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中华老年骨科与康复电子杂志 ›› 2024, Vol. 10 ›› Issue (05) : 294 -300. doi: 10.3877/cma.j.issn.2096-0263.2024.05.006

髋部骨折

老年股骨颈骨折术后患者心理弹性现状及影响因素分析
单良1,(), 刘怡1, 于涛1, 徐丽1   
  1. 1. 100013 北京市和平里医院骨科
  • 收稿日期:2024-03-18 出版日期:2024-10-05
  • 通信作者: 单良
  • 基金资助:
    北京市和平里医院科研项目任务书(2022-1-21)

The psychological resilience status and influencing factors of elderly patients with femoral neck fractures after surgery

Liang Shan1,(), Yi Liu1, Tao Yu1, Li Xu1   

  1. 1. Department of Orthopedics, Beijing Hepingli Hospital, Beijing 100013, China
  • Received:2024-03-18 Published:2024-10-05
  • Corresponding author: Liang Shan
引用本文:

单良, 刘怡, 于涛, 徐丽. 老年股骨颈骨折术后患者心理弹性现状及影响因素分析[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(05): 294-300.

Liang Shan, Yi Liu, Tao Yu, Li Xu. The psychological resilience status and influencing factors of elderly patients with femoral neck fractures after surgery[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(05): 294-300.

目的

探讨老年股骨颈骨折术后患者心理弹性现状及影响因素的影响。

方法

应用Logistic回归分析2022年5月至2023年5月在我院收治的120例老年股骨颈骨折患者一般资料,其中男56例,女64例,评估患者自杀风险(NGASR)、贝克抑郁量表(BDI)、贝克焦虑量表(BAI)、领悟社会支持量表(PSSS)、自我接纳问卷(SAQ)与心理弹性的相关性,并采用R软件(R3.3.2)和软件包rms构建预测老年股骨颈骨折术后患者心理弹性评分降低的列线图模型。

结果

Pearson检验结果显示,BDI评分与老年股骨颈骨折术后患者心理弹性呈明显负相关(r=0.753,P<0.001),PSSS评分(r=0.819)、SAQ评分(r= 0.714)与老年股骨颈骨折术后患者心理弹性呈明显正相关(均P<0.001);多因素Logistic回归分析显示SAQ评分<40分(OR=9.217)、PSSS评分≤60分(OR=12.569)是心理弹性的危险因素(P<0.05),年龄≤70岁(OR=0.533)、大专及以上(OR=0.548)、BDI评分<45分(OR=0.617)是心理弹性的保护因素(P<0.05);根据多因素Logistic回归分析结果构建列线图模型,结果年龄≤70岁为21.23分,非本大专以上学历为18.87分,BDI评分>45分得分为15.53分,PSSS评分≤60分得分为51.43分,SAQ评分<40分得分为39.22分,总分为146.28分。

结论

PSSS评分≤60分、SAQ评分<40分是影响老年股骨颈骨折患者心理弹性的危险因素,年龄≤70岁、大专及以上文化程度、BDI评分≤45分为保护因素,有利于指导临床上制定个性化干预措施,以改善老年股骨颈骨折患者的心理弹性,提高治疗效果。

Objective

To explore the psychological resilience status and influencing factors of elderly patients with femoral neck fractures after surgery.

Methods

Logistic regression analysis was conducted on the general information of 120 elderly patients with femoral neck fractures admitted to our hospital from May 2022 to May 2023, and the correlation between the Nurses' Global Assessment of Suicide Risk (NGASR), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Perceived Social Support Scale (PSSS), Self Acceptance Questionnaire (SAQ), and psychological resilience was evaluated. R software (R3.3.2) and software package rms were used to construct predictions for elderly femoral neck fractures. A column chart model of decreased psychological resilience scores in patients after neck fracture surgery.

Results

The Pearson test results showed that the BDI score was significantly negatively correlated with the psychological resilience of elderly patients with femoral neck fractures after surgery (r=0.753, P<0.001), while the PSSS (r=0.819) and SAQ (r=0.714) were significantly positively correlated with the psychological resilience of elderly patients with femoral neck fractures after surgery (all P<0.001); Multivariate logistic regression analysis showed that SAQ score<40 (OR=9.217) and PSSS score ≤ 60 (OR=12.569) were risk factors for psychological resilience (P<0.05), while age ≤70 years old (OR=0.533), college degree or above (OR=0.548), and BDI score <45 (OR=0.617) were protective factors for psychological resilience (P<0.05); Based on the results of multiple logistic regression analysis, a column chart model was constructed. The results showed that age ≤70 years old scored 21.23 points, non college education or above scored 18.87 points, BDI score >45 points scored 15.53 points, PSSS score ≤60 points scored 51.43 points, SAQ score <40 points scored 39.22 points, and the total score was 146.28 points.

Conclusions

PSSS score ≤60 points and SAQ score<40 points are risk factors affecting the psychological resilience of elderly patients with femoral neck fractures. Age ≤70 years old, college education or above, and BDI score ≤45 points are protective factors, which are conducive to guiding the development of personalized intervention measures in clinical practice to improve the psychological resilience of elderly patients with femoral neck fractures and improve treatment effectiveness.

表1 老年股骨颈骨折术后患者不同临床特征间心理弹性得分的比较(分,±s
临床特征 例数 心理弹性得分 t/F P
性别     0.710 0.479
男性 56 38.31±6.68    
女性 64 37.43±6.76    
年龄(岁)     2.410 0.018
61~70 71 33.93±9.36    
>70 49 29.85±8.75    
BMI(kg/m2     1.175 0.333
过轻 25 35.55±8.11    
正常 86 36.57±8.79    
超重 9 35.34±8.67    
骨折原因     1.227 0.279
交通事故伤 32 44.43±10.12    
摔伤 34 35.41±10.23    
高处坠落 38 43.56±11.21    
砸伤 16 44.85±10.91    
文化程度     30.711 <0.001
初中及以下 73 33.35±11.12    
高中 19 32.25±12.57    
大专及以上 28 51.58±10.23    
骨折部位     -0.141 0.888
左侧 57 37.42±9.80    
右侧 63 37.67±9.66    
受伤至手术时间     0.359 0.720
<12 69 36.68±10.82    
≥12 51 35.99±9.84    
抑郁症家族史     0.986 0.932
44 36.62±8.78    
76 36.77±9.49    
骨折类型     1.324 0.217
头下型 23 42.26±12.26    
基底型 31 39.26±12.67    
经颈型 34 41.51±11.46    
头颈型 32 43.33±11.01    
人均月收入(元)     -0.199 0.843
<3000 57 37.57±8.70    
≥3000 63 37.23±9.89    
自杀念想     -3.248 0.002
26 33.36±8.28    
94 39.41±8.44    
心理治疗     -3.833 <0.001
未接受 46 33.46±6.67    
接受 74 39.58±9.46    
BDI评分(分)     4.883 <0.001
29~45 78 41.16±9.20    
>45 42 32.52±9.33    
BAI评分(分)     0.059 0.953
26~40 67 37.75±10.45    
>40 53 37.64±9.66    
PSSS评分(分)     20.224 <0.001
<37 30 35.65±8.56    
37~60 68 36.66±10.10    
>60 22 50.53±11.82    
SAQ评分(分)     -3.717 <0.001
<40 91 35.15±9.59    
≥40 29 42.57±8.58    
图1 BDI、PSSS、SAQ评分与老年股骨颈骨折术后患者心理弹性的相关性分析
表2 赋值说明
表3 老年股骨颈骨折术后患者多因素Logistic回归分析
图2 预测股骨颈骨折术后患者心理弹性的列线图模型
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