康复锻炼自我效能、锻炼计划对人工髋关节置换术患者健康信念和康复锻炼依从性的链式中介作用-现代医学

康复锻炼自我效能、锻炼计划对人工髋关节置换术患者健康信念和康复锻炼依从性的链式中介作用

单位：1. 新疆医科大学护理学院, 新疆乌鲁木齐 830011;
2. 新疆医科大学第六附属医院关节外科, 新疆乌鲁木齐 830011;
3. 新疆维吾尔自治区人民医院骨创伤科, 新疆乌鲁木齐 830011;
4. 新疆医科大学第五附属医院护理部, 新疆乌鲁木齐 830011

关键词：人工髋关节置换术健康信念康复锻炼自我效能锻炼计划康复锻炼依从性

分类号：R473.6

出版年·卷·期（页码）：2023·51·第九期（1214-1220）

摘要：

目的：探讨康复锻炼自我效能和锻炼计划对人工髋关节置换术患者健康信念和康复锻炼依从性的链式中介作用。方法：于2023年1—4月，采用一般资料调查问卷、康复锻炼依从性量表、康复锻炼自我效能量表、锻炼计划量表及健康信念量表对乌鲁木齐市3所三级甲等医院227例人工髋关节置换术患者进行调查，进而构建结构方程模型。结果：227例人工髋关节置换术患者康复锻炼依从性总分平均为(52.14±11.40)分，健康信念总分平均为(149.30±27.75)分，康复锻炼自我效能总分平均为(84.18±16.73)分，锻炼计划总分平均为(28.46±7.81)分。人工髋关节置换术患者健康信念得分与康复锻炼自我效能得分、锻炼计划得分及康复锻炼依从性得分呈正相关(r=0.447、0.545、0.650，均P<0.001)；康复锻炼自我效能得分与锻炼计划得分、康复锻炼依从性得分呈正相关(r=0.558、0.686，均P<0.001)；锻炼计划得分与康复锻炼依从性得分呈正相关(r=0.711，P<0.001)。路径分析显示，人工髋关节置换术患者健康信念可直接影响康复锻炼依从性，还可通过康复锻炼自我效能和锻炼计划间接正向影响康复锻炼依从性，也可通过康复锻炼自我效能、锻炼计划链式中介正向影响康复锻炼依从性。结论：康复锻炼自我效能、锻炼计划对人工髋关节置换术患者健康信念和康复锻炼依从性起链式中介作用。

Objective: To explore the chain intermediary effect of rehabilitation exercise self-efficacy and exercise plan on health beliefs and rehabilitation exercise compliance in patients undergoing artificial hip replacement. Methods: From January to April 2023, a survey was conducted on 227 patients undergoing hip replacement surgery at three tertiary hospitals in Urumqi using a general information survey questionnaire, rehabilitation exercise compliance scale, rehabilitation exercise self-efficacy scale, exercise plan scale, and health belief scale, and a structural equation model was constructed. Results: The average total score of rehabilitation exercise compliance for 227 patients undergoing artificial hip replacement was(52.14±11.40), the average total score of health belief was(149.30±27.75), the average total score of rehabilitation exercise self-efficacy was(84.18±16.73), and the average total score of exercise plan was(28.46±7.81). There was a positive correlation between health beliefs score and rehabilitation exercise self-efficacy score, exercise plan score, and rehabilitation exercises compliance score in patients undergoing artificial hip replacement surgery(r=0.447,0.545,0.650, all P<0.001). Rehabilitation exercise self-efficacy score was positively correlated with exercise plan score and rehabilitation exercise compliance score(r=0.558,0.686, all P<0.001). There was a positive correlation between exercise plan score and rehabilitation exercise compliance score(r=0.711, P<0.001). Path analysis showed that the health beliefs of patients undergoing artificial hip replacement can directly affect rehabilitation exercise compliance, and can also indirectly affect rehabilitation exercise compliance through rehabilitation exercise self-efficacy and exercise plan. It can also positively affect rehabilitation exercise compliance through the chain intermediary effect of rehabilitation exercise self-efficacy and exercise plan. Conclusion: Self-efficacy and exercise plan of rehabilitation exercise play a chain intermediary role in health beliefs and rehabilitation exercise compliance of patients undergoing artificial hip replacement.

