Chinese General Practice ›› 2024, Vol. 27 ›› Issue (15): 1867-1872.DOI: 10.12114/j.issn.1007-9572.2023.0262

• Original Research • Previous Articles     Next Articles

Analysis of the Current Status and Influencing Factors of Self-management in Patients with Degenerative Spinal Deformity

  

  1. 1. Administrative Office, the First Affiliated Hospital of Army Medical University, Chongqing 400000, China
    2. Department of Orthopedics, the General Hospital of Western Theater Command, PLA, Chengdu 610000, China
    3. Department of Orthopedics, the First Affiliated Hospital of Army Medical University, Chongqing 400000, China
    4. Department of Emergency Medicine, the First Affiliated Hospital of Army Medical University, Chongqing 400000, China
  • Received:2023-02-20 Revised:2023-06-14 Published:2024-05-20 Online:2024-02-28
  • Contact: LIU Lei

退行性脊柱畸形患者的自我管理现状及影响因素研究

  

  1. 1.400000 重庆市,陆军军医大学第一附属医院医院办公室
    2.610000 四川省成都市,中国人民解放军西部战区总医院骨科
    3.400000 重庆市,陆军军医大学第一附属医院骨科
    4.400000 重庆市,陆军军医大学第一附属医院急诊医学科
  • 通讯作者: 刘蕾
  • 作者简介:
    作者贡献:张曌、刘蕾负责文章的构思与设计;张曌、郑婷婷、王钰姝负责研究的实施与数据收集;张曌进行数据整理,统计学分析与结果解释,撰写论文;罗飞负责论文写作指导,提供行政支持;刘蕾负责质量控制及审校,并对文章整体负责。
  • 基金资助:
    重庆市卫生健康委项目(2022WSJK007); 重庆市科卫联合医学科技创新四大工程重点项目(2023ZDXM018)

Abstract:

Background

In recent years, the prevalence of degenerative spinal deformity (DSD) has been increasing annually. Patients have to live with DSD for a long time from the onset of disease until surgical intervention is required, and self-management during this period is crucial for the development and progression of DSD. However, the current status and influencing factors of self-management in DSD patients remain unclear, making it difficult to tailor effective intervention measures.

Objective

To investigate the current status and influencing factors of self-management in patients with DSD, so as to provide a clinical reference for the development of targeted intervention programs.

Methods

A total of 200 patients with DSD who attended the Department of Orthopedics in the First Affiliated Hospital of Army Medical University from June 2020 to December 2022 using a convenience sampling method to conduct questionnaire survey. The demographic information, Visual Analogue Scale (VAS) score, Oswestry Disability Index (ODI) score, Medical Outcomes Study Social Support Survey (MOS-SSS) score, and Chronic Disease Self-management Behavior Scale score were collected. Multiple linear regression were used to analyze the influencing factors of chronic disease self-management behaviors of patients.

Results

A total of 191 (95.5%) valid questionnaires were recovered. The average age of the patients was (62.6±11.6) years, including 144 cases (75.4%) of scoliosis, 37 cases (19.4%) of kyphosis and 10 cases (5.2%) of lateral kyphosis. The total score of self-management behaviors was (22.94±11.97). The standardized scores for each dimension of self-management behaviors were cognitive symptom management (26.27±15.83), doctor-patient communication (23.53±16.27) and exercise (18.42±11.00) in descending order. The results of correlation analysis showed that age, BMI, monthly per capita household income, education level, smoking history, function disorder and medical social support were significantly correlated with the scores of each dimension and total score of Chronic Disease Self-management Behavior Scale (P<0.05). The multiple linear regression analysis results showed that medical social support, education level, monthly per capita household income, and bone mineral density were influencing factors of Chronic Disease Self-management Behavior Scale scores (P<0.05) .

Conclusion

The level of self-management behavior in patients with DSD is low. Medical social support, education level, economic level, and bone mineral density are the main influencing factors of self-management behaviors. Healthcare providers should improve self-management behaviors of DSD patients in clinical practice to help them manage their diseases effectively by strengthening education and enhancing social support.

Key words: Spinal diseases, Degenerative spinal deformity, Self-management, Root cause analysis, Multiple linear regression

摘要: 背景 近年来,退行性脊柱畸形(DSD)的患病率逐年上升,从疾病发生到需手术干预之前,患者将与疾病长期共存,期间自我管理对DSD的发展及转归至关重要。然而,DSD患者的自我管理现状及影响因素尚不明确,无法针对性地制订有效的干预措施。目的 研究DSD患者的自我管理现状并分析其影响因素,为制订针对性的干预方案提供临床参考。方法 采用便利抽样法对2020年6月—2022年12月于陆军军医大学第一附属医院骨科就诊的200例DSD患者进行问卷调查,收集患者的人口统计学资料、视觉模拟评分、Oswestry功能障碍指数问卷(ODI)评分、医疗社会支持量表(MOS-SSS)评分以及慢病自我管理行为量表评分。构建多元线性回归模型分析患者慢病自我管理行为量表评分的影响因素。结果 共回收有效问卷191份(95.5%),患者的平均年龄为(62.6±11.6)岁,其中脊柱侧弯144例(75.4%),后凸37例(19.4%),侧后凸10例(5.2%)。慢病自我管理行为量表总分为(22.94±11.97)分,各维度标准化得分由高到低依次为认知症状管理(26.27±15.83)分、医患交流(23.53±16.27)分和运动锻炼(18.42±11.00)分。相关性分析结果显示,年龄、BMI、家庭人均月收入、受教育程度、吸烟史、ODI评分、MOS-SSS评分与慢病自我管理行为量表各维度评分和总分显著相关(P<0.05)。多元线性回归分析模型结果显示,MOS-SSS评分、受教育程度、家庭人均月收入和骨密度是DSD患者慢病自我管理行为量表评分的影响因素(P<0.05)。结论 DSD患者的自我管理行为水平较低,MOS-SSS评分、受教育程度、经济水平和骨密度是DSD患者自我管理的影响因素,医护人员在临床实践中应从加强教育、提升社会支持等方面增强患者的自我管理行为,帮助患者有效管理疾病。

关键词: 脊柱疾病, 退行性脊柱畸形, 自我管理, 影响因素分析, 多元线性回归