运动恐惧介导的疾病感知对经皮冠状动脉介入治疗术后患者康复运动依从性的影响  

Effect of Kinesiophobia Mediated Disease Perception on Rehabilitation Exercise Adherence in Patients Undergoing Percutaneous Coronary Intervention

作　　者：李娟利[1] 陈方圆[1] 郑小璞[1] 陈晨[1] 李睿[1] LI Juanli;CHEN Fangyuan;ZHENG Xiaopu;CHEN Chen;LI Rui(The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院,陕西西安710061

出　　处：《康复学报》2023年第3期216-222,共7页Rehabilitation Medicine

基　　金：陕西省重点研发计划(2019ZDLSF01-01-01)。

摘　　要：目的:探讨经皮冠状动脉介入治疗(PCI)术后患者疾病感知对康复运动依从性的影响,及运动恐惧在其中所起的作用。方法:使用方便抽样的方法,选取于2021年1—12月间在西安交通大学第一附属医院随访就诊的313例PCI术后患者作为研究对象。采用基本资料调查表、疾病感知问卷简化版、心脏康复运动依从性问卷和心脏疾病运动恐惧量表对患者情况进行调查。结果:PCI术后患者中康复运动依从性好者65例(20.77%),依从性一般者185例(59.11%),依从性差者63例(20.13%),显示PCI术后患者康复运动依从性一般。PCI术后患者疾病感知得分为(41.46±5.85)分;疾病感知可直接预测PCI术后患者的康复运动依从性,疾病感知的负性情绪越强烈,运动依从性越差。运动恐惧得分为(34.84±5.33)分,其中25.88%患者存在高度恐惧;疾病感知与运动恐惧之间具有显著相关性(r=0.542,P<0.01),不同依从性组别患者的疾病感知和运动恐惧差异均有统计学意义(F=12.339,P<0.05;F=4.419,P<0.05)。多分类因变量中介效应检验结果显示,疾病感知可预测患者的运动恐惧(t=5.336,P<0.01),运动恐惧和疾病感知均可负向预测患者的康复运动依从性(OR=0.347,P<0.01;OR=0.456,P<0.05),疾病感知可负向预测患者的康复运动依从性(OR=0.431,P<0.05),对回归系数标准化后显示,运动恐惧在疾病感知和康复运动依从性间起部分中介作用,中介效应占总效应的41.00%。结论:PCI术后患者的疾病感知可直接预测其康复运动依从性,也可通过运动恐惧的中介作用而影响到其依从性。医务工作者可引导患者客观科学面对疾病和治疗,疏导患者运动恐惧心理,提高其康复运动依从性。Objective:To explore the effect of kinesiophobia mediated disease perception on rehabilitation exercise adherence in patients undergoing percutaneous coronary intervention(PCI).Methods:A total of 313 outpatients who have been treated with PCI and followed up in the First Affiliated Hospital of Xi'an Jiaotong University from January to December 2021 were recruited with the convenient sampling method.The included patients were investigated with the basic data questionnaire,the simplified version of the Disease Perception Questionnaire,the Exercise Adherence for Cardiac Rehabilitation Questionnaire,and the Kinesiophobia Scale.Results:There were 65 patients(20.77%)with good rehabilitation exercise adherence after PCI treatment,185 patients(59.11%)with fair rehabilitation exercise adherence and 63 patients(20.13%)with poor rehabilitation exercise adherence.The overall results showed that the rehabilitation exercise adherence of patients after PCI treatment was fair.The disease perception score of patients after PCI treatment was(41.46±5.85).Thus disease perception could directly predict the rehabilitation exercise adherence of patients after PCI treatment.The stronger the negative emotion of disease perception,the worse the rehabilitation exercise adherence.The mean score of kinesiophobia was(34.84±5.33),and 25.88%of patients showed a high level of kinesiophobia.There was a significant correlation between disease perception and kinesiophobia(r=0.542,P<0.01),and there were statistically significant differences between disease perception and kinesiophobia among patients in different adherence level groups(F=12.339,P<0.05;F=4.419,P<0.05).The mediation analysis for categorical dependent variable showed that disease perception could predict the kinesiophobia of the patients(t=5.336,P<0.01),both kinesiophobia and disease perception could negatively predict the rehabilitation exercise adherence of the patients(OR=0.347,P<0.01;OR=0.456,P<0.05),and disease perception could negatively predict the rehabilitation exercise adher

关 键 词：经皮冠状动脉介入治疗 疾病感知 康复运动依从性 运动恐惧 

分 类 号：R541.4[医药卫生—心血管疾病]