疼痛灾难化在全膝关节置换术后病人在院期间社会支持与焦虑抑郁的中介作用

刘嘉; 刘芳; 姚洁; 李晓伟; 王若楠

doi:10.13898/j.cnki.issn.1000-2200.2022.12.029

疼痛灾难化在全膝关节置换术后病人在院期间社会支持与焦虑抑郁的中介作用

Mediating effects of the pain catastrophization on social support and anxiety, depression in hospitalized patients after total knee arthroplasty

摘要

摘要:
目的了解全膝关节置换术后病人疼痛灾难化、社会支持及医院焦虑抑郁现状，探讨疼痛灾难化在全膝关节置换术后病人社会支持及医院焦虑抑郁的作用机制，为减少术后病人在院期间焦虑抑郁提供参考。
方法采用一般资料调查表、疼痛灾难化问卷、社会支持量表及医院焦虑抑郁量表，对234例全膝关节置换术后48 h的病人进行问卷调查。采用描述性分析进行数据处理，应用Pearson相关分析检验变量之间的相关性，使用AMOS21.0建立研究变量间的结构方程模型，验证疼痛灾难化的中介效应。
结果全膝关节置换术后病人疼痛灾难化总分（18.21±9.23）分，社会支持总分（37.91±6.81）分，医院焦虑总分（4.76±3.23）分，抑郁总分（6.55±3.18）分。疼痛灾难化与社会支持呈负相关（r=-0.464，P < 0.01），疼痛灾难化与医院焦虑、抑郁呈正相关（r=0.311，0.419，P < 0.01），社会支持总分与医院焦虑、抑郁呈负相关（r=-0.440，-0.548，P < 0.01）；疼痛灾难化在社会支持与医院焦虑中介效应为0.037 8，中介效应所占比为7.5%；疼痛灾难化在社会支持与医院抑郁中介效应为0.098 8，中介效应所占比为17.7%。
结论全膝关节置换术后病人医院焦虑抑郁处于较高水平，疼痛灾难化、社会支持均处于一般水平，社会支持水平可通过疼痛灾难化影响病人术后医院焦虑抑郁。

Abstract:
ObjectiveTo understand the current situation of pain catastrophization, social support and hospital anxiety and depression in patients after total knee arthroplasty, explore the mechanism of pain catastrophization in social support and hospital anxiety and depression of patients, and provide the reference for reducing anxiety and depression in postoperative patients during hospitalization.
MethodsTwo hundred and thirty-four patients with total knee arthroplasty were investigated using the general data questionnaire, pain catastrophization questionnaire, social support scale and hospital anxiety and depression scale after 48 hours of total knee arthroplasty.The descriptive analysis was used for the data processing, the Pearson correlation analysis was used to test the correlation between variables, and the AMOS21.0 was used to establish a structural equation model to verify the mediating effects of pain catastrophization.
ResultsThe total pain catastrophization score, total social support score, total hospital anxiety score and total depression score in patients after total knee arthroplasty were(18.21±9.23), (37.91±6.81), (4.76±3.23) and(6.55±3.18) points, respectively.The pain catastrophitization was negatively correlated with social support(r=-0.464, P < 0.01), and positively correlated with hospital anxiety and depression(r=0.311, 0.419, P < 0.01).The total social support was negatively correlated with hospital anxiety and depression(r=-0.440, -0.548, P < 0.01).The mediating effect of pain catastrophization on social support and hospital anxiety was 0.037 8, which accounted for 7.5%.The mediating effect of pain catastrophization on social support and hospital depression was 0.098 8, which accounted for 17.7%.
ConclusionsThe hospital anxiety and depression of patients after total knee arthroplasty are at a high level, and the pain catastrophization and social support are at an average level.The level of social support can influence the hospital anxiety and depression of patients after surgery through the pain catastrophizing.

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