老年腰椎间盘突出症病人疼痛信念与认知衰弱的关系:睡眠质量的中介作用及焦虑的调节作用

The relationship between pain belief and cognitive frailty in patients with lumbar disc herniation: the mediating role of sleep quality and the moderating role of anxiety

目的:探讨老年腰椎间盘突出症病人疼痛信念、睡眠质量、焦虑与认知衰弱的关系。方法:采用便利抽样法选取2021年6月-2021年12月锦州市2所三级甲等综合医院336例老年腰椎间盘突出症病人为研究对象,采用一般资料调查表、疼痛数字评定量表(NRS)、疼痛信念与感知量表(PBPI)、阿森斯失眠量表(AIS)、焦虑自评量表(SAS)、衰弱筛查量表(FRAIL)和简易精神状态量表(MMSE)对其进行问卷调查。结果:老年腰椎间盘突出症病人疼痛信念得分为(-0.90±9.41)分;睡眠质量得分为(6.11±4.24)分;焦虑得分为(50.56±9.48)分;其中79例(23.5%)有认知衰弱。Logistic回归分析发现,睡眠质量、焦虑和疼痛信念是老年腰椎间盘突出症病人发生认知衰弱的影响因素(P<0.05)。中介作用分析结果显示,睡眠质量在疼痛信念与认知衰弱间有明显的间接作用(Z=6.615,P<0.05),中介效应占总效应的比例为40.1%。焦虑在疼痛信念与认知衰弱间起调节作用(β=3.361,P<0.05)。结论:疼痛信念通过睡眠质量影响老年腰椎间盘突出症病人认知衰弱的患病率,焦虑调节了疼痛信念与认知衰弱的关系。

Objective:To explore the relationship between pain belief, sleep quality, anxiety and cognitive frailty in elderly patients with lumbar disc herniation.Methods:From June 2021 to December 2021,a total of 336 elderly patients with lumbar disc herniation from two third grade A general hospitals in Jinzhou City were selected as the research objects by convenience sampling.The general information questionnaire, Pain Beliefs and Perceptions Inventory(PBPI),Athens Insomnia Scale(AIS),Self-Rating Anxiety Scale(SAS),Frail Scale(FRAIL) and Mini-Mental State Examination(MMSE)were used to investigate the patients.Results:The pain belief score of elderly patients with lumbar disc herniation was(-0.90±9.41),the sleep quality score was(6.11±4.24),the anxiety score was(50.56±9.48).Among them, 79 cases(23.5%) had cognitive frailty.Logistic regression analysis found that sleep quality, anxiety and pain belief were the influencing factors of cognitive frailty in elderly patients with lumbar disc herniation(P<0.05).The results of mediation analysis showed that sleep quality had a significant indirect effect between pain belief and cognitive frailty(Z=6.615,P<0.05),and the mediating effect accounted for 40.1% of the total effect.Anxiety played a moderating role between pain belief and cognitive frailty(β=3.361,P<0.05).Conclusions:Pain belief affects the prevalence of cognitive frailty in elderly patients with lumbar disc herniation through sleep quality, and anxiety moderates the relationship between pain belief and cognitive frailty.