运动恐惧在全膝关节置换术后患者疼痛灾难化与锻炼依从性间的中介作用-现代医学

运动恐惧在全膝关节置换术后患者疼痛灾难化与锻炼依从性间的中介作用

单位：1. 贵州医科大学护理学院, 贵州贵阳 550025;
2. 贵州医科大学附属医院护理部, 贵州贵阳 550001;
3. 北京积水潭医院贵州医院骨科, 贵州贵阳 550014

分类号：R684

出版年·卷·期（页码）：2023·51·第九期（1257-1262）

摘要：

目的：分析全膝关节置换术后患者运动恐惧在疼痛灾难化与锻炼依从性间的中介作用。方法：采用便利抽样法，选取贵州医科大学附属医院和北京积水潭医院贵州医院行全膝关节置换术的278例住院患者为调查对象，采用一般资料调查表、疼痛灾难化量表、恐动症Tampa评分表、骨科患者功能锻炼依从性量表进行调查。结果：全膝关节置换术后患者疼痛灾难化得分为(30.37±8.11)分，运动恐惧得分为(35.12±7.40)分，锻炼依从性得分为(54.60±5.68)分；疼痛灾难化与运动恐惧(r=0.959，P＜0.01)呈正相关、与锻炼依从性(r=-0.904，P＜0.01)呈负相关，运动恐惧与锻炼依从性(r=-0.911，P＜0.01)呈负相关；运动恐惧在疼痛灾难化与锻炼依从性间具有显著的中介作用，中介效应占总效应比为59.0%。结论：全膝关节置换术后患者疼痛灾难化可以直接影响锻炼依从性，也可以通过运动恐惧间接影响锻炼依从性，临床护理人员应尽早识别患者疼痛灾难化思想，实施有针对性的干预方式，达到降低运动恐惧，提高锻炼依从性的目的。

Objective: To analyze the mediating effect of kinesiophobia on pain catastrophizing and exercise compliance in total knee arthroplasty patients. Methods: By convenience sampling,278 inpatients undergoing total knee arthroplasty were selected as subjects;and general information questionnaire,Pain Catastrophe Scale,Tampa score of phobia,Orthopedic Patients' Functional Exercise Compliance Scale were used as investigating tools.Results: The pain catastrophizing score，Kinesiophobia score and exercise compliance score of total knee arthroplasty patients were(30.37±8.11),(35.12±7.40) and(54.60±5.68) points, respectively. Pain catastrophizing was positively correlated with exercise fear(r=0.959，P<0.01)，And negatively correlated with exercise compliance(r=-0.904,P<0.01)，and negatively correlated with exercise fear and exercise compliance(r=-0.911,P<0.01). Kinesophobia played a mediating role between pain catastrophizing and exercise compliance，and the mediating effect accounted for 59.0% of the total effect.Conclusion: Pain catastrophizing in total knee arthroplasty patients can directly affect exercise compliance，and it can also indirectly affect exercise compliance through kinesiophobia. Clinical nurses should identify patients' pain catastrophizing thoughts as early as possible and implement targeted interventions to reduce kinesiophobia and improve exercise compliance.

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