参考文献：

[1] MENG Y,DENG B,LIANG X,et al.Effectiveness of self-efficacy-enhancing interventions on rehabilitation following total hip replacement:a randomized controlled trial with six-month follow-up[J].J Orthop Surg Res,2022,17(1):225.
[2] KRIŠTOF M P,STROJNIK V,KAVI G,et al.Effects of early home-based strength and sensory-motor training after total hip arthroplasty:study protocol for a multicenter randomized controlled trial[J].Trials,2022,23(1):929.
[3] FERGUSON R J,PALMER A J,TAYLOR A,et al.Hip replacement[J].Lancet,2018,392(10158):1662-1671.
[4] LI Y,XIE W,XIAO W,et al.Progress in osteoarthritis research by the National Natural Science Foundation of China[J].Bone Res,2022,10(1):41.
[5] O'MARA-GARDNER K,REDFERN R E,BAIR J M.Establishing a geriatric hip fracture program at a Level 1 Community Trauma Center[J].Orthop Nurs,2020,39(3):171-179.
[6] 李信欣,吕启圆,李江圳,等.髋关节置换术后患者院外功能锻炼依从性与健康信念的纵向研究[J].中华护理杂志,2019,54(8):1180-1184.
[7] 陈红欣,赵婷,刘丹,等.加速康复外科指导下视频健康宣教在老年髋关节置换术患者康复中的应用观察[J].老年医学与保健,2023,29(3):597-601.
[8] 杜静静,杨慧敏,赵丹.髋关节置换术后患者不同阶段院外功能锻炼依从性与健康信念的动态变化及其相关性[J].齐鲁护理杂志,2020,26(22):4-7.
[9] 缪春梅.HBM模式对老年髋关节置换术后髋关节功能、依从性及效能感影响研究[J].现代医学,2016,44(5):733-737.
[10] 张远星,陈璐,季翠玲,等.中青年出血性脑卒中患者功能锻炼依从性的影响因素及路径分析[J].护理学报,2022,29(20):6-10.
[11] BIERBAUER W,BERMUDEZ T,BERNARDO A,et al.Implementation of a novel medication regimen following cardiac rehabilitation:an application of the Health Action Process Approach[J].Int J Behav Med,2023,30(1):30-37.
[12] 王荣,张爽爽,丰花,等.基于LEARNS模式的康复训练对髋部骨折患者术后功能恢复的影响[J].川北医学院学报,2023,38(3):417-420.
[13] 王海燕,许燕玲,胡三莲,等.中文版康复自我效能感量表的信效度评价[J].中华现代护理杂志,2014,20(3):268-270.
[14] 谭媛媛,和晖,杨秀贤,等.骨科患者功能锻炼依从性量表的编制及信度效度检验[J].中国护理管理,2019,19(11):1626-1631.
[15] 朱金凤,狄恒丹,季翠玲,等.中青年脑卒中患者运动自我效能及锻炼计划与运动依从性的相关性研究[J].护理学杂志,2022,37(23):36-39.
[16] 沈梦英.中国成年人锻炼行为的干预策略:TPB与HAPA两个模型的整合[D].北京:北京体育大学,2016.
[17] 邱皓政.结构方程模型原理与应用[M].2版.北京:中国轻工业出版社,2019:25.
[18] 于侠,李伦兰,祁金梅,等.人工髋关节置换患者遵医行为影响因素分析及护理对策[J].安徽医药,2014(5):981-983.
[19] 史燕燕,王秋菊.健康信念对膝关节置换术后患者膝关节功能恢复及功能锻炼依从性的影响[J].中华现代护理杂志,2021,27(6):817-821.
[20] CAETANO L,PACHECO B D,SAMORA G,et al.Self-efficacy to engage in physical exercise and walking ability best predicted exercise adherence after stroke[J].Stroke Res Treat,2020:2957623.
[21] 周月琴,陈肖,汤样华.增强自我效能干预对股骨颈骨折患者功能恢复的影响[J].中华现代护理杂志,2022,28(28):3950-3954.
[22] 倪雪琴,林培芬.赋能教育模式在髋关节置换后功能锻炼中的应用[J].中华关节外科杂志(电子版),2019,13(5):637-640.
[23] 王冰,董磊,王巧云.动机性访谈在全髋关节置换术患者康复训练中的应用效果[J].中华现代护理杂志,2022,28(9):1238-1242.
[24] SHELTON E,BARRETO N B,BIDWELL S,et al.Engagement and adherence with a web-based prehabilitation program for patients awaiting abdominal colorectal surgery[J].J Gastrointest Surg,2021,25(12):3198-3207.
[25] HU S,HU Y,WANG S,et al.Predicting physical activity in kidney transplant recipients:an application of the health action process approach model[J].Psychol Health Med,2023,28(3):772-784.

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