上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2024, Vol. 44 ›› Issue (8): 959-967.doi: 10.3969/j.issn.1674-8115.2024.08.004

• 临床护理专题 • 上一篇    下一篇

康复自我效能在髋/膝关节置换术后住院患者领悟社会支持与康复锻炼依从性间的中介作用

许嘉乐1(), 傅利勤2, 吴红2, 昝娇娇2, 吴菁1()   

  1. 1.海军军医大学护理系，上海 200433
    2.海军军医大学第一附属医院关节骨病外科，上海 200433
  • 收稿日期:2023-10-05 接受日期:2024-03-04 出版日期:2024-08-28 发布日期:2024-08-27
  • 通讯作者: 吴菁 E-mail:2547969055@qq.com;qingqing20030511@163.com
  • 作者简介:许嘉乐（2002—），女，硕士生；电子信箱：2547969055@qq.com。
  • 基金资助:
    国家自然科学基金(71904200);海军军医大学深蓝护理科研项目登峰人才计划(2022KYD01)

Mediating effect of rehabilitation self-efficacy on perceived social support and rehabilitation exercise adherence in hospitalized patients after hip/knee arthroplasty

XU Jiale1(), FU Liqin2, WU Hong2, ZAN Jiaojiao2, WU Jing1()   

  1. 1.Department of Nursing, Naval Medical University, Shanghai 200433, China
    2.Department of Joint and Orthopedic Disease Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
  • Received:2023-10-05 Accepted:2024-03-04 Online:2024-08-28 Published:2024-08-27
  • Contact: WU Jing E-mail:2547969055@qq.com;qingqing20030511@163.com
  • Supported by:
    National Natural Science Foundation of China(71904200);Deep Blue Summit Nursing Research Program of Naval Medical University(2022KYD01)

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摘要：

目的·探讨髋/膝关节置换术后住院患者领悟社会支持、康复自我效能、康复锻炼依从性之间的关系，并检验康复自我效能在领悟社会支持与康复锻炼依从性关系间的中介作用。方法·采取方便抽样法，选择2021年10月—2023年2月海军军医大学第一附属医院（上海长海医院）骨关节病区的141例全髋/膝关节置换术后住院患者作为研究对象。使用一般资料调查表评估患者年龄、性别等一般人口学资料和疾病、手术信息。使用康复锻炼依从性量表（Rehabilitation Exercise Adherence Scale，REAS）评估关节置换患者术后康复锻炼的依从性；使用康复自我效能感量表（Self-Efficacy for Rehabilitation Outcome Scale，SER）评估患者康复锻炼的自我效能水平；使用领悟社会支持量表（Perceived Social Support Scale，PSSS）评估患者个体主观感受的社会支持水平。采用Pearson相关性分析检验变量间的关系，采用Bootstrap法探究康复自我效能在领悟社会支持与康复锻炼依从性关系间的中介作用。结果·共发放问卷167份，回收有效问卷141份，有效回收率84.4%。141例关节置换患者年龄范围为26~84岁，平均年龄（64.75±10.74）岁，以老年人为主。关节置换患者SER得分为（100.45±21.71）分，PSSS得分为（68.29±10.89）分，REAS得分为（11.93±2.29）分。Pearson相关性分析结果显示关节置换患者SER得分、PSSS得分、REAS得分两两之间均呈显著正相关。中介效应分析结果显示，领悟社会支持对康复锻炼依从性影响的间接效应显著（效应值为0.033，95%CI 0.017~0.058，P<0.05），领悟社会支持对康复锻炼依从性影响的直接效应不显著（效应值为0.027，95%CI -0.008~0.065，P>0.05）。结论·领悟社会支持正向预测康复锻炼依从性，康复自我效能在两者之间起完全中介作用，直接干预康复自我效能感优于调节领悟社会支持水平。

关键词: 关节置换, 自我效能, 领悟社会支持, 依从性, 中介效应

Abstract:

Objective ·To explore the correlation among perceived social support, rehabilitation self-efficacy and rehabilitation exercise adherence of in-patients after hip/knee arthroplasty, and examine the mediating role of rehabilitation self-efficacy in the correlation between perceived social support and rehabilitation exercise adherence. Methods ·A convenience sampling method was used, and 141 post-total hip/knee arthroplasty inpatients in the bone and joint ward of the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital) from October 2021 to February 2023 were selected as the study subjects. The general demographic data, such as age and gender, and the information of disease and operation were assessed by using General Data Questionnaire. The adherence to rehabilitation exercise in patients after hip/knee arthroplasty was assessed by using the Rehabilitation Exercise Adherence Scale (REAS); the self-efficacy of rehabilitation exercise was assessed by using the Self-Efficacy for Rehabilitation Outcome Scale (SER); the social support level of individual subjective feelings of the patients was assessed by using the Perceived Social Support Scale (PSSS). Pearson's correlation analysis was used to test the correlation between the variables, and Bootstrap method was used to investigate the mediating role of rehabilitation self-efficacy in the correlation between perceived social support and rehabilitation exercise adherence. Results ·A total of 167 questionnaires were distributed and 141 valid questionnaires were recovered, with a valid recovery rate of 84.4%. The age range of the 141 patients after hip/knee arthroplasty was 26?84 years old, and the average age was (64.75±10.74) years old. The total score of SER of the patients after hip/knee arthroplasty was (100.45±21.71), the total score of PSSS was (68.29±10.89), and the total score of REAS was (11.93±2.29). Pearson's correlation analysis results showed that there was a significant correlation between SER score and PSSS score, SER score and REAS score, and PSSS score and REAS score in patients after hip/knee arthroplasty. The mediation effect analysis showed that the indirect effect of perceived social support on rehabilitation exercise adherence was significant (effect value 0.033, 95%CI 0.017?0.058, P<0.05), and the direct effect of perceived social support on rehabilitation exercise adherence was not significant (effect value 0.027, 95%CI -0.008?0.065, P>0.05). Conclusion ·Perceived social support positively predicts rehabilitation exercise adherence, and rehabilitation self-efficacy fully mediates the correlation. Direct intervention in rehabilitation self-efficacy is superior to moderating the level of perceived social support.

Key words: joint replacement, self-efficacy, perceived social support, compliance, mediating effect

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