康复锻炼自我效能、锻炼计划对人工髋关节置换术患者健康信念和康复锻炼依从性的链式中介作用

The chain intermediary effect of rehabilitation exercise self-efficacy and exercise plan on health beliefs and rehabilitation exercise compliance in patients undergoing artificial hip replacement

目的:探讨康复锻炼自我效能和锻炼计划对人工髋关节置换术患者健康信念和康复锻炼依从性的链式中介作用。方法:于2023年1—4月,采用一般资料调查问卷、康复锻炼依从性量表、康复锻炼自我效能量表、锻炼计划量表及健康信念量表对乌鲁木齐市3所三级甲等医院227例人工髋关节置换术患者进行调查,进而构建结构方程模型。结果:227例人工髋关节置换术患者康复锻炼依从性总分平均为(52.14±11.40)分,健康信念总分平均为(149.30±27.75)分,康复锻炼自我效能总分平均为(84.18±16.73)分,锻炼计划总分平均为(28.46±7.81)分。人工髋关节置换术患者健康信念得分与康复锻炼自我效能得分、锻炼计划得分及康复锻炼依从性得分呈正相关(r=0.447、0.545、0.650,均P<0.001);康复锻炼自我效能得分与锻炼计划得分、康复锻炼依从性得分呈正相关(r=0.558、0.686,均P<0.001);锻炼计划得分与康复锻炼依从性得分呈正相关(r=0.711,P<0.001)。路径分析显示,人工髋关节置换术患者健康信念可直接影响康复锻炼依从性,还可通过康复锻炼自我效能和锻炼计划间接正向影响康复锻炼依从性,也可通过康复锻炼自我效能、锻炼计划链式中介正向影响康复锻炼依从性。结论:康复锻炼自我效能、锻炼计划对人工髋关节置换术患者健康信念和康复锻炼依从性起链式中介作用。

Objective:To explore the chain intermediary effect of rehabilitation exercise self-efficacy and exercise plan on health beliefs and rehabilitation exercise compliance in patients undergoing artificial hip replacement.Methods:From January to April 2023,a survey was conducted on 227 patients undergoing hip replacement surgery at three tertiary hospitals in Urumqi using a general information survey questionnaire,rehabilitation exercise compliance scale,rehabilitation exercise self-efficacy scale,exercise plan scale,and health belief scale,and a structural equation model was constructed.Results:The average total score of rehabilitation exercise compliance for 227 patients undergoing artificial hip replacement was(52.14±11.40),the average total score of health belief was(149.30±27.75),the average total score of rehabilitation exercise self-efficacy was(84.18±16.73),and the average total score of exercise plan was(28.46±7.81).There was a positive correlation between health beliefs score and rehabilitation exercise self-efficacy score,exercise plan score,and rehabilitation exercises compliance score in patients undergoing artificial hip replacement surgery(r=0.447,0.545,0.650,all P<0.001).Rehabilitation exercise self-efficacy score was positively correlated with exercise plan score and rehabilitation exercise compliance score(r=0.558,0.686,all P<0.001).There was a positive correlation between exercise plan score and rehabilitation exercise compliance score(r=0.711,P<0.001).Path analysis showed that the health beliefs of patients undergoing artificial hip replacement can directly affect rehabilitation exercise compliance,and can also indirectly affect rehabilitation exercise compliance through rehabilitation exercise self-efficacy and exercise plan.It can also positively affect rehabilitation exercise compliance through the chain intermediary effect of rehabilitation exercise self-efficacy and exercise plan.Conclusion:Self-efficacy and exercise plan of rehabilitation exercise play a chain intermediary role in health beliefs and rehabilitation exercise compliance of patients undergoing artificial hip replacement.