全膝关节置换患者术前心理弹性现状及其影响因素分析

目的 探讨全膝关节置换患者术前心理弹性现状并分析其影响因素。 方法 采用便利抽样法,选取2021年3月—7月在上海市某三级甲等医院关节外科住院的183例择期行全膝关节置换术的患者作为调查对象。基于心理弹性模型选定潜在影响变量,采用一般资料调查表、西安大略和麦克马斯特大学骨关节炎指数、康纳戴维森心理弹性量表、慢性病自我效能量表、希望指数量表、心理困扰量表、社会支持评定量表、医学应对方式问卷进行调查。采用多元线性回归进行心理弹性影响因素分析。 结果 全膝关节置换患者术前心理弹性水平为（59.98±9.20）分。多元线性回归分析显示,患者文化程度（β=0.202,P<0.001）、自我效能（β=0.319,P<0.001）、希望（β=0.363,P<0.001）、屈服应对（β=-0.149,P=0.010）可影响全膝关节置换患者术前心理弹性,共解释68.20%的总变异。 结论 全膝关节置换患者术前心理弹性整体水平较低,临床实践中应重视健康教育与心理辅导,提高患者的自我效能和希望水平,避免消极应对方式,促进患者的手术预后。

The status and influencing factors associated with psychological resilience in preoperative patients with total knee arthroplasty

Objective To investigate the status and influencing factors of preoperative psychological resilience in patients with total knee arthroplasty（TKA）. Methods By employing the convenient sampling method,183 patients with knee osteoarthritis who were about to receive elective TKA were enrolled in a tertiary hospital in Shanghai from March to July 2021. Based on the resilience model,potential influencing variables were selected. Data were collected using the General Information Questionnaire,WOMAC Osteoarthritis Index,Connor-Davidson Resilience Scale,Chronic Disease Self-efficacy Scale,Herth Hope Index,Kessler Psychological Distress Scale,Social Support Rating Scale and Medical Coping Modes Questionnaire in questionnaire survey. Multiple linear regression was used to analyze the influencing factors of psychological resilience. Results The preoperative psychological resilience level of patients undergoing TKA was 59.98（SD 9.20）,which was lower than the domestic norm. Multiple linear regression analysis showed that the patient’s educational level（β=0.202,P<0.001）,self-efficacy（β=0.319,P<0.001）,hope（β=0.363,P<0.001）,resignation coping style（β=-0.149,P=0.010） could affect the preoperative psychological resilience of patients undergoing TKA,which explained 68.20% of the total variance. Conclusion The overall level of preoperative psychological resilience in patients undergoing TKA is low. Health education and psychological counseling should be paid to improve patients’ level of self-efficacy and hope,and reduce negative coping styles,thus to promote patients’ psychological resilience and surgical prognosis.