摘要
目的探讨老年髋膝关节置换术(THA/TKA)患者术后自我康复现状,并分析患者生活质量的影响因素。方法选择2020年1月至2022年1月琼海市人民医院收治的190例老年THA/TKA手术患者为研究对象,使用问卷调查的方式,统计老年THA/TKA治疗者出院后家庭康复6个月时的自我康复现状。采用SPSS 20.0统计软件进行数据分析。根据数据类型,分别采用单因素方差分析、t检验或χ^(2)检验进行组间比较。采用多元线性回归分析老年THA/TKA治疗者术后生活质量的影响因素。结果190份调查问卷中,回收有效问卷179份。179例患者简明健康调查量表(SF-36)各维度平均得分为(54.41±8.77)分;患者术后髋、膝关节优良率分别为40.00%(36/90)和42.70%(38/89);患者整体自护能力分级及社会支持水平多处于中低水平[85.47%(153/179)和88.83%(159/179)];焦虑、抑郁发生率分别为25.14%(45/179)和27.37%(49/179);自我康复训练依从性多处于良或差水平[33.52%(60/179)和46.37%(83/179)]。多元线性回归分析结果提示,术后并发症(β=-3.854,P<0.001)及抑郁(β=-0.277,P<0.001)对老年THA/TKA治疗者生活质量有负向预测作用;自护能力(β=0.236,P<0.001)、社会支持水平(β=0.611,P<0.001)及自我康复训练依从性(β=0.213,P<0.001)对其生活质量有正向预测作用,回归方程差异显著(F=13.115,P<0.001),这些变量共同解释生活质量的50.60%的变异。结论老年THA/TKA患者术后6个月自我康复整体现状不佳,术后并发症、自护能力、社会支持水平、抑郁及自我康复训练依从性是老年THA/TKA治疗者生活质量的独立影响因素,建议临床从这些方面入手,改善患者术后生活质量。
Objective To investigate the postoperative self-rehabilitation in the elderly patients with total hip/knee arthroplasty(THA/TKA)and analyze the factors affecting their quality of life.Methods A total of 190 elderly THA/TKA patients in Qionghai People′s Hospital from January 2020 to January 2022 were enrolled as the study subjects.A questionnaire survey was conducted to statistically analyze the status quo of their at-home self-rehabilitation at 6 months after discharge.SPSS statistics 20.0 was employed to process the data.According to the data type,one-way analysis of variance,t test orχ^(2)test was used for intragroup comparison.Multivariate linear regression analysis was used to analyze the factors affecting the postoperative quality of life of the elderly THA/TKA patients.Results Among the 190 questionnaires distributed,179 valid responses were returned.The survey found that the average score of various dimensions of 36-item short form health survey(SF-36)in the 179 elderly THA/TKA patients was(54.41±8.77)points.The excellent and good rate of the hip was 40.00%(36/90)in the THA patients,and that of the knee was 42.70%(38/89)in the TKA patients.The overall self-care ability and social support were mostly at low and middle levels[(85.47%(153/179)and 88.83%(159/179)].The incidence rates of anxiety and depression were 25.14%(45/179)and 27.37%(49/179)respectively.The compliance to the self-rehabilitation training was mostly good[(33.52%(60/179)]or poor[(46.37%(83/179)].Multivariate linear regression analysis suggested that postoperative complications(β=-3.854;P<0.001)and depression(β=-0.277;P<0.001)had a negative predictive effect on the quality of life of the elderly THA/TKA patients,and that self-care ability(β=0.236;P<0.001),social support level(β=0.611;P<0.001)and compliance to the self-rehabilitation training(β=0.213;P<0.001)had a positive predictive effect,and the regression equation was significant(F=13.115;P<0.001).These variables together explained 50.60%of the variation in quality of life.Conclusion The overall self-rehabilitation in the elderly THA/TKA patients at 6 months after surgery is not good,and postoperative complications,self-care ability,social support,depression and compliance to self-rehabilitation training are independent factors affecting their quality of life.It is suggested to improve the quality of life of patients after surgery in these aspects.
作者
王汝婷
王雪
王雪妃
刘旭晓
Wang Ruting;Wang Xue;Wang Xuefei;Liu Xuxiao(Department of Spinal Joint Surgery,Qionghai People′s Hospital,Qionghai 571400,Hainan Province,China)
出处
《中华老年多器官疾病杂志》
2023年第12期890-894,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
海南省自然科学基金(822QN483)。
关键词
老年人
髋膝关节置换术
自我康复
aged
total hip/knee arthroplasty
self-rehabilitation
