全膝关节置换术后恐动症及其影响因素研究

关键词：膝骨关节炎  全膝关节置换  恐动症  运动恐惧  影响因素

Keywords:knee osteoarthritis  total knee arthroplasty  kinesiophobia  fear of movement  influencing factors

摘要：

      摘要 目的：调查全膝关节置换术后患者恐动症的发生情况并分析其影响因素，为术后恐动症的干预提供理论基础。 方法：对2021年3月—6月期间在北京大学第三医院骨科行全膝关节置换的患者进行问卷调查，收集社会人口学资料和相关问卷评估信息。按恐动症评分（TSK）分组，采用SPSS 26.0软件进行恐动症发生的单因素及多因素Logistic回归分析。 结果：①恐动症的单因素分析：恐动组年龄（67.17±5.57岁）与非恐动组年龄（64.59±5.85岁）差异存在显著性意义（P=0.016）。②恐动症的多因素分析：年龄（OR=1.128， 95%CI： 1.035—1.229， P=0.006）、焦虑抑郁情绪（OR=1.278， 95%CI： 1.128—1.448， P＜0.001）是恐动症发生的危险因素；一般自我效能感（OR=0.873， 95%CI： 0.789—0.967， P=0.009）是恐动症发生的保护因素。 结论：全膝关节置换术后患者恐动症发生率较高，患者的焦虑抑郁情绪、年龄是术后恐动症发生的危险因素，自我效能是术后恐动症发生的保护因素。医疗人员应关注老年全膝关节置换术后患者，采取措施缓解术后焦虑抑郁情绪，增强患者自我效能，以使患者早期开展功能锻炼，促进机体康复。

Abstract:

      Abstract Objective： To investigate the occurance of kinesiophobia in patients after total knee anthroplasty （TKA） and analyze its influencing factors in order to provide a theoretical basis for postoperative kinesiophobia intervention. Method： A questionnaire survey was conducted on patients underwent total knee arthroplasty in the Department of Orthopedics， Peking University Third Hospital from March to June 2021， and sociodemographic data and relevant questionnaire evaluation information were collected. Patients were grouped by score of Tampa Scale for Kinesiophobia （TSK） and SPSS26.0 software was used to perform univariate and multivariate Logistic regression analysis of kinesiophobia. Result： ①Univariate analysis of kinesiophobia： There was significant difference between the age of the kinesiophobia group （67.17 ± 5.57） and the age of the non-kinesiohpobia group （64.59±5.85，P=0.016）. ②Multivariate analysis of kinesiophobia： Age （OR=1.128， 95%CI：1.035—1.229， P=0.006）， anxiety and depression （OR=1.278， 95%CI：1.128—1.448， P＜0.001） were risk factors of kinesiophobia while general self-efficacy （OR=0.873， 95%CI：0.789—0.967， P=0.009） was the protective factor of kinesiophobia. Conclusion： The incidence of kinesiophobia is high in patients after total knee arthroplasty. Anxiety， depression， and age of patients are risk factors of kinesiophobia after surgery， and self-efficacy is a protective factor of kinesiophobia after surgery. Medical staff should pay attention to elderly patients after TKA， take measures to relieve postoperative anxiety and depression， and enhance patients' self-efficacy， so that patients can carry out early functional exercises and promote physical recovery.