创伤性下肢截肢术后患者积极心理资本水平变化的前瞻性纵向研究  

Positive psychological capital level in patients after traumatic lower limb amputation: a prospective longitudinal study

作　　者：尹慧珍[1] 李博[1] 张欣欣 李西娟[1] 贾亚南 裴理辉[1] 贾英岚[1] Yin Huizhen;Li Bo;Zhang Xinxin;Li Xijuan;Jia Yanan;Pei Lihui;Jia Yinglan(Department of Emergency Medicine/Trauma Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院急诊医学科/创伤中心,郑州450052

出　　处：《中华现代护理杂志》2025年第6期784-790,共7页Chinese Journal of Modern Nursing

基　　金：河南省医学科技攻关计划省部共建青年项目(SBGJ202103076);河南省教育厅高等学校重点科研项目计划(22A320067);郑州大学第一附属医院护理科研专项(HLKY2023002)。

摘　　要：目的探讨创伤性下肢截肢患者术后15个月内的积极心理资本水平及其变化趋势,识别患者积极心理资本水平薄弱时间段,为后续干预提供依据。方法本研究为前瞻性纵向研究。采用便利抽样法,于2021年1月—2022年11月选取郑州大学第一附属医院急诊医学部收治的143例创伤性下肢截肢患者为研究对象。采用一般情况调查表、积极心理资本问卷(PPQ)分别在术后第3天(T1)、出院当天(T2)、出院1个月(T3)、2个月(T4)、3个月(T5)、6个月(T6)、9个月(T7)、12个月(T8)、15个月(T9)共9个时间点对患者进行问卷调查。采用Graph Pad prism 9.5软件和SPSS 21.0软件对9个时间点数据进行单因素重复测量方差分析和结果绘图,使用Bonferroni多重比较检验对数据进行两两比较。结果T1~T9时间点参与调查的患者分别有143、139、132、129、122、120、119、118、116例,失访率为18.88%(27/143)。116例创伤性下肢截肢术后患者9个时间点的PPQ得分分别为(103.25±9.03)、(108.53±9.32)、(104.38±9.60)、(99.71±9.61)、(95.82±9.55)、(91.49±9.41)、(93.34±9.29)、(93.53±9.14)、(93.62±9.05)分,除T2和T3时间点外,其余时间点PPQ得分均数均低于理论均值(104分)。单因素重复测量方差分析结果显示,创伤性下肢截肢术后患者在术后第3天至出院15个月积极心理资本水平变化差异有统计学意义(F=990.144,P<0.01),Bonferroni多重比较检验结果显示,除T7、T8、T9时间点彼此间进行两两比较差异无统计学意义(P>0.05)以外,其余两两比较差异均有统计学意义(P<0.05),PPQ总分以及自我效能维度、韧性维度、希望维度、乐观维度分值曲线变化均呈先短暂升高,后持续下降,再缓慢升高至平稳的趋势。结论创伤性下肢截肢患者在术后第3天至出院15个月积极心理资本水平变化幅度较大,呈出院时短暂升高,后持续下降再缓慢升高至平稳的趋势。医护人员应动态关注创伤性下肢截肢�Objective To explore the level of positive psychological capital and its trends in traumatic lower limb amputation patients during the 15 months after surgery,and to identify the time period when the patients'level of positive psychological capital is weak,so as to provide a basis for interventions.MethodsThis study was a prospective longitudinal study.Convenience sampling was used to select 143 patients with traumatic lower limb amputation admitted to the Department of Emergency Medicine of the First Affiliated Hospital of Zhengzhou University from January 2021 to November 2022 for the study.General information questionnaire,Positive Psychological-Capital Questionnaire(PPQ)were used on the third postoperative day(T1),on the day of discharge(T2),1 month(T3),2 months(T4),3 months(T5),6 months(T6),9 months(T7),12 months(T8),and 15 months(T9)after discharge for a total of nine time points to administer the questionnaire to the patients.One-way repeated-measures ANOVA and plotting of results were performed on the nine time-point data using Graph Pad prism 9.5 software and SPSS 21.0 software,and the data were compared two-by-two using the Bonferroni multiple comparison test.ResultsThere were 143,139,132,129,122,120,119,118,and 116 patients who participated in the survey from T1 to T9 time points,with a loss to follow-up rate of 18.88%(27/143).PPQ scores of 116 traumatic lower limb amputation patients at nine time points were(103.25±9.03),(108.53±9.32),(104.38±9.60),(99.71±9.61),(95.82±9.55),(91.49±9.41),(93.34±9.29),(93.53±9.14),(93.62±9.05),and the mean PPQ scores were lower than the theoretical mean(104)at all time points except T2 and T3 time points.One-way repeated-measures ANOVA showed that the difference in the change in the level of positive psychological capital of patients after traumatic lower limb amputation from postoperative day 3 to 15 months after discharge was statistically significant(F=990.144,P<0.01).Bonferroni's multiple comparison test showed that there was no statistically significant di

关 键 词：创伤 下肢截肢 积极心理资本 纵向研究 调查研究 

分 类 号：R473.6[医药卫生—护理学]