老年单侧全髋关节置换患者康复期参与生产性活动的现状及影响因素研究

doi:10.3761/j.issn.0254-1769.2025.18.008

摘要/Abstract

摘要：

目的调查老年单侧全髋关节置换患者术后康复期参与生产性活动现状并分析其影响因素，旨在为临床护理实践提供借鉴。方法采用便利抽样方法，选取2024年5—11月连云港市某三级甲等医院关节外科收治的242例老年单侧全髋关节置换患者作为调查对象，于其术后首次下床接受康复训练1周后采用一般资料调查问卷、生产性参与量表、改良Barthel指数评定量表、焦虑自评量表、抑郁自评量表、社区老年人跌倒风险感知量表、恐动症Tampa评分量表17条目版、领悟社会支持量表、老年人社会隔离量表进行调查。结果回收有效问卷230份，老年单侧全髋关节置换患者术后康复期生产性参与量表得分为（31.13±3.69）分，多元线性回归分析显示，年龄、文化程度、居住地、BMI是否正常、合并慢性疾病数量、距离手术时间、生活是否能自理、跌倒风险感知、有无恐动症、领悟社会支持和社会隔离是老年单侧全髋关节置换患者术后康复期参与生产性活动的影响因素（P<0.05）。结论老年单侧全髋关节置换患者术后康复期参与生产性活动水平较低，并受到多种因素影响，医护人员应根据以上影响因素制订针对性的干预方案，提升其参与生产性活动水平。

关键词: 单侧全髋关节置换术, 老年人, 生产性参与, 影响因素分析, 护理

Abstract:

Objective To investigate the current status of productive engagement of elderly patients undergoing unilateral total hip arthroplasty in postoperative rehabilitation period. Methods From May to Novermber 2024，242 elderly patients undergoing the first total hip arthroplasty from the joint surgery department of Nanjing Medical University Kangda College First Affiliated Hospital were selected as investigation subjects. They were investigated in postoperative rehabilitation period after receiving rehabilitation training for a week at getting out of bed for the first time after surgery by the Basic Information Questionnaire，Productive Engagement Scale，Improved Barthel Index Rating Scale，Self-Rating Anxiety Scale，Self-Rating Depression Scale，Fall Risk Perception Scale for Community-dwelling Older Adults，Tampa Rating Scale（17 Item Version），Perceived Social Support Scale and Social Isolation Scale for the Elderly. Results In the 230 valid questionnaires，the score of productive engagement of elderly patients undergoing unilateral total hip arthroplasty was（31.13±3.69） points in postoperative rehabilitation period. The Linear regression analysis showed that age，education level，place of residence，normal BMI，number of coexisting chronic diseases，time after surgery，ability of self-care，fall risk perception，Tampa，perceived social support and social isolation were all significant influencing factors for productive engagement of elderly patients undergoing unilateral total hip arthroplasty in postoperative rehabilitation period（P<0.05）. Conclusion The level of productive engagement of elderly patients undergoing unilateral total hip arthroplasty in postoperative rehabilitation period is relatively low. Their productive engagement were influenced by many factors. Clinical medical staff should develop intervention plans based on such influence factors to improve their level of productive participation.

Key words: Unilateral Total Hip Arthroplasty, Aged, Productive Engagement, Root Cause Analysis, Nursing Care

陈瑛, 殷媛媛, 许凤琴. 老年单侧全髋关节置换患者康复期参与生产性活动的现状及影响因素研究[J]. 中华护理杂志, 2025, 60(18): 2223-2230.

CHEN Ying, YIN Yuanyuan, XU Fengqin. Investigation of current status and influencing factors of productive engagement of elderly patients undergoing unilateral total hip arthroplasty in postoperative rehabilitation period[J]. Chinese Journal of Nursing, 2025, 60(18): 2223-2230.

图/表 4

表1 老年单侧全髋关节置换患者的一般资料及术后康复期生产性参与量表得分的单因素分析（n=230）

Table 1 Single factor comparison of productive engagement of elderly patients undergoing unilateral total hip arthroplasty in postoperative rehabilitation period（n=230）

表2 老年单侧全髋关节置换患者术后康复期焦虑、抑郁、跌倒风险感知、恐动症、领悟社会支持、社会隔离和参与生产性活动的相关性分析（n=230，r 值）

Table 2 Correlation analysis among anxiety，depression，fall risk perception，tampa, perceived social support,social isolation and productive engagement（n=230，r value）

表3 自变量赋值

Table 3 Independent variable assignment

表4 老年单侧全髋关节置换患者术后康复期参与生产性活动影响因素的多元线性回归分析结果（n=230）

Table 4 Results of linear regression analysis of influencing factors of elderly patients undergoing unilateral total hip arthroplasty in postoperative rehabilitation period（n=230）

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