全膝关节置换术后患者恐动症的影响因素研究

doi:10.3761/j.issn.0254-1769.2021.10.003

摘要/Abstract

摘要：

目的通过建立结构方程模型分析全膝关节置换术后患者恐动症的影响因素。方法采用便利抽样法,于2019年12月—2020年9月采用凯斯勒10量表、抑郁自评量表、D型人格量表、疼痛灾难化量表和恐动症Tampa评分,对河南省某三级甲等综合医院494例行全膝关节置换术的患者进行调查。结果最终共纳入463例患者,恐动症发生率为38.2%,构建的模型数据拟合度良好。其中,疼痛灾难化对恐动症有直接正向效应（β=0.461,P<0.001）,抑郁对恐动症有直接和间接正向效应（β=0.162,P<0.001;β=0.063,P<0.001）,D型人格和压力水平对恐动症有间接正向效应（β=0.144,P<0.001;β=0.186,P<0.001）。结论全膝关节置换术后患者恐动症发生率偏高,科研及临床工作者均应重视患者的疼痛灾难化、心理状况、人格及压力水平对其恐动症的影响,以便采取措施改善全膝关节置换术后患者的康复结局。

关键词: 关节成形术,置换,膝, 恐动症, 疼痛灾难化, 心理护理, 影响因素分析

Abstract:

Objective To explore the multifactorial model of kinessiophobia in patients with total knee arthroplasty,and to provide a reference for the intervention of kinessiophobia. Methods From December 2019 to September 2020,494 patients with knee arthroplasty in a tertiary hospital of Henan province were investigated with the Kessler Psychological Distress Scale（K10）,Self-rating Depression Scale,Type D Personality Scale-14,Pain Catastrophizing Scale and Tampa Scale for Kinesiophobia. Results The incidence of panic disorder was 38.2%,and the model data was well-fitted. Pain disaster depression has a direct positive effect on kinessiophobia（β=0.461,P<0.001）;depression has a direct and indirect positive effect on kinessiophobia（β=0.162,P<0.001;β=0.063,P<0.001）,and Type D personality and stress level have an indirect positive effect on kinessiophobia（β=0.144,P<0.001;β=0.186,P<0.001）. Conclusion The incidence of kinessiophobia is high. Researchers and clinicians should pay attention to the impact of patients’ pain catastrophe,psychological condition,personality and stress level on their kinessiophobia,and take measures to help the patients for improving their rehabilitation outcome after total knee arthroplasty.

Key words: Arthroplasty,Replacement,Knee, Kinessiophobia, Pain Catastrophe, Psychological Nursing, Root Cause Analysis

徐慧萍, 张炎改, 刘延锦, 郭玉茹, 蔡立柏, 张浩洁, 牛雅丽, 王琦, 黄倩, 李慧景. 全膝关节置换术后患者恐动症的影响因素研究[J]. 中华护理杂志, 2021, 56(10): 1460-1465.

XU Huiping, ZHANG Yangai, LIU Yanjin, GUO Yuru, CAI Libai, ZHANG Haojie, NIU Yali, WANG Qi, HUANG Qian, LI Huijing. A multifactorial model of kinessiophobia in patients with knee arthroplasty[J]. Chinese Journal of Nursing, 2021, 56(10): 1460-1465.

图/表 3

表1 模型变量间的相关性分析结果（r值）

Table 1 Correlation analysis results between model variables（r value）

图1 全膝关节置换术患者恐动症多因素作用模型

Figure 1 Multi-factorial model of kinesiophobia in patients undergoing total knee arthroplasty

表2 模型各变量对恐动症的效应值

Table 2 The effect of each variable of the model on kinesiophobia

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