全膝关节置换病人疼痛灾难化水平及影响因素的纵向研究

    A Longitudinal Study on Pain Catastrophizing Level and Its Influencing Factors in Patients Undergoing Total Knee Arthroplasty

    • 摘要:
      目的调查全膝关节置换病人在术前、术后不同阶段的疼痛灾难化水平情况,并分析其影响因素。
      方法采用便利抽样选取120例全膝关节置换病人作为研究对象,采用纵向研究设计,分别在术前1 d(T1),术后3 d(T2),术后2周(T3)、术后1个月(T4)、术后3个月(T5)5个时间点调查病人的疼痛灾难化、疼痛程度、社会支持、家庭关怀度、焦虑抑郁和睡眠情况,比较5次测量结果的差异性并分析病人疼痛灾难化的影响因素。
      结果5个时间点疼痛灾难化得分分别为(26.17±8.84)分、(25.80±7.54)分、(15.75±3.66)分、(10.08±3.00)分、(7.60±2.54)分;多因素线性回归分析结果显示,测定时间、性别、职业、文化程度、疼痛程度、社会支持、家庭关怀度、焦虑、抑郁及睡眠均为TKA病人疼痛灾难化的影响因素(P < 0.05~P < 0.01)。
      结论全膝关节置换病人存在较高的疼痛灾难化水平且呈动态变化,临床医护工作人员应及时评估病人疼痛灾难化的动态变化情况,关注人口学、疾病、心理、社会等多项因素对病人疼痛灾难化的影响并制定相应干预措施。

       

      Abstract:
      ObjectiveTo investigate the pain catastrophizing level in patients undergoing total knee arthroplasty (TKA) at different stages before and after operation, and to analyze its influencing factors.
      MethodsOne hundred and twenty TKA patients were selected by convenience sampling method.A longitudinal study was designed to measure the pain catastrophizing level, pain degree, social support, family care, anxiety and depression, and sleep status of the patients at 5 time points: 1 day before operation(T1), 3 days after operation (T2), 2 weeks after operation(T3), 1 month after operation(T4), and 3 months after operation(T5). The differences of the 5 measurements were compared, and the influencing factors of the patient' pain catastrophizing were analyzed.
      ResultsThe pain catastrophizing scores at five time points were (26.17±8.84), (25.80±7.54), (15.75±3.66), (10.08±3.00), and (7.60±2.54), respectively.The analysis results of multi-factor linear regression showed that the measured time, sex, occupation, education degree, pain degree, social support, family care, anxiety and depression, and sleep were all influencing factors of pain catastrophizing in TKA patients (P < 0.05 to P < 0.01).
      ConclusionsTKA patients have a high pain catastrophizing level which dynamically changes.Clinical medical staff should timely assess the dynamic changes of patients' pain catastrophizing; pay attention to the impact of demography, diseases, psychology, society, and other factors on the pain catastrophizing level of patients; and develop intervening measures.

       

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