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

doi:10.3877/cma.j.issn.2096-0263.2024.05.006

Abstract

Abstract:

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.

Key words: Femoral neck fracture, Psychological resilience, Logistic regression anal ysis, Influencing factors, Column chart model

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]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(05): 294-300.

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Figures/Tables 5

References 20

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临床特征	例数	心理弹性得分	t/F值	P值
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
有	44	36.62±8.78
无	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
有	26	33.36±8.28
无	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

临床特征	例数	心理弹性得分	t/F值	P值
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
有	44	36.62±8.78
无	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
有	26	33.36±8.28
无	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

变量	赋值说明
年龄≤70	否=0；是=1
大专以上学历	否=0；是=1
自杀念想	否=0；是=1
心理治疗	否=0；是=1
BDI评分<45	否=0；是=1
PSSS评分<60	否=0；是=1
SAQ评分<40	否=0；是=1

变量	赋值说明
年龄≤70	否=0；是=1
大专以上学历	否=0；是=1
自杀念想	否=0；是=1
心理治疗	否=0；是=1
BDI评分<45	否=0；是=1
PSSS评分<60	否=0；是=1
SAQ评分<40	否=0；是=1

变量	β	SE	Wald	P	OR（95% CI）
年龄≤70岁	1.845	0.683	6.432	0.005	0.533（0.114，0.854）
大专以上学历	4.537	1.245	5.198	0.023	0.548（0.323，0.787）
自杀念想	3.986	1.307	5.622	0.067	1.228（0.724，1.968）
心理治疗	1.217	0.543	7.083	0.101	0.866（0.363，1.331）
BDI评分<45分	1.085	0.721	8.142	0.034	0.617（0.353，0.914）
PSSS评分≤60分	1.338	0.694	7.549	0.001	12.569（8.593，16.341）
SAQ评分<40分	1.468	0.714	8.257	0.004	9.217（7.453，13.244）

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