腰椎间盘突出症保守治疗患者院外功能锻炼依从性潜在类别发展轨迹及影响因素  

Potential Developmental Trajectory and Influencing Factors of Out-of-hospital Functional Exercise Compliance in Patients with Lumbar Disc Herniation Treated Conservatively

作　　者：吴玉珍 吴思滨 袁闽红 WU Yuzhen;WU Sibin;YUAN Minhong(Disinfection and Supply Center,Leping Hospital of Traditional Chinese Medicine,Leping 333300,China)

机构地区：[1]乐平市中医医院消毒供应中心,江西乐平333300

出　　处：《中国医学创新》2025年第4期116-120,共5页Medical Innovation of China

摘　　要：目的:探讨腰椎间盘突出症(LDH)保守治疗患者院外功能锻炼依从性,构建其发展轨迹,并分析不同类别的影响因素。方法:选取2020年1月—2023年10月在乐平市中医医院保守治疗的LDH患者230例,采用院外功能锻炼依从性问卷评估患者出院前3 d、出院后1、3、6个月功能锻炼依从性,通过增长混合模型分析类别最优数量并命名,进行单因素分析及多因素logisitic回归分析院外功能锻炼依从性轨迹差异的独立影响因素。结果:患者出院后的依从性发展轨迹可分为依从性低型、依从性由高到低型、依从性高型。单因素分析及多因素logistic回归分析结果显示,疼痛程度、社会支持、人格类型是患者依从性由高到低型的独立影响因素,疼痛程度、伴随症状、自我效能、社会支持、人格类型是依从性高型患者的独立影响因素(P<0.05)。结论:LDH患者院外功能锻炼依从性轨迹可分为依从性低型、依从性由高到低型、依从性高型,其受疼痛程度、社会支持、人格类型等因素影响,提示医护人员可根据各影响因素制定个性化护理措施控制依从性轨迹发展。Objective:To explore the compliance of out-of-hospital functional exercise in patients with lumbar disc herniation(LDH)conservative treatment,to construct its development trajectory and analyze the influencing factors of different categories.Method:A total of 230 LDH conservative treatment patients in Leping Hospital of Traditional Chinese Medicine from January 2020 to October 2023 were selected.The outof-hospital functional exercise compliance questionnaire was used to evaluate the patients'functional exercise compliance 3 days before discharge,1 month and 3,6 months after discharge.The optimal number of categories was analyzed and named through the growth mixed model.Univariate analysis and multifactor logisitic regression were performed to analyze the independent influencing factors of compliance trajectory of out-of-hospital functional exercise differences.Result:The compliance development trajectory of patients after discharge be divided into low compliance,high to low compliance and high compliance.The results of univariate analysis and multivariate logistic regression analysis showed that pain intensity,social support,and personality type were independent factors influencing patients with high to low compliance.Pain intensity,accompanying symptoms,self-efficacy,social support,and personality type were independent factors influencing patients with high compliance(P<0.05).Conclusion:The adherence trajectories of LDH patients to outpatient functional exercises can be categorized into low compliance,high to low compliance and high compliance.These trajectories are influenced by factors such as pain severity,social support,and personality type.This suggests that healthcare providers can develop personalized care plans based on these factors to control the development of adherence trajectories.

关 键 词：腰椎间盘突出症 功能锻炼依从性 潜在类别 发展轨迹 影响因素 

分 类 号：R473.6[医药卫生—护理学]