Abstract:

Objective Exploring the longitudinal interplay between family resilience and fear of disease recurrence in elderly patients with adjacent vertebral re-fracture after percutaneous kyphoplasty（PKP） and their spouses，to provide a theoretical basis for reducing recurrence fear in both parties. Methods Using a convenience sampling method，225 elderly patients with adjacent vertebral re-fracture after PKP and their spouses，admitted to the First Affiliated Hospital of Soochow University between March 2023 and June 2024，were selected as study participants. Family resilience and fear of disease progression were assessed using the Family Resilience Assessment Scale and the Fear of Progression Questionnaire-Short Form，respectively，at 3 time points：postoperative（T1），pre-discharge（T2），and 1 month after discharge（T3）. Statistical analyses included equivalence testing and cross-lagged analysis within the Actor-Partner Interdependence Model（APIM）. Results A total of 217 valid questionnaires were collected（with an effective rate of 97.31%）. The actor effects of the interaction between family resilience and fear of disease recurrence in patients with adjacent vertebral re-fracture after PKP and their spouses were significant. Specifically，family resilience in both patients（T1→T2：β=-0.09；T2→T3：β=-0.08；all P<0.01） and spouses（T1→T2：β=-0.08；T2→T3：β=0.07；all P<0.01） negatively predicted their own fear of disease recurrence at the next time point. Conversely，fear of disease recurrence in both patients（T1→T2：β=-0.13；T2→T3：β=-0.11；all P<0.001） and spouses（T1→T2：β=-0.10，P<0.001；T2→T3：β=0.08，P<0.01） negatively predicted their own family resilience at the subsequent stage. Significant partner effects were observed for fear of disease recurrence：fear of disease recurrence in patients（T1→T2：β=0.11；T2→T3：β=0.10；all P<0.001） and spouses（T1→T2：β=0.08；T2→T3：β=0.08；all P<0.01） positively predicted their partner’s fear of disease recurrence at the next time point. Conclusion There is a longitudinal interaction between family resilience and fear of disease recurrence in elderly patients with adjacent vertebral re-fracture after PKP and their spouses. Healthcare professionals should emphasize its assessment and management，and rationally utilize this interaction to reduce the fear of disease recurrence in both patients and their spouses.

Key words: Aged, Percutaneous Kyphoplasty, Re-Fracture, Spouse, Family Resilience, Fear of Disease Recurrence, Nursing Care

摘要：

目的 探讨老年经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）术后邻近椎体再骨折患者和配偶家庭复原力与疾病复发恐惧间的纵向相互作用，为降低双方复发恐惧提供理论依据。方法 采用便利抽样法，选取2023年3月—2024年6月苏州市某三级甲等医院收治的225例老年PKP术后邻近椎体再骨折患者和配偶作为调查对象，采用家庭复原力评估量表、恐惧疾病进展简化量表分别于术后（T1）、出院前（T2）、出院后1个月（T3）进行调查。采用等价性检验、主客体互倚模型的交叉滞后分析进行统计分析。结果 回收有效问卷217份，有效问卷回收率为97.31%。PKP术后邻近椎体再骨折患者和配偶家庭复原力与疾病复发恐惧行为相互作用的主体效应具有显著性，即患者（T1→T2：β=-0.09，T2→T3：β=-0.08，均P<0.01）和配偶（T1→T2：β=-0.08，T2→T3：β=0.07，均P<0.01）的家庭复原力可以负向预测下一阶段自身的疾病复发恐惧；患者（T1→T2：β=-0.13，T2→T3：β=-0.11，均P<0.001）和配偶（T1→T2：β=-0.10，P<0.001，T2→T3：β=0.08，P<0.01）的疾病复发恐惧可以负向预测一下阶段患者的家庭复原力。疾病复发恐惧的客体效应具有显著性，即患者（T1→T2：β=0.11，T2→T3：β=0.10，均P<0.001）和配偶（T1→T2：β=0.08，T2→T3：β=0.08，均P<0.01）的疾病复发恐惧可以正向预测下一阶段对方的疾病复发恐惧。结论 PKP术后邻近椎体再骨折患者和配偶家庭复原力及疾病复发恐惧存在纵向相互作用，建议医护人员重视患者和配偶的评估和管理，合理利用其相互关系，尽可能降低患者和配偶的疾病复发恐惧水平。

关键词: 老年人, 经皮椎体后凸成形术, 再骨折, 配偶, 家庭复原力, 疾病复发恐惧, 护理