构建胸腰椎压缩性骨折患者术后功能锻炼依从性的预测模型及护理干预分析  

To construct the prediction model and nursing intervention analysis of postoperative functional exercise compliance in patients with thoracolumbar compression fractures

作　　者：王娜 陈春娇 张素华 章鹏 Wang Na;Chen Chunjiao;Zhang Suhua;Zhang Peng(Pingxiang Mining Group Co.,Ltd.General Hospital,Pingxiang,Jiangxi 337000,China)

机构地区：[1]萍乡矿业集团有限责任公司总医院,江西萍乡337000

出　　处：《首都食品与医药》2025年第4期137-140,共4页Capital Food Medicine

基　　金：江西省卫生健康委科技项目(编号:202130562)。

摘　　要：目的构建胸腰椎压缩性骨折患者术后功能锻炼依从性的预测模型并分析护理干预方案。方法选取在我院诊治的482例进行功能锻炼的胸腰椎压缩性骨折患者,选取时间段为2021年5月-2024年5月,回顾性分析患者的临床资料,根据功能锻炼依从性量表分为依从性较好组386例及依从性较差组96例。多因素Logistic回归分析胸腰椎压缩性骨折患者术后功能锻炼依从性的影响因素。ROC曲线分析胸腰椎压缩性骨折患者术后功能锻炼依从性的预测价值。构建胸腰椎压缩性骨折患者术后功能锻炼依从性的列线图预测模型,并通过校正曲线及决策曲线进行验证与评估。结果相较于依从性较差组,依从性较好组患者情绪状态(积极)、文化程度(高)、社会支持(高)、护理干预(循序渐进式护理)占比明显增加,GERS评分明显升高,VAS评分明显下降(P<0.05)。经ROC曲线分析,VAS评分、GERS评分曲线下面积(AUC)分别为0.877、0.706,且最佳截断值分别为≤4分、>33分,对预测功能锻炼依从性均具有一定价值(P<0.05)。Logistic回归分析,情绪状态(消极)、社会支持(低)、护理干预(常规护理)、低GERS评分均为功能锻炼依从性较好的独立危险因素(P<0.05)。基于独立影响因素构建胸腰椎压缩性骨折患者术后功能锻炼依从性的列线图预测模型,预测胸腰椎压缩性骨折患者术后功能锻炼依从性的C-index为0.879(95%CI:0.795-912),经拟合优度检验卡方值为10.83,P=0.212>0.05,预测值与观测值无明显差异,表示模型拟合度较高;当预测阈值>0.18时,列线图风险预测模型临床净收益均高于独立预测因子。结论基于情绪状态、社会支持、护理干预、GERS评分等胸腰椎压缩性骨折患者术后功能锻炼依从性的影响因素构建列线图预测模型,准确度较高,且具有较高的预测价值。Objective To construct a predictive model for postoperative functional exercise compliance in patients with thoracolumbar compression fractures and analyze the nursing intervention plan.Methods 482 patients with thoracolumbar compression fracture who were treated and treated in our hospital for functional exercise were selected from May 2021 to May 2024.Clinical data of the patients were retrospectively analyzed,and they were divided into a good compliance group(386 cases)and a poor compliance group(96 cases)according to the functional exercise compliance scale.Multivariate Logistic regression analysis of the influencing factors of postoperative functional exercise compliance in patients with thoracolumbar compression fractures.Predictive value of ROC curve in analyzing postoperative functional exercise compliance in patients with thoracolumbar compression fractures.The prediction model of postoperative functional exercise compliance of patients with thoracolumbar compression fractures was constructed and verified and evaluated by correction curve and decision curve.Results Compared with the poor compliance group,the proportion of emotional state(positive),educational level(high),social support(high)and nursing intervention(progressive nursing)in the good compliance group was significantly increased,GERS score was significantly increased,and VAS score was significantly decreased(P<0.05).According to ROC curve analysis,VAS score and GERS score area under curve(AUC)were 0.877 and 0.706,respectively,and the best cut-off values were≤4 points and>33 points,respectively,which had certain value in predicting functional exercise compliance(P<0.05).Logistic regression analysis showed that emotional state(negative),social support(low),nursing intervention(routine care)and low GERS score were all independent risk factors for better compliance with functional exercise(P<0.05).Based on the nomogram prediction model of postoperative functional exercise compliance of patients with thoracolumbar compression fractures based on

关 键 词：胸腰椎压缩性骨折 功能锻炼依从性 预测模型构建 护理干预 

分 类 号：R473.6[医药卫生—护理学]