认知行为干预联合早期功能锻炼在腰椎间盘突出症术后恐动症患者中的应用  

Application of cognitive behavioral intervention combined with early functional exercise in patients with kinesiophobia after lumbar disc herniation surgery

作　　者：袁甜 赵衍 倪艳 邱俊骏 张玲霞[2] Yuan Tian;Zhao Yan;Ni Yan;Qiu Junjun;Zhang Lingxia(Department of Orthopedics,Nanjing First Hospital,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;Department of Surgery,Nanjing First Hospital,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)骨科,南京210006 [2]南京医科大学附属南京医院(南京市第一医院)外科,南京210006

出　　处：《中华现代护理杂志》2022年第29期4082-4087,共6页Chinese Journal of Modern Nursing

摘　　要：目的:探讨认知行为干预联合早期功能锻炼对腰椎间盘突出症术后恐动症患者的影响。方法:采用方便抽样法,选取2020年9月—2021年9月南京市第一医院骨科收治的腰椎间盘突出症术后恐动症患者90例为研究对象,采用随机数字表法将其分为干预组和对照组,各45例。对照组采用常规护理,干预组在常规护理基础上给予认知行为干预联合早期功能锻炼。比较两组患者入组时、出院时和术后1、3个月恐动症Tampa量表(TSK)、恐惧逃避信念问卷(FABQ)、功能锻炼依从性量表(EARS)及日本骨科学会下腰痛评分量表(JOA)评分。结果:干预后,干预组患者出院时、术后1个月、术后3个月TSK、FABQ评分均低于对照组,干预组患者出院时、术后1个月、术后3个月EARS及JOA评分均高于对照组,差异均有统计学意义(P<0.05)。结论:认知行为干预联合早期功能锻炼可有效降低腰椎间盘突出症术后患者的恐动症水平及恐惧逃避信念,提升其锻炼依从性,有效改善患者的躯体功能。Objective To explore the effect of cognitive behavioral intervention combined with early functional exercise on kinesiophobia in patients with lumbar disc herniation after surgery.Methods From September 2020 to September 2021,the convenient sampling was used to select 90 patients with kinesiophobia after lumbar disc herniation surgery in Department of Orthopedics in Nanjing First Hospital as the research objects.They were divided into the intervention group and the control group by the random number table,with 45 cases in each group.The control group received routine nursing,while the intervention group received cognitive behavioral intervention combined with early functional exercise on the basis of routine nursing.The scores of Tampa Scale for Kinesiophobia(TSK),Fear Avoidance Beliefs Questionnaire(FABQ),Exercise Adherence Rating Scale(EARS)and Japanese Orthopaedic Association(JOA)were compared between the two groups at the time of admission,at discharge and 1 and 3 months after the operation.Results After the intervention,the TSK and FABQ scores of the patients in the intervention group were lower than those in the control group at the time of discharge,1 month after surgery and 3 months after surgery;the EARS and JOA scores of patients in the intervention group were higher than those in the control group at the time of discharge,1 month and 3 months after operation,and the differences were all statistically significant(P<0.05).Conclusions Cognitive-behavioral intervention combined with early functional exercise can effectively reduce the level of kinesiophobia and fear-avoidance beliefs in patients with postoperative lumbar disc herniation,improve their exercise compliance and effectively improve their physical function.

关 键 词：腰椎间盘突出症 恐动症 早期康复 功能锻炼 认知行为干预 恐惧逃避信念 

分 类 号：R473.6[医药卫生—护理学]