体外循环下心脏瓣膜手术后患者运动恐惧的影响因素分析

Analysis of influencing factors of kinesiophobia in patients after cardiac valve surgery under cardiopulmonary bypass

目的了解体外循环下心脏瓣膜手术后患者运动恐惧的现状, 明确其影响因素, 为制订改善运动恐惧水平的干预策略提供参考。方法采用便利抽样法选取2022年2—9月在浙江大学医学院附属第二医院初次接受体外循环下心脏瓣膜手术的患者为研究对象, 以一般资料调查表、心脏病患者运动恐惧量表、运动自我效能量表、疼痛灾难化量表、家庭关怀度指数问卷为研究工具进行横断面调查, 并对影响因素进行单因素和二元Logistic回归分析。结果最终纳入219例患者, 其中97例患者存在运动恐惧, 占44.3%(97/219)。二元Logistic回归分析显示, 家庭月收入、术后首次下床时间、跌倒恐惧、家庭关怀度、疼痛灾难化是体外循环下心脏瓣膜手术后患者运动恐惧的重要影响因素(均P<0.05)。结论体外循环下心脏瓣膜手术后患者运动恐惧发生率较高, 医护人员应重点关注家庭月收入水平较低、术后首次下床时间晚、存在跌倒恐惧的患者, 同时加强与患者和家属的沟通、重视术后急性疼痛的管理, 以减少或避免运动恐惧的发生, 使患者从早期下床活动中受益。

Objective To know the current situation of kinesiophobia in patients after cardiac surgery under cardiopulmonary bypass,and to clarify its influencing factors,so as to provide reference for developing intervention strategies to improve kinesiophobia level.Methods This was a cross-sectional study.From February 2022 to September 2022,the patients after cardiac valve surgery under cardiopulmonary bypass in the Second Affiliated Hospital Zhejiang University School of Medicine were investigated by convenience sampling methods.The survey was conducted using the General Information Questionnaire,The Tampa Scale for Kinesiophobia Heart,Exercise Self-Efficacy Scale,Pain Catastrophizing Scale,and Adaptation,Partnership,Growth,Affection and Resolve(APGAR)as research tools,and the influencing factors were analyzed using univariate and binary Logistic regression analysis.Results A total of 219 patients were included,of which 97 patients(44.3%)had kinesiophobia.The results of binary Logistic regression analysis showed that monthly family income level,first time out of bed after operation,fear of falling,the family APGAR,and pain catastrophizing were significant influencing factors of kinesiophobia in patients after heart valve surgery under cardiopulmonary bypass(all P<0.05).Conclusions The prevalence of kinesiophobia is high among patients after heart valve surgery under cardiopulmonary bypass.Clinicians should pay attention to patients with low monthly family income level,late first time out of bed after surgery,and fear of falling,as well as strengthen communication with patients and families,focus on the management of acute postoperative pain.In order to reduce or avoid the occurrence of kinesiophobia and enable patients to benefit from early ambulation.