老年腰椎间盘突出症患者自我效能水平及其影响因素

Chronic pain self-efficacy and its influencing factors in elderly patients with lumbar disc herniation

摘要:

目的 了解老年腰椎间盘突出症(LDH)患者慢性疼痛自我效能状况,探讨其影响因素。方法 选取2018年3月至2018年12月西安市3所医院收治的拟进行髓核摘除、植骨融合内固定手术治疗的老年LDH患者231例。应用慢性疼痛自我效能感量表、焦虑自评量表、患病行为问卷、视觉模拟评分表为研究工具进行调查。采用SPSS 17.0软件进行统计分析。采用多元线性逐步回归分析筛选自我效能感的影响因素。结果 老年LDH患者慢性疼痛自我效能得分为41~74(60.33±8.88)分；在3个维度的条目均分中,疼痛管理自我效能感维度得分最高(3.05±0.46)分,躯体功能自我效能维度得分最低(2.63±0.35)分。多元线性逐步回归分析显示,焦虑、患病行为水平、腰腿疼痛程度、合并慢性病、文化程度与老年LDH患者自我效能水平密切相关(P<0.05)。结论 老年LDH患者的慢性疼痛自我效能感整体处于中等水平,疼痛管理自我效能感水平最高,躯体功能自我效能感最低；焦虑、患病行为、腰腿疼痛、合并慢性病是老年LDH患者慢行疼痛自我效能感的危险因素,而高文化水平是其保护因素。

Abstract:

Objective To understand chronic pain self-efficacy in the elderly patients with lumbar disc herniation (LDH) and to explore its influencing factors. Methods From March 2018 to December 2018, a total of 231 elderly patients with LDH were sampled from 3 hospitals in Xi′an, who were to be treated with removal of nucleus pulposus, bone graft fusion and internal fixation. An analysis was made using Chronic Pain Self-efficacy Scale (CPSS), self-rated anxiety scale, illness behavior questionnaire and visual analog scale. Statistical analysis was performed using SPSS statistics 17.0, and multivariate linear stepwise regression analysis was performed for influencing factors of self-efficacy. Results The chronic pain self-efficacy in the patients with LDH scored 41-74 (60.33±8.88)points. Of the three dimensions, the highest score was for pain management [(3.05±0.46)points], and the lowest was for physical function [(2.63±0.35)points]. Multivariate linear stepwise regression analysis showed that anxiety, level of illness behavior, severity of pain in the lumbar and legs, comorbidity of other chronic diseases, and degree of education were closely related to the self-efficacy level of the elderly LDH patients (P<0.05). Conclusion Patients with LDH have a moderate overall chronic pain self-efficacy. Self-efficacy is the highest for pain management and the lowest for physical function. Anxiety, illness behavior, pain level, comorbidity of other chro-nic diseases are risk factors of the chronic pain self-efficacy in the patients with LDH, and high education level is its protective factor.