老年髋关节置换术患者运动感知的分型预测及护理启示

doi:10.3761/j.issn.0254-1769.2025.19.009

摘要/Abstract

摘要：

目的探究老年髋关节置换术（hip arthroplasty，HA）患者运动感知的潜在类别及特征，分析不同类别的预测因素，为临床护理实践提供参考。方法采用便利抽样法，选取2024年10月—2025年2月就诊于桂林市2所三级甲等医院6个骨科病区的230例老年HA患者作为调查对象。采用一般资料调查表、髋膝关节置换术病人锻炼益处及障碍感知量表、中文版恐动症评估简表、5项改良衰弱指数、康复自我效能感量表进行调查。采用潜在剖面分析识别老年HA患者运动感知的潜在类别，采用决策树模型探索不同类别的预测因素。结果回收有效问卷222份，有效问卷回收率为96.52%。老年HA患者运动感知分为3个类别：高益处-低障碍组（19.82%）、低益处-高障碍组（22.07%）、轻微障碍组（58.11%）。衰弱、恐动症、康复自我效能、居住地、文化程度、日常锻炼情况是老年HA患者运动感知潜在剖面的预测因素（均P<0.05），衰弱位于决策树模型根节点。结论老年HA患者运动感知有待提高，且存在群体异质性，医护人员应重点关注低益处-高障碍组和轻微障碍组的患者，根据各类别特征及预测因素开展精准干预，以改善其运动感知。

关键词: 髋关节置换术, 老年人, 锻炼益处, 锻炼障碍, 潜在剖面分析, 决策树, 护理

Abstract:

Objective To explore the potential categories of exercise perception in elderly hip arthroplasty（HA） patients，analyze the prediction factors of different categories，and provide references for clinical nursing. Methods A convenience sampling method was used to select elderly HA patients treated in 6 orthopedic wards of 2 tertiary A hospitals in Guilin from October 2024 to February 2025. The general data questionnaire，Exercise Benefits and Barriers Perception Scale for Hip/Knee Throplasty Patients，Tampa Scale of Kinesiophobia，the 5-Factor Modified Frailty Index，and Self-Efficacy for Rehabilitation Outcome Scale were used for investigation. Latent profile analysis was used to identify the potential categories of exercise perception of elderly HA patients，and decision tree model was used to explore the core predictive factors of different profile. Results 222 valid questionnaires were collected, with an effective response rate of 96.52%. A total of 222 elderly HA patients were divided into 3 profiles：high benefit-low barrier group（19.82%），low benefit-high barrier group（22.07%），and mild barrier group（58.11%）. Frailty，kinesophobia，rehabilitation self-efficacy，residence，educational level and daily exercise were significant predictors of latent profiles（P<0.05），and the frailty was located in the root node of the decision tree model. Conclusion The level of exercise perception in elderly HA patients needs to be improved，and shows population heterogeneity. Medical staff should prioritize interventions for low benefit-high barrier and mild-barrier groups，implementing targeted strategies based on profile characteristics and predictive factors to improve their exercise perception.

Key words: Hip Arthroplasty, Aged, Exercise Benefits, Exercise Barriers, Latent Profile Analysis, Decision Tree, Nursing Care

谢倩明, 廖春燕, 陈国伟, 彭艳红, 蒋桂香, 唐慧华. 老年髋关节置换术患者运动感知的分型预测及护理启示[J]. 中华护理杂志, 2025, 60(19): 2364-2370.

XIE Qianming, LIAO Chunyan, CHEN Guowei, PENG Yanhong, JIANG Guixiang, TANG Huihua. Classification prediction of exercise perception in elderly hip arthroplasty patients and nursing implications[J]. Chinese Journal of Nursing, 2025, 60(19): 2364-2370.

图/表 3

表1 调查对象的一般资料及运动感知潜在剖面的单因素分析[例（百分比，%）]

Table 1 The general information of the participants and univariate analysis of the potential profile of exercise perception[cases（percentage，%）]

表2 老年髋关节置换术患者运动感知潜在剖面模型拟合信息（n=222）

Table 2 Model fit information for latent profile analysis of exercise perception in elderly HA patients（n=222）

图1 老年髋关节置换术患者运动感知潜在剖面图注：Y表示锻炼益处感知分量表，Y1~Y3为功能康复维度，Y4~Y8为生活与健康维度；Z表示锻炼障碍感知分量表，Z1~Z3为疾病症状维度，Z4~Z6为不良后果维度，Z7~Z8为锻炼信息维度。

Figure 1 Latent profile of exercise perception in elderly HA patients

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