老年全髋关节置换术患者康复运动恐惧的现况及其影响因素调查

Investigation on the status and influencing factors of rehabilitation exercise fear in elderly patients undergoing hip arthroplasty

目的 探究老年全髋关节置换术患者康复运动恐惧的影响因素及护理策略。方法 选取医院2021年4月—2022年3月收治的全髋关节置换术患者176例为调查对象,分析患者临床资料,采用一般资料问卷、中文版恐动症评估简表(TSK)、视觉模拟评分法(VAS)、运动自我效能量表(SEE)、自我感受负担量表(SPBS)对患者进行评价,统计伴有康复运动恐惧的患者例数,通过单因素分析、多因素Logistic回归模型分析,筛选老年全髋关节置换术患者康复运动恐惧的影响因素,并讨论护理策略。结果 经TSK量表评价得到伴有康复运动恐惧(>37分)的患者48例,发生率为27.27%;单因素分析结果显示,老年全髋关节置换术患者康复运动恐惧的影响因素有年龄、文化水平、家庭人均月收入、身体质量指数(BMI)、术后跌倒史、术后康复指导、术后疼痛状况、运动自我效能、自我感受负担(P<0.05);多因素Logistic回归分析显示,老年全髋关节置换术患者康复运动恐惧的影响因素有年龄、初中及以下文化水平、术后跌倒史、术后康复指导、术后疼痛状况、运动自我效能低水平、中重度自我感受负担(P<0.05)。结论 老年全髋关节置换术患者术后康复运动阶段仍伴有不同程度的运动恐惧,年龄大、初中及以下文化水平、有术后跌倒史、无术后康复指导、术后疼痛严重、运动自我效能水平低、中重度自我感受负担的患者发生康复运动恐惧的可能性较大。

Objective To explore the influencing factors and nursing strategies of exercise fear in elderly patients undergoing total hip replacement.Methods A totoal of 176 patients with total hip arthroplasty admitted from April2021 to March 2022 were selected as the study subjects,we analyzed the clinical data of patients,evaluated the patients with general data questionnaire,Chinese-version Tampa scale for kinesiophobia(TSK),visual analogue scale(VAS),self-efficacy for exercise scale(SEE) and self-perceived burden scale(SPBS),and counted the number of patients with rehabilitation exercise fear.Through single factor analysis and multivariate Logistic regression model analysis,we screened the influencing factors of rehabilitation exercise fear of elderly patients with total hip replacement,and discussed the nursing strategy.Results According to the evaluation of TSK scale,there were48 patients with fear of rehabilitation exercise(>37 points),with an incidence of 27.27%.Univariate analysis showed that the influencing factors of exercise fear in elderly patients with total hip arthroplasty include age,education level,family average monthly income,body mass index(BMI),postoperative fall history,postoperative rehabilitation guidance,postoperative pain status,exercise self-efficacy,and self-perceived burden(P<0.05).Multivariate Logistic regression analysis showed that the influencing factors of exercise fear in elderly patients with total hip arthroplasty include age,education level of junior high school and below,postoperative fall history,postoperative rehabilitation guidance,postoperative pain status,low level of exercise self-efficacy,moderate and severe self-perceived burden(P<0.05).Conclusion The elderly patients with total hip arthroplasty still have different levels of fear of movement in the rehabilitation stage after operation.Patients with older age,education level of junior high school and below,history of postoperative fall,no postoperative rehabilitation guidance,severe postoperative pain,low level of exercise self-efficacy,moderate and severe self-perceived burden are more likely to develop rehabilitation exercise fear.