前交叉韧带重建术后病人恐动症的影响因素分析

Analysis of influencing factors on postoperative kinesophobia in patients undergoing anterior cruciate ligament reconstruction

目的:探讨前交叉韧带重建术(ACLR)术后病人恐动症发生的影响因素,并进行路径分析。方法:采用目的抽样法,选取2021年8月—2022年11月入住山西省某三级甲等医院运动医学科拟行ACLR的255例病人为研究对象,采用一般资料调查表、自我感受负担量表、Lysholm膝关节评分、疼痛灾难化量表、Connor-Davidson心理弹性量表、恐动症Tampa评分量表对病人进行调查。结果:255例ACLR术后病人恐动症Tampa评分量表得分为(43.25±9.89)分,恐动症发生率为65.9%。伤后手术时机、自我感受负担、心理弹性及疼痛灾难化为ACLR术后病人恐动症发生的主要影响因素(P<0.05)。路径分析结果显示,疼痛灾难化与自我感受负担不仅对恐动症产生直接影响,而且还通过心理弹性对恐动症产生间接影响。结论:ACLR术后病人恐动症发生率较高,医务人员应关注ACLR术后病人的心理状态,采取针对性的干预措施和健康教育方案提高病人心理弹性水平,降低恐动症发生率。

Objective:To explore influencing factors on postoperative kinesophobia in patients undergoing anterior cruciate ligament reconstruction(ACLR)and conduct pathway analysis.Methods:A total of 225 patients who planned to undergo ACLR in the sports medicine department of a tertiary grade A hospital in Shanxi province were selected by purposive sampling method as the research subjects from August 2021 to November 2022.General information questionnaires,Self-Perceived Burden Scale,Lysholm Knee Score,Pain Catastrophizing Scale,Connor-Davidson Resilience Scale and Tampa Scale for Kinesiophobia were used to investigate patients.Results:The score of Tampa Scale for Kinesiophobia in 255 postoperative patients undergoing ACLR was 43.25±9.89 points,and the incidence of kinesophobia was 65.9%.The timing of surgery,self-perceived burden,psychological resilience,and pain catastrophizing were the main influencing factors(P<0.05)for the occurrence of postoperative kinesophobia in patients undergoing ACLR.The path analysis results showed that the pain catastrophizing and self-perceived burden not only had direct impact on the development of kinesophobia,but also had an indirect impact on the development of kinesophobia through psychological resilience.Conclusions:The incidence of kinesophobia in postoperative patients undergoing ACLR is high.Medical staff should pay attention to the psychological status of postoperative patients undergoing ACLR,adopt targeted intervention measures and health education programs to improve their psychological resilience and reduce the incidence of kinesophobia.