全髋关节置换手术患者经验性回避现状及影响因素分析

目的 探讨全髋关节置换手术患者经验性回避现状,并分析其影响因素,为临床干预提供理论依据。 方法 采用时间阶段连续病例整群抽样法,选取2018年2—12月在广州市红十字会医院接受全髋关节置换的227例患者作为研究对象,采用一般情况调查表、接纳与行动问卷第二版(AAQ-Ⅱ)、一般自我效能感量表(GSES)及社会支持评定量表(SSRS)进行调查。 结果 全髋关节置换手术患者经验性回避得分为(26.26±7.44)分;单因素分析显示,不同性别、文化程度、Harris髋关节评分的全髋关节置换手术患者经验性回避得分差异有统计学意义(均P<0.05);Pearson相关分析结果显示,全髋关节置换手术患者经验性回避与一般自我效能、社会支持各维度得分及总分均呈负相关(均P<0.05);多元逐步回归分析,结果显示一般自我效能感、社会支持总分、Harris髋关节评分、性别依次进入回归方程(F=37.115,P<0.001)。 结论 全髋关节置换手术患者经验性回避水平较高,且受性别、Harris髋关节评分、一般自我效能感、社会支持等多方面因素影响。临床工作者应采取针对性干预,实施自我效能感干预,调动患者的社会支持系统,从而降低患者的经验性回避水平。 

Analysis of the current situation and influencing factors of experiential avoidance in patients with total hip arthroplasty

Objective To investigate the current situation of experiential avoidance in patients with total hip arthroplasty, and to analyze the influencing factors to provide theoretical basis for clinical intervention. Methods Using time stage continuous cases the cluster sampling method, 227 patients with total hip arthroplasty at two top three hospitals(Guangzhou Red Cross Hospital, The Second Affiliated Hospital of Guangzhou Medical University) from February to December 2018 were selected. All patients were surveyed by the general questionnaire, Acceptance and Action Questionnaire-2 nd Edition(AAQ-Ⅱ), General Self-Efficacy Scale(GSES) and Social Support Rating Scale(SSRS). Results The experiential avoidance score of patients with total hip arthroplasty was(26.26±7.44) points. Univariate analysis showed that patients with different gender, education, and Harris hip score had statistically significant differences in their experiential avoidance scores(all P<0.05). Pearson correlation analysis showed that the general self-efficacy, social support dimensions and total scores of patients were negatively correlated(all P<0.05). Multiple stepwise regression analysis showed that general self-efficacy, total social support score, Harris hip score, and gender entered the regression equation(F=37.115, P<0.001). Conclusion Patients with total hip arthroplasty have a higher level of experiential avoidance, and gender, Harris hip score, general self-efficacy, and social support influence it. Clinicians should take targeted interventions, implement self-efficacy interventions, and mobilize the patient's social support system to reduce the level of experiential avoidance.