膝骨关节炎患者实施运动疗法需求及影响因素调查

Investigation and study on demand and influencing factors of exercise therapy in patients with knee osteoarthritis

目的膝骨关节炎(knee osteoarthritis,KOA)是一种以关节软骨变性、破坏及骨质增生为特征的常见慢性进展性关节疾病,目前有效预防和治疗KOA已成为重大公共问题。本研究调查分析KOA患者实施运动疗法的需求及影响因素,为实施以运动疗法为主的健康管理提供参考依据。方法采用整群抽样问卷调查的方法,抽取云南省1家三甲医院和1家二甲专科医院2017-01-01-2017-06-30收治的110例KOA患者作为调查对象。进行运动疗法需求及影响因素的调查。结果 110例KOA患者中轻度疼痛46例(41.8%),中度32例(29.1%),重度32例(29.1%)。了解KOA相关保健知识的患者仅占总人数的33.6%,66.4%患者不了解相关保健知识。膝关节疼痛处理方式中,62.7%患者选择到医院就诊,46.4%患者选择擅自服用止疼药。仅有27例(31.4%)KOA患者表示了解运动疗法。运动疗法认知途径主要通过医务人员(28.9%)、微信平台(21.0%)和同伴推荐(19.7%)获取,电视和报纸所占比例较小。77.3%患者对运动疗法持"会有效果""可能有效果"的态度,71.8%患者明确表示在今后治疗中需要运动疗法的治疗。多因素分析显示,运动疗法态度(OR=5.467,95%CI为2.634～11.348,P<0.001)、KOA保健知识(OR=12.170,95%CI为2.794～53.007,P=0.001)、运动疗法知晓情况(OR=4.073,95%CI为1.128～14.701,P=0.032)、运动习惯(OR=4.581,95%CI为1.596～13.146,P=0.005)、疼痛程度(OR=1.796,95%CI为1.076～2.998,P=0.025)是影响KOA患者运动需求的因素。结论 KOA患者对运动疗法的了解程度较低,但对运动疗法需求较高。对运动疗法的态度、KOA保健知识、运动疗法知晓情况、运动习惯和疼痛程度是KOA患者运动需求的影响因素。

OBJECTIVE Knee osteoarthritis(KOA)is a common chronic progressive joint disease characterized by degeneration,destruction and osteoporosis of articular cartilage.At present,effective prevention and treatment of KOA has become a major public problem.This study investigates and analyses the needs and influencing factors of exercise therapy in KOA patients,and provides reference for the implementation of exercise therapy-based health management.METHODS Using cluster sampling questionnaire,110 KOA patients admitted to a third-class A hospital and a secondclass hospital in Yunnan province from January 1,2017 to June 30,2017 were selected as the subjects of the survey.The demand and influencing factors of exercise therapy were investigated.RESULTS According to WOMAC score,among 110 KOA patients,46(41.8%)had mild pain,32(29.1%)had moderate pain and 32(29.1%)had severe pain.Only 33.6%of KOA patients knew about KOA,66.4%of them did not know about KOA.In the treatment of knee pain,62.7%of patients chose to go to hospital,and 46.4%chose to take painkillers without authorization.Only 27 cases(31.4%)of KOA patients expressed their knowledge of exercise therapy.The cognitive pathways of exercise therapy were mainly acquired through medical staff(28.9%),Wechat platform(21.0%)and peer recommendation(19.7%).Television and newspapers accounted for a small proportion.77.3%of the patients had an'effective'and'possibly effective'attitude towards exercise therapy,and 71.8%of the patients clearly indicated that they needed exercise therapy in future treatment.Multivariate analysis showed that attitude to exercise therapy(OR=5.467,95%CI:2.634-11.348,P<0.001),KOA health knowledge(OR=12.170,95%CI:2.794-53.007,P=0.001),awareness of exercise therapy(OR=4.073,95%CI:1.128-14.701,P=0.032),exercise habits(OR=4.581,95%CI:1.596-13.146,P=0.005),pain degree(OR=1.796,95%CI:1.076-2.998,P=0.025)were the influencing factors of exercise demand in KOA patients.CONCLUSIONS KOA patients have a low understanding of exercise therapy,but have a high demand for it.Attitudes towards exercise therapy,knowledge of KOA health care,knowledge of exercise therapy,exercise habits and pain degree are the influencing factors of exercise demand of KOA patients.