老年腰椎压缩性骨折术后恐动影响因素及护理措施探析

Analysis of influencing factors and nursing countermeasures of postoperative panic in elderly patients with lumbar compression fracture

目的:探讨老年骨质疏松性腰椎压缩性骨折(OVCF)术后患者恐动情况及影响因素、护理对策。方法:选取医院收治的104例老年OVCF术后患者,使用恐动症坦帕评分表(TSK)评价恐动情况,根据评分分为两组。收集患者一般资料,包括性别、年龄、体质指数、婚姻状况、文化水平、负面情绪、术后疼痛程度、骨折至就医时间、手术方式、家庭人均月收入、自我效能感等。对一般资料进行单因素分析,再对差异有统计学意义因素的项目进行多因素Logistic回归分析。结果:104例患者中,有47例患者TSK>37分,57例患者TSK≤37分;单因素分析显示,两组文化水平、负面情绪、术后疼痛程度、手术方式、自我效能感对比,差异有统计学意义(P<0.05);Logistic回归分析显示,初中及以下文化水平、有负面情绪、中度/重度术后疼痛程度、手术方式为传统手术、低水平自我效能感是影响老年OVCF术后患者恐动症发生的独立危险因素(P<0.05且OR>1)。结论:OVCF术后恐动症的发生与文化水平、负面情绪、术后疼痛程度、手术方式、自我效能感有关,临床应加以重视,制定相关护理对策,针对性地减轻以上因素影响,可以减少恐动症的发生。

Objective:To investigate the fear of movement,influencing factors,and nursing strategies in elderly patients with osteoporotic lumbar vertebral compression fractures(OVCF)after surgery.Method:A total of 104 elderly OVCF postoperative patients admitted to hospital were selected,and their fear of movement was evaluated using the Tampa scale for fear of movement(TSK).They were divided into two groups based on their scores.Collect general information of patients,including gender,age,body mass index,marital status,educational level,negative emotions,postoperative pain level,time from fracture to medical treatment,surgical method,per capita monthly income of the family,self-efficacy,etc.Perform univariate analysis on general data,and then perform multivariate logistic regression analysis on factors with statistical differences.Among the 104 patients,47 had TSK scores greater than 37 and 57 had TSK scores less than or equal to 37;There was a statistically significant difference in cultural level,negative emotions,postoperative pain level,surgical method,and self-efficacy between the two groups(P<0.05);Logistic regression analysis showed that education level at or below junior high school,negative emotions,moderate/severe postoperative pain,traditional surgical methods,and low levels of self-efficacy were independent risk factors for the occurrence of anxiety disorder in elderly OVCF patients after surgery(P<0.05 and OR>1).Conclusion:The occurrence of postoperative fear of movement after OVCF is related to cultural level,negative emotions,postoperative pain level,surgical method,and self-efficacy.Clinical attention should be paid to it,relevant nursing strategies should be formulated,and the impact of the above factors should be targeted to reduce the occurrence of fear of movement.