胫骨平台骨折患者术后早期功能锻炼依从性调查及影响因素分析

摘要

Objective To investigate the compliance and influencing factors of postoperative function exercise in patients with tibial plateau fractures .Methods By convinience sampling method , 60 patients who were diagnosed with tibial plateau fracturesand and needed to receive postoperative function exercise were surveyed at the third day after surgery by general information , compliance of functional exercise , numerical rating scale ( NRS) , self-rating anxiety scale ( SAS) and self-rating depression scale ( SDS) .Influencing factors of compliance in patients with postoperative function exercise were analyzed by Logistic regression anslysis . Results Among 60 postoperative patients with tibial plateau fractures , there were 28 patients of noncompliance , which accounted for 46.7%, while there were 32 patients of compliance and that accounted for 53.35%.The Logistic regression analysis showed that: anxiety (OR=1.71, 95%CI 1.54~1.90), depression (OR=3.01, 95%CI 1.99~4.54), pain (OR=1.99, 95%CI 1.65~2.38), marital status (OR=1.69, 95%CI 1.22~2.32 ) were seperated dangerous factors that would affect the early postoperative function exercise of patients with tibial plateau fractures , and cultural degree ( OR=0.89, 95%CI 0.81~0.94) was its protective factor.Conclusions The compliance of early functional exercise in patients with tibial plateau fractures is not high, and anxiety, depression, pain, marital status are influencing factors of compliance .Health education and psychological intervention should be strengthened to improve the compliance and rehabilitation effect .%目的：探讨胫骨平台骨折患者术后早期功能锻炼依从性的影响因素。方法采用便利抽样法，选取2015年1—11月上海交通大学附属第六人民医院收治的胫骨平台骨折术后患者60例，术后第3天采用一般资料调查表、功能锻炼依从性量表、数字评定法（ NRS）、焦虑自评量表（ SAS）、抑郁自评量表（ SDS）对患者进行调查，采用Logistic回归对胫骨平台骨折患者术后早期功能锻炼依从性的影响因素进行统计分析。结果60例患者术后早期功能锻炼依从者32例，依从率为53．3％；不依从者28例，占46．7％；Logistic回归分析结果提示：焦虑（ OR＝1．71，95％CI 1．54～1．90）、抑郁（ OR＝3．01，95％CI 1．99～4.54）、疼痛（OR＝1．99，95％CI 1．65～2．38）、婚姻状况（OR＝1．69，95％CI 1．22～2．32）是影响胫骨平台骨折患者术后早期功能锻炼依从性的独立危险因素，文化水平是其保护因素（ OR＝0．89，95％CI 0．81～0．94）。结论胫骨平台骨折患者术后早期功能锻炼的依从性较差，焦虑、抑郁、疼痛、婚姻状况影响患者的功能锻炼依从性，应加强心理干预、健康宣教，提高患者依从性，改善康复锻炼效果。