全膝关节置换术后患者恐动症的影响因素研究

目的 通过建立结构方程模型分析全膝关节置换术后患者恐动症的影响因素。 方法 采用便利抽样法,于2019年12月—2020年9月采用凯斯勒10量表、抑郁自评量表、D型人格量表、疼痛灾难化量表和恐动症Tampa评分,对河南省某三级甲等综合医院494例行全膝关节置换术的患者进行调查。 结果 最终共纳入463例患者,恐动症发生率为38.2%,构建的模型数据拟合度良好。其中,疼痛灾难化对恐动症有直接正向效应（β=0.461,P<0.001）,抑郁对恐动症有直接和间接正向效应（β=0.162,P<0.001;β=0.063,P<0.001）,D型人格和压力水平对恐动症有间接正向效应（β=0.144,P<0.001;β=0.186,P<0.001）。 结论 全膝关节置换术后患者恐动症发生率偏高,科研及临床工作者均应重视患者的疼痛灾难化、心理状况、人格及压力水平对其恐动症的影响,以便采取措施改善全膝关节置换术后患者的康复结局。

A multifactorial model of kinessiophobia in patients with knee arthroplasty

Objective To explore the multifactorial model of kinessiophobia in patients with total knee arthroplasty,and to provide a reference for the intervention of kinessiophobia. Methods From December 2019 to September 2020,494 patients with knee arthroplasty in a tertiary hospital of Henan province were investigated with the Kessler Psychological Distress Scale（K10）,Self-rating Depression Scale,Type D Personality Scale-14,Pain Catastrophizing Scale and Tampa Scale for Kinesiophobia. Results The incidence of panic disorder was 38.2%,and the model data was well-fitted. Pain disaster depression has a direct positive effect on kinessiophobia（β=0.461,P<0.001）;depression has a direct and indirect positive effect on kinessiophobia（β=0.162,P<0.001;β=0.063,P<0.001）,and Type D personality and stress level have an indirect positive effect on kinessiophobia（β=0.144,P<0.001;β=0.186,P<0.001）. Conclusion The incidence of kinessiophobia is high. Researchers and clinicians should pay attention to the impact of patients’ pain catastrophe,psychological condition,personality and stress level on their kinessiophobia,and take measures to help the patients for improving their rehabilitation outcome after total knee arthroplasty.