全髋关节置换术患者结果期望及影响因素的研究

Outcome expectations of total hip arthroplasty and the influencing factors

目的了解中国基层县市区域三级甲等综合医院住院患者全髋关节置换术(THA)术前结果期望,探讨相关影响因素,为医护人员临床决策提供依据。方法选取潍坊市某县级城市三级甲等综合医院2023年1月至2024年3月拟行髋关节置换的住院患者255例,术前1 d利用简体中文版《首次全髋关节置换术患者结果期望调查问卷》进行问卷调查,当场指导填写,当场回收后进行统计学分析。结果患者结果期望值总分为(61.62±5.81)分,均值(3.41±0.33)分,得分最高前5项依次为自己穿鞋袜(3.91±0.29)分、心理健康(3.87±0.34)分、减少药物应用(3.85±0.31)分、改善疼痛(3.81±0.39)分、摆脱辅助器械(3.80±0.40)分;相关性分析发现年龄、文化程度及照护者类型与期望值强相关(P<0.01);进一步回归分析发现,年龄是患者结果期望的主要影响因素(P<0.01)。结论THA患者术前对手术结果的期望较高,医护人员应根据患者的年龄、文化程度及照护者类型、手术原因制订个性化干预措施,优化患者的结果期望。

Objective To understand the preoperative outcome expectations of total hip arthroplasty(THA)patients in the regional third-level comprehensive hospital of a county-level city in China,and to explore the influencing factors,thus providing evidences for clinical decision-making by medical and nursing staff.Methods A total of 255 patients scheduled for THA in a county-level city in Weifang,a third-level comprehensive hospital were selected from January 2023 to March 2024.The"Outcome Expectation for the First time of Total Hip Arthroplasty Questionnaire"in simplified Chinese was used for questionnaire survey on the day before surgery.The questionnaires were guided and filled out on the spot,and the data were statistically analyzed after being collected on the spot.Results The total score of the outcome expectations was(61.62±5.81)points,with a mean score of(3.41±0.33)points.The top five highest scores were as follows:putting on shoes and socks(3.91±0.29)points,psychological health(3.87±0.34)points,reducing the use of medication(3.85±0.31)points,improving pain(3.81±0.39)points,and getting rid of auxiliary devices(3.80±0.40)points.Age,education level,and caregiver type were strongly correlated with the expectation value(P<0.01).Regression analysis further found that age was the main influencing factor of the outcome expectation(P<0.01).Conclusion THA patients have high preoperative expectations for surgical outcomes,and medical and nursing staff should formulate individualized intervention measures based on the patient's age,education level,caregiver type,and surgical indications to optimize the outcome expectations.