疼痛灾难化对全膝关节置换术患者锻炼依从性影响的有调节的中介效应

Relationship between pain catastrophizing andexercise compliance among patients undergoing total knee arthroplasty:a moderated mediating effect

目的探讨全膝关节置换术患者运动恐惧在疼痛灾难化与锻炼依从性之间的中介作用及健康信念的调节作用。方法采用便利抽样法,选取行全膝关节置换术的364例住院患者作为调查对象,采用一般资料调查表、疼痛灾难化量表、恐动症Tampa评分、骨科患者功能锻炼依从性量表、新版健康信念量表进行调查。结果疼痛灾难化与运动恐惧呈正相关(r=0.540)、与锻炼依从性及健康信念呈负相关(r=-0.517、-0.314);运动恐惧在疼痛灾难化与锻炼依从性之间起部分中介作用,中介效应占总效应的46.62%;健康信念对运动恐惧的中介作用起到调节作用(P<0.05)。结论全膝关节置换术患者运动恐惧在疼痛灾难化与锻炼依从性之间具有中介作用,健康信念对其中介作用有调节作用。建议医护人员重视疼痛灾难化对锻炼依从性的影响,帮助其提高健康信念,从而促进患者主动参与锻炼。

Objective To explore the mediating effect of kinesophobia on pain catastrophizing and exercise compliance and the moderating effect of health beliefs in patients undergoing total knee arthroplasty.Methods By convenience sampling,364 inpatients undergoing total knee joint replacement were selected as subjects.General information questionnaire,Pain Catastrophizing Scale,Tampa Scale for Kinesiophobia,Orthopedic Patients′Functional Exercise Compliance Scale,and the new version of Health Belief Scale were used as investigating tools.Results Pain catastrophe was positively correlated with exercise fear(r=0.540),but negatively correlated with exercise compliance(r=-0.517)and health beliefs(r=-0.314).The kinesophobia played a partial mediating role between pain catastrophizing and exercise compliance,with the mesomeric effect accounting for 46.62%of the total effect.Health belief played a moderating role in the mediating pathway between pain catastrophizing and exercise compliance(P<0.05).Conclusion In total knee replacement patients,kinesophobia has mediating effect between pain catastrophizing and exercise compliance.Health belief has moderating effect on the mediating path.It is recommended that clinical medical staff should pay attention to the influences of pain catastrophizing on exercise compliance,and help the patients improve their health beliefs,so as to promote their active participation in exercise.