膝骨关节炎患者恐动症的现状及其影响因素分析

Current situations and influential factors of kinesiophobia in patient with knee osteoarthritis

目的调查膝骨关节炎(knee osteoarthritis,KOA)患者恐动症发生现状并分析其影响因素,为恐动症干预方案的制定提供理论依据。方法采用便利抽样法,选取2019年5月至10月深圳市某三级医院关节外科、疼痛科门诊及住院部的166例KOA患者,应用一般资料调查表、恐动症Tampa评分表(Tampa scale of kinesiophobia,TSK)、疼痛视觉模拟评分法(visual analogue scale/score,VAS)、多维度健康心理控制源(multidimensional health locus of control,MHLC)量表进行问卷调查。采用Pearson相关性分析和多元线性回归分析筛选KOA患者恐动症发生的影响因素。结果KOA患者恐动症发生率为64.46%,TSK得分为(38.25±3.58)分。患者恐动症与内控型、有势力的他人型呈负相关,与疼痛和健康机遇/命运型呈正相关(P<0.05)。多元线性回归分析显示,患病年限、疼痛和MHLC倾向是KOA患者恐动症的影响因素(P<0.05),其可共同解释总变异的65.30%。结论KOA患者恐动症发生率较高,医护人员应重视该人群恐动症的评估,针对患病年限、疼痛、MHLC倾向制定相应干预措施,提高患者功能锻炼积极性,降低恐动症水平。

Objective To investigate the current situations of kinesiophobia onsets in patients with knee osteoarthritis(KOA)and its influencing factors in order to provide references for clinical intervention.Methods A total of 166 patients with KOA were enrolled from a general hospital in Shenzhen by convenience sampling method.The study was carried out by using a self-designed general data questionnaire,Tampa scale for Kinesiophobia(TSK),visual analogue scale/score(VAS)and the multidimensional health locus of control(MHLC)scale.Pearson correlation analysis and multiple linear regression analysis were used to screen the influencing factors of kinesiophobia in KOA patients.Results The incidence of kinesiophobia in the 166 patients was 64.46%,and TSK score was(38.25±3.58).Kinetophobia of the patient was negatively correlated with internal health locus of control(IHLC)and personal health locus of control(PHLC),and positively with pain and chance health locus of control(CHLC)(P<0.05).Multiple linear regression analysis showed that the course of the disease,pain,and MHLC were the main influencing factors of kinesiophobia in the patients(P<0.05),together which could explain 65.30%of total variation of kinesiophobia.Conclusions The incidence of kinesiophobia in KOA patients is relatively high,and medical staff should pay attention to the evaluation of the symptoms of kinesiophobia among the patients with KOA.Targeted intervention measures should be taken to enable patients to carry out functional exercises and help them to reduce the level of kinesiophobia.