经皮脊柱内镜下腰椎间盘摘除术中青年患者术后自我管理行为与康复质量的影响因素分析  

Analysis of influencing factors on self-management behavior and rehabilitation quality of young andmiddle-aged patients after percutaneous endoscopic lumbar discectomy

作　　者：刘仕平 连学辉 肖红利 金传述 张莉 Liu Shiping;Lian Xuehui;Xiao Hongli;Jin Chuanshu;Zhang Li(Department of Orthopedics,the First People's Hospital of Guiyang,Guiyang 550002,Guizhou,China;Discipline Inspection and Supervision Office,the Affiliated Hospital of Zunyi Medical University,Zunyi 563009,Guizhou,China)

机构地区：[1]贵阳市第一人民医院骨科,贵州贵阳550002 [2]遵义医科大学附属医院纪委监察室,贵州遵义563009

出　　处：《加速康复外科杂志》2024年第3期107-112,共6页JOURNAL OF ENHANCED RECOVERY AFTER SURGERY

基　　金：贵州省卫生健康委科学技术基金项目(gzwkj2022-366);贵阳市卫生健康局科学技术计划项目(【2021】筑卫健科技合同字第8号);贵阳市科技计划项目(筑科合同[2021]-6-1号)。

摘　　要：目的:调查经皮脊柱内镜下腰椎间盘摘除术(percutaneous endoscopic lumbar discectomy,PELD)中青年患者术后自我管理行为现状,分析其影响因素,为临床相关康复干预措施提供依据。方法:采用方便抽样法选取2022年11月至2023年4月于贵阳市第一人民医院骨科门诊复查的125例PELD中青年患者作为调查对象,使用自行设计的一般资料调查表、慢性病患者自我管理行为量表、社会支持评定量表评估患者术后自我管理行为,分析术后自我管理行为的影响因素。结果:本次调查共发放问卷130份,回收有效问卷125份,有效问卷回收率为96.15%(125/130)。PELD中青年患者术后自我管理行为得分为(30.11±8.15)分,其中运动锻炼维度得分为(10.67±3.45),条目均分(2.88±1.12)分;认知症状管理实践维度得分为(12.56±4.20)分,条目均分(3.09±0.69)分;与医生的沟通维度总评分为(6.88±2.80)分,条目均分(3.23±0.94)分。单因素分析显示,年龄、文化程度、家庭人均月收入、工作状况、医疗付费方式、社会支持是PELD中青年患者术后自我管理行为的影响因素(均P <0.05);多元线性回归分析显示文化程度、家庭月收入、社会支持为PELD中青年患者术后自我管理行的主要影响因素(均P <0.05)。结论:PELD中青年患者术后自我管理行为处于中下等水平,临床医务人员应多关注文化水平较低、家庭月收入较低的患者,同时利用社会支持提高患者的自我管理行为水平。Objective:To investigate the current status of self-management behaviors in young and middle-aged patients after percutaneous endoscopic lumbar discectomy(PELD)and analyze its influencing factors,aiming to provide reference for clinical intervention measures.Method:A self-designed questionnaire was used to investigate 125 patients with PELD at the First People's Hospital of Guiyang.The chronic disease self-management behavior measuring scale and the social support rating scale were used to analyze the influencing factors.Result:A total of 130 questionnaires were distributed and 125 effective questionnaires returned,with a recovery rate of 96.15%(125/130).The average score of self-management behavior in young and middle-aged patients after percutaneous endoscopic lumbar discectomy was(30.11±8.15)points,and the subscale score of exercise and training was(10.67±3.45)points,with an item mean score of(2.88±1.12)points,and the subscale score of cognitive symptom management practice was(12.56±4.20)points,with an item mean score of(3.09±0.69)points,and the total score of communication with doctors was(6.88±2.80)points,with an item mean score of(3.23±0.94)points.The age,education level,household monthly income,work status,medical payment method,and social support were influencing factors of self-management behavior in young and middle-aged patients after percutaneous endoscopic lumbar discectomy(allP<0.05).Besides,education level,household monthly income,and social support were the main influencing factors of self-management behavior in young and middle-aged patients after percutaneous endoscopic lumbar discectomy(all P<0.05).Conclusion:The self-management behavior of young and middle-aged patients after percutaneous endoscopic lumbar discectomy is at a medium to low level.Clinical medical staff should pay more attention to patients with low education level and low household monthly income,and utilize social support to improve their self-management behavior level.

关 键 词：中青年 经皮脊柱内镜下腰椎间盘摘除术 术后自我管理 康复质量 

分 类 号：R473.6[医药卫生—护理学]