老年急性脊椎骨折患者疾病不确定感影响因素分析

付长中樊蕴辉①史宇平②

(河北省唐山市丰南区新兴社区卫生服务站河北唐山063300;①华北理工大学附属医院;②唐山市第二医院)

[摘要]①目的分析老年急性脊椎骨折患者疾病不确定感的影响因素，为患者的综合健康教育提供依据。②方法收集临床186例急性脊椎骨折患者为研究对象，分别在伤后3周和3个月以问卷调查方式收集和评测患者疾病不确定感、疼痛程度、残疾程度、日常生活能力以及一般临床资料，应用Logistic回归分析老年急性脊椎骨折患者疾病不确定感的影响因素。③结果3周和3个月时患者的疾病不确定感为中等水平，但3周时患者的疾病不确定感评分显著高于3个月。Logistic回归分析显示影响3周时患者疾病不确定感的主要因素为骨折类型、变形程度、疼痛等(OR值分别为OR=4.886，4.428和4.024；均P<0.05)；影响3个月时患者疾病不确定感的主要因素为行动能力、残疾程度、自我照顾行为等(OR值分别为OR=4.032，3.382，3.366；均P<0.05)；高文化程度是疾病不确定感的保护因素(OR=0.610或0.599，P<0.05)。④结论老年急性脊椎骨折患者存在疾病不确定感，且其随疾病病程改变。

[关键词]老年急性脊椎骨折疾病不确定感影响因素

[中图分类号]R 197.61[文献标识码]A

【通讯作者】樊蕴辉。

Influencing factors of illness uncertainty in elderly patients with acute vertebral fractureFUChangzhong,FANYunhui,SHIYuping(FengnanXinxingCommunityHealthServiceStationofFengnanDistrict,Tangshan063000,China)

ABSTRACT[]ObjectiveTo analyze influencing factors of illness uncertainty in elderly with acute vertebral fracture，providing the basis for comprehensive health education of patients.MethodsWe selected totally 186 cases of elderly patient with acute vertebral fracture as subject.Illness uncertainty，pain，disability，daily life and clinical index were evaluated after 3 weeks and 3 months respectively.The influencing factors of illness uncertainty in elderly with acute vertebral fracture were analyzed by Logistic regression.ResultsThe uncertainty degree of acute vertebral fracture is in medium after 3 weeks and 3 months respectively,but scores of illness uncertainty of the 3 weeks were significantly higher than that of 3 months;Logistic regression analysis showed that the main influencing factors of illness uncertainty in 3 weeks included the fracture type，deformation degree and pain degree(OR=4.886,4.428 and 4.024;all P<0.05);while influencing factors of illness uncertainty included action ability，disability degree and caring behavior oneself (OR=4.032,3.382 and 3.366;all P<0.05);high culture degree was protective factors of illness uncertainty(OR=0.610 or 0.599,P<0.05).ConclusionThe patient with acute vertebral fracture s had the illness uncertainty and the illness uncertainty changed with disease progression.Medical staff should determine its source and take measures to reduce uncertainty.

[KEYWORDS]Elderly.Acute vertebral fracture.Illness uncertainty.Influencing factors

急性骨质疏松性脊椎骨折是老年人骨质疏松性骨折的最常见形式，临床资料显示较小的外力即可导致老年急性脊椎骨折，其发生风险在50岁以上骨质疏松女性患者中可高达32%以上[1]。急性骨质疏松性脊椎骨折治疗和恢复过程往往伴有严重的持续性疼痛、残疾、日常生活行为减少，严重降低患者生活质量[2]。疾病不确定感是指患者缺乏确定与疾病有关事物的能力，疾病不确定感一旦产生，其所带来的负向情绪不仅会干扰患者寻求与疾病有关的信息的能力；……