交通大学附属第六人民医院创伤骨科收治的69例重度创伤性骨折术后患者为研究对象,采用恐惧疾病进展简化量表(fear of progression questionnaire-short form,FoP-Q-SF)评估患者恐惧疾病进展(fear of progression,FoP)水平,并分析FoP水平与疾病不确定感的相关性。结果全部患者的FoP-Q-SF总分为18-53分,平均(31.31±7.06)分,共有26例(37.7%)患者FoP-Q-SF总分≥34分,存在心理功能失调。年龄60-70岁、小学文化程度、家庭人均月收入<4000元、无医保、无子女陪伴、内科合并症≥3个、简明损伤定级和创伤严重程度评分(abbreviated injury scale-injury severity score,AIS-ISS)>25分、Mishel疾病不确定感量表(Mishel’s uncertainty in illness scale,MUIS)评分≥117.5分、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分为≥35分、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分为≥21分患者的FoPQ-SF总分分别显著高于年龄≥71岁、大专及以上文化程度、家庭人均月收入>6000元、有医保、有子女陪伴、内科合并症≤2个、AIS-ISS≤25分、MUIS评分≤74.7分、HAMD评分为≤19分、HAMA评分为≤13分患者(均P<0.05)。多元线性回归分析结果表明,家庭人均月收入、MUIS评分、HAMA评分均为重度创伤性骨折患者术后FoP水平的独立影响因素(均P<0.05)。结论不少重度创伤性骨折患者术后复发恐惧感较强,家庭人均月收入越低、疾病不确定感水平越高、焦虑情绪越严重,患者的复发恐惧感越强,临床上应对此类患者进行针对性的健康宣教与心理干预。

Objective To study the correlation between fear of recurrence and uncertainty of illness in patients with severe traumatic fracture after operation.Method Sixty-nine patients with severe traumatic fracture after operation from January 2018 to October 2020 in the Department of Orthopedic Trauma in Shanghai Jiaotong University Affiliated Sixth People’s Hospital were enrolled for the study.The fear of progression questionnaire-short form(FoP-Q-SF)was performed to evaluate the fear of progression(FOP)level,and the correlation between FoP level and uncertainty of illness was analyzed.Result The total score of FoP-Q-SF in all patients ranged from 18 to 53 points,with an average score of(31.31±7.06)points.Total scores of 26 patients(37.7%)were more than 34 points,and they stuffed from psychological imbalance.The total score of FoP-Q-SF scale in patients with age 60 to 70 years old,primary school education level,family per capita monthly income<4000 yuan,no medical insurance,no child accompanying,medical complications≥3,abbreviated injury scale-injury severity score(AIS-ISS)score>25 points,Mishel’s uncertainty in illness scale(MUIS)score≥117.5 points,Hamilton depression scale(HAMD)score≥35 points,Hamilton anxiety scale(HAMA)score≥21 points were significantly higher than those in patients with age≥71 years old,junior college and above education level,family per capita monthly income>6000 yuan,medical insurance,child accompanying,medical complications≤2,AIS-ISS score≤25 points,MUIS score≤74.7 points,HAMD score≥19 points,HAMA score≤13 points(all P<0.05).Multiple linear regression analysis showed that family per capita monthly income,MUIS score and HAMA score were the independent influencing factors of FoP level in patients with severe traumatic fracture after operation(all P<0.05).Conclusion Quite a few patients with severe traumatic fracture after operation have strong fear of recurrence.The lower the family per capita monthly income,the higher the level of disease uncertainty and anxiety,and the stronger the fear of recurrence,so the targeted health education and psychological intervention should be given in clinical.