老年骨质疏松性脊柱骨折患者术后恐动症情况及影响因素分析

Investigation of postoperative kinesiophobia in elderly patients with osteoporotic spinal fracture and its influencing factors

目的调查老年骨质疏松性脊柱骨折患者术后恐动症情况,并分析其影响因素,为临床制定干预措施提供参考。方法采用便利抽样法,将北京积水潭医院2021年6月至2022年6月收治的134例老年骨质疏松性脊柱骨折患者作为调查对象,全部患者均行经皮穿刺球囊扩张式椎体后凸成型术治疗,术前应用一般资料调查表详细记录患者一般资料,术后1 d应用恐动症Tampa评分表(TSK)评估老年骨质疏松性脊柱骨折患者恐动症发生情况并分组,分析可能影响老年骨质疏松性脊柱骨折患者术后恐动症发生的影响因素。结果术后1 d,134例老年骨质疏松性脊柱骨折患者中,发生恐动症20例,发生率为14.93%;恐动症组睡眠质量差、存在负性情绪占比高于非恐动症组,差异有统计学意义(P<0.05);恐动症组社会支持及自我效能感评分低于非恐动症组,差异有统计学意义(P<0.05);经Logistic回归分析显示,睡眠质量差、存在负性情绪是老年骨质疏松性骨折患者术后发生恐动症的危险因素(OR>1,P<0.05),社会支持及自我效能感评分高是其保护因素(OR<1,P<0.05)。结论老年骨质疏松性骨折患者术后发生恐动症发生率高,可能受睡眠质量差、社会支持水平高、存在负性情绪、自我效能感水平高等因素影响。

Objective To investigate the postoperative kinesiophobia of elderly patients with osteoporotic spinal fracture and its influencing factors,thus providing references for clinical intervention.Methods A total of 134 elderly patients with osteoporotic spinal fracture admitted to Beijing Jishuitan Hospital from June 2021 to June 2022 were investigated by convenient sampling.All patients underwent percutaneous balloon kyphoplasty.The baseline characteristics of the patients were recorded before the operation.Patients were allocated to two groups according to the presence or absence of kinesiophobia in elderly patients with osteoporotic spinal fracture 1d after the operation,which was evaluated with the Tampa Scale of Kinesiophobia(TSK).Influencing factors for the postoperative kinesiophobia in elderly patients with osteoporotic spinal fracture after percutaneous balloon kyphoplasty were analyzed.Results A total of 20/134(14.93%)elderly patients with osteoporotic spinal fracture developed kinesiophobia 1d after the operation.The proportions of poor sleep quality and negative emotion in kinesiophobia group were significantly higher than those in non-kinesiophobia group(P<0.05).The scores of social support and self-efficacy in kinesiophobia group were significantly lower than those in non-kinesiophobia group(P<0.05).Logistic regression analysis showed that poor sleep quality and negative emotion were risk factors for postoperative kinesiophobia in elderly patients with osteoporotic fracture(OR>1,P<0.05),and high scores of social support and self-efficacy were protective factors(OR<1,P<0.05).Conclusion The incidence of postoperative kinesiophobia in elderly patients with osteoporotic fractures is high,which may be affected by poor sleep quality,high level of social support,negative emotions and high level of self-efficacy.