髋膝关节置换术患者康复自我效能感在正念与恐动症间的中介效应研究

doi:10.3761/j.issn.0254-1769.2022.10.004

摘要/Abstract

摘要：

目的探讨髋膝关节置换术患者康复自我效能感在正念与恐动症间的中介效应。方法采用便利抽样法,于2019年7月—2021年2月,选取在杭州市3所三级甲等医院骨科首次行髋或膝关节置换术的348例患者作为调查对象,应用一般资料调查表、恐动症Tampa量表、正念注意觉知量表和康复自我效能感量表进行调查,运用结构方程模型深入剖析康复自我效能感在正念与恐动症间的中介效应。结果正念和康复自我效能感均可直接负向预测恐动症（P<0.001,P=0.003）,康复自我效能感在正念与恐动症间起部分中介作用,间接负向预测恐动症,中介效应为-0.232,占总效应的42.49%。结论髋膝关节置换术患者的康复自我效能感是正念与恐动症间的中介变量,医护人员可以通过提高患者的正念水平,增强其康复自我效能感,进而弱化患者的恐动心理和行为。

关键词: 关节成形术,置换,髋, 人工膝关节, 正念, 康复自我效能感, 恐动症, 康复护理

Abstract:

Objective To explore the mediating effect of rehabilitation self-efficacy between mindfulness and kinesiophobia in patients undergoing hip or knee arthroplasty. Methods A questionnaire survey was carried out in 348 eligible patients who underwent hip or knee arthroplasty for the first time in the orthopedics wards of 3 comprehensive tertiary hospitals in Hangzhou during July 2019 to February 2021. The questionnaires include the general data questionnaire,Tampa Scale for Kinesiophobia（TSK-17）,Mindfulness Attention Awareness Scale（MAAS）,and Self-Efficacy for Rehabilitation Outcome Scale（SER）.A structural equation model was used to analyze the mediating effect of rehabilitation self-efficacy between mindfulness and kinesiophobia. Results Both mindfulness and rehabilitation self-efficacy could negatively predict kinesiophobia directly（P<0.001,P=0.003）;rehabilitation self-efficacy played a part of the mediating role between mindfulness and kinesiophobia,and could negatively predict kinesiophobia indirectly with an effect of -0.232,which accounted for 42.49% of the total effect. Conclusion Rehabilitation self-efficacy is a mediator between mindfulness and kinesiophobia in patients undergoing hip or knee arthroplasty. Doctors and nurses should take measures to enhance patients’ mindfulness and self-efficacy in rehabilitation,so as to reduce patients’ fear and fear related behavior.

Key words: Arthroplasty,Replacement,Hip, Knee Prosthesis, Mindfulness, Rehabilitation Self-Efficacy, Kinesiophobia, Rehabilitation Nursing

郦杭婷, 沈娇妮, 万昕瑞, 何桂娟. 髋膝关节置换术患者康复自我效能感在正念与恐动症间的中介效应研究[J]. 中华护理杂志, 2022, 57(10): 1177-1183.

LI Hangting, SHEN Jiaoni, WAN Xinrui, HE Guijuan. The mediating effect of rehabilitation self-efficacy between mindfulness and kinesiophobia in patients undergoing hip or knee arthroplasty[J]. Chinese Journal of Nursing, 2022, 57(10): 1177-1183.

图/表 5

表1 调查对象的一般资料（n=348）

Table 1 General information of surveyed patients（n=348）

表2 髋膝关节置换术患者正念注意觉知量表、康复自我效能感量表、恐动症Tampa量表得分情况（n=348）

Table 2 The scores of mindfulness,rehabilitation self-efficacy,and kinesiophobia scale in patients undergoing hip or knee replacement surgery（n=348）

表3 髋膝关节置换术患者正念注意觉知量表、康复自我效能感量表、恐动症Tampa量表得分的相关性分析（n=348）

Table 3 Correlations among mindfulness,rehabilitation self-efficacy,and kinesiophobia in patients undergoing hip or knee replacement surgery（n=348）

表4 髋膝关节置换术患者正念、康复自我效能感对恐动症的影响效应

Table 4 Effect of mindfulness and rehabilitation self-efficacy on kinesiophobia among patients undergoing hip or knee replacement surgery

图1 髋膝关节置换术患者正念、康复自我效能感对恐动症的影响路径

Figure 1 Path of the effect of mindfulness and rehabilitation self-efficacy on kinesiophobia among patients undergoing hip or knee replacement surgery

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