A study on the trajectory and influencing factors of joint awareness in patients with total knee arthroplasty

doi:10.3761/j.issn.0254-1769.2024.09.009

Abstract

Abstract:

Objective To explore the trajectory and influencing factors of joint awareness after total knee arthroplasty. Methods With the method for convenience sampling，patients who met the standards for total knee arthroplasty from July 2021 to March 2022 were selected. General information，severity of osteoarthritis，anxiety and depression，and self-efficacy were investigated before surgery（T0）. Joint awareness was investigated at 1 month （T1），3 months（T2），and 6 months（T3） after surgery，respectively. Latent growth curve model was used to describe the overall trend of joint awareness；latent class growth model was used to analyze latent subgroups；logistic regression analysis was used to determine the impact of related variables on the trajectory of joint awareness. Results The scores of joint awareness were（32.70±5.80），（47.67±4.67） and （61.53±7.81） respectively at T1 to T3，and joint awareness showed an increasing trend（P<0.001）. The trajectory of joint awareness was divided into 2 potential subgroups：the rapid growth group（61.83%） and the slow growth group（38.17%）. Age，BMI，other chronic diseases or not，years of osteoarthritis，severity of osteoarthritis，anxiety，depression，and self-efficacy affected the trend of joint awareness（all P<0.05）. Conclusion Joint awareness showed a linear growth trend with the postoperative time，and there were 2 potential subgroups in the trajectory. Medical workers could develop corresponding interventions based on the influencing factors to improve patients’ postoperative awareness of artificial joints.

Key words: Total Knee Arthroplasty, Joint Awareness, Trajectory, Root Cause Analysis, Longitudinal Study, Nursing Care

摘要：

目的探究全膝关节置换患者关节遗忘的变化轨迹及其影响因素。方法采用便利抽样法，选取2021年7月—2022年3月在山东省青岛市某三级甲等医院关节外科住院的280例全膝关节置换患者作为调查对象。在术前（T0）调查患者的一般资料、骨关节炎严重程度、焦虑抑郁、自我效能感，在术后1个月（T1）、术后3个月（T2）及术后6个月（T3）分别调查关节遗忘度。采用潜变量增长模型探究关节遗忘的变化轨迹、潜类别增长模型识别变化轨迹是否存在异质性亚组，Logistic回归分析判断相关变量对关节遗忘变化轨迹的影响。结果 241例全膝关节置换患者全称参与3次调查。在T1~T3时间点，全膝关节置换患者的关节遗忘得分分别为（32.70±5.80）、（47.67±4.67）、（61.53±7.81）分，关节遗忘呈线性增长趋势（P<0.001）；关节遗忘变化轨迹分为快速增长组（61.83%）、缓慢增长组（38.17%）；年龄、BMI、是否合并其他慢性疾病、骨关节炎患病年限、骨关节炎严重程度、焦虑、抑郁、自我效能感影响关节遗忘的变化趋势（均P<0.05）。结论全膝关节置换患者关节遗忘随术后时间的延长呈现线性增长趋势，关节遗忘变化轨迹存在2个潜在亚组。医护人员可以根据全膝关节置换患者关节遗忘的影响因素制订相应干预措施，提高患者术后对人工关节的遗忘度。

关键词: 全膝关节置换, 关节遗忘, 变化轨迹, 影响因素分析, 纵向研究, 护理

LI Qi, SU Qingqing, ZHANG Yaoyao, WANG Tiantian, LÜ Jing, LI Yake, LI Haiyan. A study on the trajectory and influencing factors of joint awareness in patients with total knee arthroplasty[J]. Chinese Journal of Nursing, 2024, 59(9): 1084-1090.

李琪, 苏晴晴, 张瑶瑶, 王田田, 吕静, 李亚可, 李海燕. 全膝关节置换患者关节遗忘变化轨迹及影响因素研究[J]. 中华护理杂志, 2024, 59(9): 1084-1090.

Figures/Tables 4

Table 1 Univariate analysis of the developmental trajectory subgroup of joint awareness in patients with total knee anthroplasty

Table 2 Parameter estimation for unconditional LGCM of joint awareness in patients with total knee anthroplasty（n=241）

Table 3 Summary of LCGM fitting indices for joint awareness in patients with total knee anthroplasty（n=241）

Table 4 Logistic regression analysis of the developmental trajectory subgroup of joint awareness（n=241）

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