手部肌腱损伤术后3个月运动恐惧现状及其危险因素分析-现代医学

手部肌腱损伤术后3个月运动恐惧现状及其危险因素分析

单位：1. 青岛市第八人民医院手足外科, 山东青岛 266100;
2. 青岛市市立医院感染性疾病科, 山东青岛 266011

分类号：R473.6

出版年·卷·期（页码）：2025·53·第十期（1630-1636）

摘要：

目的：调查分析手部肌腱损伤患者术后3个月的运动恐惧现状及其危险因素，为临床减轻患者术后运动恐惧感，促进患者手功能恢复提供参考。方法：便利抽样选取青岛市第八人民医院手足外科2023年1月至2024年12月收治的手部肌腱损伤术后患者148例，对其发放一般资料调查表、恐动症量表(TSK)-17、运动自我效能感量表(SEE)、社会支持量表(SSRS)及广泛性焦虑障碍量表(GAD)-7，统计患者TSK-17评分及恐动症发生率，单因素及Logistic回归分析恐动症发生的相关因素，Pearson相关性及多元线性回归分析TSK-17评分与其他量表评分的关系。结果：TSK-17评分(34.29±4.27)分，恐动症(＞36分)发生率为28.38%。恐动症组与非恐动症组职业、优势手、合并症、并发症、功能康复、SEE、SSRS及GAD-7评分比较差异有统计学意义(P＜0.05)。Logistic回归分析显示，合并症(OR=0.233，P=0.010)、SEE评分(OR=0.934，P=0.003)、SSRS评分(OR=0.830，P=0.001)及GAD-7评分(OR=1.204，P=0.029)是术后3个月恐动症发生独立影响因素(P＜0.05)。TSK-17总分与SEE及SSRS总分均呈负相关(r=-0.332、-0.193，均P＜0.05)，与GAD-7评分呈正相关(r=0.314，P＜0.001)。多元线性回归分析显示，合并症、SEE、SSRS及GAD-7评分共同解释术后3个月运动恐惧水平总变异的26.50%。结论：手部肌腱损伤患者术后3个月，超过1/4的患者存在运动恐惧问题，有合并症、自我效能感低、社会支持水平低是恐动症发生的独立危险因素。

Objective: To investigate and analyze the status and risk factors of exercise fear 3 months after surgery in patients with hand tendon injury surgery, so as to provide reference for reducing the clinical exercise fear and improving the recovery effect of hand function. Methods: A total of 148 postoperative patients with hand tendon injury admitted to the Department of Hand and Foot Surgery of the Eighth People's Hospital of Qingdao from January 2023 to December 2024 were selected by convenient sampling method. The patients were investigated with general data questionnaire, Tampa Scale Kinesiophobia(TSK)-17, self-efficacy for exercise scale(SEE), social support rating scale(SSRS) and generalized anxiety disorder scale(GAD)-7. The TSK-17 score and the incidence of kinesiophobia were analyzed. The correlation factors of kinesiophobia were analyzed by univariate and Logistic regression, and the relationships between TSK-17 score and other scales scores were analyzed by Pearson correlation and multiple linear regression. Results: The TSK-17 score was(34.29±4.27) points, and the incidence of kinesiophobia(>36 points) was 28.38%. There were statistically significant differences in occupation, dominant hand, complications, functional rehabilitation, SEE, SSRS and GAD-7 scores between the kinesiophobia group and the non-kinesiophobia group(P<0.05). Logistic regression analysis showed complications(OR=0.233, P=0.010), SEE score(OR=0.934, P=0.003), SSRS score(OR=0.830, P=0.001) and GAD-7 score(OR=1.204, P=0.029) were independent factors affecting the occurrence of kinesiophobia 3 months after surgery(P<0.05). The score of TSK-17 was negatively correlated with SEE and SSRS scores(r=-0.332,-0.193, both P<0.05), and positively correlated with the score of GAD-7(r=0.314, P<0.001). Multiple linear regression analysis showed that complications, SEE, SSRS and GAD-7 scores together explained 26.50% of the total variation in exercise fear level at 3 months after surgery. Conclusion: More than a quarter of patients have exercise fear problems 3 months after hand tendon injury surgery. Complications, low self-efficacy and low level of social support are independent risk factors for the occurrence of kinesiophobia.

