中青年腰椎间盘突出症患者各阶段遵医行为特征调查分析

Investigation and analysis on the compliance behavior characteristics of young and middle-aged patients with lumbar disc herniation in different stages

目的调查中青年腰椎间盘突出症(lumbar disc herniation,LDH)患者各阶段遵医行为特征,并分析其影响因素。方法选择2020年6月至2021年6月上海交通大学附属第六人民医院收治的120例中青年LDH患者为研究对象,分别于术前、出院前、出院后3个月使用遵医行为调查问卷评估其遵医行为,并按照患者遵医行为特征变化,将其纳入改善组和未改善组,对比两组患者临床资料,使用多因素Logistic回归分析探讨影响中青年LDH患者遵医行为的相关因素。结果120例中青年LDH患者术前功能锻炼、工作活动、定期复查遵医行为依从性均较差,患者出院前、出院后3个月遵医行为调查问卷平均分较术前上升(均P<0.05),但出院后3个月遵医行为调查问卷平均分较出院前下降(P<0.05)。与术前比较,74例患者出院后3个月遵医行为调查问卷评分上升,改善率为61.67%。改善组与未改善组患者年龄、文化程度、家庭人均月收入、每日运动时间比较差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示,年龄≥35岁、高中以下文化程度、家庭人均月收入<3000元/月、每日运动时间0 h均为影响中青年LDH患者遵医行为的独立危险因素(均P<0.05)。结论中青年LDH患者术前遵医行为依从性较差,虽然术后短时间内依从性有所提升,但出院后患者遵医行为依从性呈下降趋势;年龄、文化程度、收入、运动频次等因素直接影响着患者遵医行为依从性,应针对重点人群展开遵医行为强化教育。

Objective To investigate the compliance behavior characteristics of young and middle-aged patients with lumbar disc herniation(LDH)in different stages and analyze its influencing factors.Method One hundred and twenty young and middle-aged LDH patients admitted to Sixth People's Hospital Affiliated to Shanghai Jiaotong University from June 2020 to June 2021 were selected,and their compliance behavior was evaluated by the questionnaire on compliance behavior before operation,before discharge and 3 months after discharge.According to the changes of patients'compliance behavior characteristics,they were included into improved group and unimproved group.The clinical data of the two groups were compared,and multivariate Logistic regression analysis was used to summarize the related factors affecting the patients'compliance behavior.Result Patients'compliance with preoperative functional exercise,work activities and regular reexamination were poor.The average score of patients'questionnaire on compliance behavior scores before and 3 months after discharge were higher than those before operation(all P<0.05),but 3 months after discharge were lower than those before discharge(P<0.05).Compared with before operation,the questionnaire on compliance behavior scores in 74 patients increased 3 months after discharge,and the improvement rate was 61.67%.There were statistically significant differences in age,education level,per capita monthly income of family and daily exercise time between improved group and unimproved group(all P<0.05).Multivariate Logistic regression analysis showed that age≥35 years old,education level below senior high school,monthly income per family<3000 yuan/month,and daily exercise time of 0 h were independent risk factors affecting the improvement of compliance behavior of young and middle-aged patients with LDH(all P<0.05).Conclusion The compliance behavior of young and middle-aged patients with LDH before operation are poor.Although the compliance is improved in a short time after operation,but the compliance of patients after discharge shows a downward trend.Age,education level,income,exercise frequency and other factors directly affect patients'compliance behavior,so intensive education on compliance behavior should be carried out for key groups.