腰椎间盘突出术后病人运动恐惧的影响因素分析

    Analysis of the influencing factors of exercise fear in patients with lumbar disc herniation after operation

    • 摘要:
      目的 调查腰椎间盘突出症(LDH)病人术后运动恐惧发生情况,并探讨其影响因素。
      方法 便利抽样法选取LDH病人105例为研究对象,采用个人资料调查表、运动恐惧评定量表(TSK)、康复锻炼自我效能量表(SER)、简化McGill疼痛问卷和恐惧-回避信念量表(FABQ)进行问卷调查。
      结果 LDH病人术后发生运动恐惧65例,占比61.90%。不同病程、是否合并慢性病和有无术前运动恐惧病人的TSK得分差异均有统计学意义(P < 0.05)。病人TSK得分与SER总分、锻炼自我效能、应对自我效能均呈明显负相关关系(P < 0.01),与感觉疼痛评级指数、情感疼痛评级指数、视觉模拟评分、现有疼痛强度和FABQ均呈明显正相关关系(P < 0.01)。多重线性回归显示,术前运动恐惧、应对自我效能、情感疼痛评级指数、现有疼痛强度和FABQ均为LDH病人术后运动恐惧的独立影响因素(P < 0.05~P < 0.01),共解释运动恐惧的83.10%。
      结论 LDH病人术后运动恐惧发生率较高,应针对影响因素关注重点人群,观察病人术后现时疼痛程度,做好健康教育,提高病人康复锻炼自我效能,降低恐惧-回避信念。

       

      Abstract:
      Objective To investigate the occurrence of exercise fear in patients with lumbar disc herniation after(LDH) surgery, and explore its influencing factors.
      Methods A total of 105 patients with LDH were selected by convenient sampling method, and investigated using the personal data questionnaire, moophobia rating scale(TSK), rehabilitation exercise self-efficacy scale(SER), simplified McGill pain questionnaire(SF-MPQ) and fear avoidance belief scale(FABQ).
      Results The exercise fear after operation in 65 cases(61.90%) were found among LDH patients.The differences of the exercise fear scores among patients with or without chronic diseases, with or without preoperative fear and with different disease course were statistically significant(P < 0.05).The TSK score was negatively correlated with SER total score, exercise self-efficacy and coping self-efficacy(P < 0.01), and positively correlated with S-PRI, A-PRI, VAS, PPI and FABQ(P < 0.01).The results of multiple linear regression showed that preoperative exercise fear, coping self-efficacy, affective pain rating index, existing pain intensity and FABQ were the independent influencing factors of postoperative exercise fear in LDH patients(P < 0.05 to P < 0.01), accounting for 83.10% of exercise fear.
      Conclusions The incidence of exercise fear is high in LDH patients after surgery, so it is necessary to pay attention to key groups according to influencing factors, observe the current pain degree of patients after surgery, do health education, improve patients' self-efficacy in rehabilitation exercise, and reduce fear-avoidance belief.

       

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