类风湿关节炎患者久坐行为现状及影响因素研究

Study on the current situation of sedentary behavior status in patients with rheumatoid arthritis and its influencing factors

目的了解类风湿关节炎(RA)患者久坐行为现状并探讨其影响因素。方法采用便利抽样法,选取2022年3-10月在我院就诊的RA患者243例,采用一般资料调查表、查而森合并症指数(CCI)、28个关节疾病活动指数(DAS28)、视觉模拟评分(VAS)、国际体力活动问卷(IPAQ)、疲劳严重程度量表(FSS)、恐动症Tampa评分表(TSK)、匹兹堡睡眠质量指数(PSQI)和患者健康问卷(PHQ-9)进行调查。结果RA患者久坐时间为8.7(5.8,10.76)h/d,存在久坐行为(即每天久坐时间>6 h)的患者有156例(64.20%)。logistic回归分析结果显示,高合并症、重度疼痛、有恐动症及CRP水平越高的RA患者越倾向于久坐(P<0.05)。结论RA患者存在较严重的久坐行为,多种因素阻碍患者做出久坐行为改变。提示医护人员应重视患者疾病状况及心理因素,建立合理的支持系统,鼓励活动恐惧较强、合并症指数高、疼痛严重的患者采取低强度活动,如站立、改变体位方式,以减少久坐,并进一步的提供干预方案为患者增加体力活动和有氧运动。

Objective To understand the current situation of sedentary behavior in patients with rheumatoid arthritis(RA)and analyze the influencing factors.Methods A total of 243 RA patients in our hospital from March to October 2022 were selected by convenience sampling method.The general information questionnaire,Charlson Comorbidity Index,28 Joint Disease Activity Index(DAS28),Visual Analogue Scale(VAS),International Physical Activity Questionnaire(IPAQ),Fatigue Severity Scale(FSS),Kinesiophobia Tampa Scale(TSK),Pittsburgh Sleep Quality Index(PSQI),and Patient Health Questionnaire(PHQ-9)were used for investigation.Results The sedentary time of RA patients was 8.7(5.8,10.76)h/d,and 156 patients(64.20%)had sedentary behavior(that is,sedentary time>6 h/d).logistic regression model analysis showed that RA patients with high comorbidities,severe pain,kinesiophobia,and higher C-reactive protein(CRP)levels were more likely to be sedentary(P<0.05).Conclusion There is a serious sedentary behavior in RA patients,and many factors hinder patients from making sedentary behavior changes.It is suggested that medical staff should pay attention to the patient's disease status and psychological factors,establish a reasonable support system,and encourage patients with strong activity fear,high complication index,and severe pain to take low-intensity activities,such as standing and changing posture to reduce sedentary,and further intervention programs are to increase patients'physical activity and aerobic exercise.