参考文献：

[1] REDDY R P,GAO T,CHEN J,et al.The effect of timing between traumatic flexor tendon injury of the hand and surgical intervention on repair failure rates[J].Orthopedics,2024,47(2):113-117.
[2] SIROUS S,TILKORN D,HAUSER J.Strecksehnenverletzungen der hand[J].Chirurg,2020,91(12):1083-1092.
[3] ALETTO C,AICALE R,OLIVA F,et al.Hand flexor tendon repair:from biology to surgery and rehabilitation[J].Hand Clin,2023,39(2):215-225.
[4] 王宇晨,陈玉红,杨光,等.心脏外科术后患者运动恐惧特征类别的潜在剖面分析[J].中华现代护理杂志,2024,30(16):2161-2167.
[5] 赖婷,吴明珑,胡凯利,等.全髋关节置换术后病人运动恐惧现状及影响因素分析[J].骨科,2024,15(3):258-262.
[6] 张莉,张子茹,张彩蕾,等.老年全髋关节置换术患者术后早期运动恐惧的潜在剖面分析及影响因素研究[J].中华现代护理杂志,2024,30(29):4002-4008.
[7] 李庆泰,田光磊.手外科诊断学[M].北京:人民卫生出版社,2009:124-126.
[8] 方积乾.卫生统计学[M].7版.北京:人民卫生出版社,2012:399-400.
[9] 潘生德,顾玉东,侍德.中华医学会手外科学会上肢部分功能评定试用标准[J].中华手外科杂志,2000,16(3):130.
[10] MILLER R P,KORI S H,TODD D D.The Tampa Scale:a measure of kinisophobia[J].Clin J Pain,1991,7(1):51.
[11] 胡文.简体中文版TSK和FABQ量表的文化调适及其在退行性腰腿痛中的应用研究[D].上海:第二军医大学,2012.
[12] RESNICK B,JENKINS L S.Testing the reliability and validity of the Self-Efficacy for Exercise scale[J].Nurs Res,2000,49(3):154-159.
[13] LEE L L,PERNG S J,HO C C,et al.A preliminary reliability and validity study of the Chinese version of the self-efficacy for exercise scale for older adults[J].Int J Nurs Stud,2009,46(2):230-238.
[14] 肖水源.《社会支持评定量表》的理论基础与研究应用[J].临床精神医学杂志,1994,4(2):98-100.
[15] SPITZER R L,KROENKE K,WILLIAMS J B W,et al.A brief measure for assessing generalized anxiety disorder:the GAD-7[J].Arch Intern Med,2006,166(10):1092-1097.
[16] 夏锐南,王瑞,张俊峰,等.经皮冠状动脉介入治疗术后患者运动恐惧的发展轨迹及影响因素[J].中华行为医学与脑科学杂志,2025,34(1):43-50.
[17] BULLOCK G S,SELL T C,ZAREGA R,et al.Kinesiophobia,knee self-efficacy,and fear avoidance beliefs in people with ACL injury:a systematic review and meta-analysis[J].Sports Med,2022,52(12):3001-3019.
[18] 张莉,张子茹,张彩蕾,等.全膝关节置换术患者恐动症水平变化轨迹及影响因素分析[J].护士进修杂志,2024,39(9):904-911.
[19] 谭娅,张玲,陈诚,等.老年髋部骨折患者术后恐动症风险预测模型构建和验证[J].现代医学,2024,52(6):938-945.
[20] YAKUT OZDEMIR H,OZALEVLI S,FELEKOGLU E,et al.Kinesiophobia and associated factors in patients with myocardial infarction[J].Percept Mot Skills,2023,130(6):2564-2581.
[21] 吴春香,林腾珠,郁毅刚,等.军人四肢骨损伤恐动症影响因素分析[J].空军航空医学,2024,40(6):540-543.
[22] TAN M,LIU Y,ZHAO R,et al.The effect of pain social support on kinesiophobia in older patients with rheumatoid arthritis:the mediating role of self-perceived burden[J].Geriatr Nurs,2023,50:52-57.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录