恐动症在髋关节置换术后患者自我效能感与疼痛灾难化间的中介效应分析-现代医学

恐动症在髋关节置换术后患者自我效能感与疼痛灾难化间的中介效应分析

单位：1. 淮安市第二人民医院骨科, 江苏淮安 223002;
2. 淮安市第二人民医院供应室, 江苏淮安 223002

分类号：R687;R619

出版年·卷·期（页码）：2026·54·第二期（296-301）

摘要：

目的： 探讨恐动症在髋关节置换术(HA)后患者自我效能感与疼痛灾难化间的中介效应。方法： 采用方便抽样方法，采用临床资料调查问卷、恐动症评分表(TSK-17)、疼痛灾难化量表(PCS)、康复自我效能感量表(SER)对本院2023年2月至2024年2月收治的153例行HA患者进行调查，分析患者术后恐动症的影响因素及其与患者疼痛灾难化、自我效能感水平的相关性，并进行恐动症的中介效应检验分析。结果： 共收集有效问卷153份。HA患者TSK-17评分总分为(39.45±4.11)分，PCS评分总分为(22.97±3.28)分，SER总分为(78.16±6.89)分。单因素分析结果表明，不同性别、年龄、受教育程度、婚姻状况、职业状态、子女情况、付费方式、基础疾病、骨折类型、置换关节、手术类型、手术入路方式及手术时长患者，其TSK-17评分对比差异无统计学意义(均P＞0.05)。存在术后并发症患者，其TSK-17评分高于无术后并发症患者(P＜0.05)。Pearson相关性分析显示，患者TSK-17评分与PCS评分呈正相关，与SER评分呈负相关(均P＜0.05)。中介效应分析结果显示，患者术后恐动症在疼痛灾难化、自我效能感之间起着部分中介作用，效应占35.80%。结论： 恐动症在HA术后患者自我效能感与疼痛灾难化之间发挥部分中介作用，应在术后康复中加强恐动症及相关心理因素的评估与干预。

Objective: To explore the mediating effect of basophobia in pain catastrophizing as well as self-efficacy of patients after hip arthroplasty(HA). Methods: Using a convenient sampling method, a questionnaire based on clinical data, the Tachyphobia Scale(TSK-17), the Pain Catastrophizing Scale(PCS), and the Self-Efficacy of Rehabilitation Scale(SER) were used to investigate 153 patients who underwent hip arthroplasty(HA) in our hospital from February 2023 to February 2024. The influencing factors of basophobia in these patients and its correlation with their levels of pain catastrophizing and self-efficacy were analyzed, and a mediation effect test analysis for basophobia was conducted. Results: A total of 153 valid questionnaires was collected. The mean total scores were(39.45±4.11) for TSK-17, (22.97±3.28) for PCS, and (78.16±6.89) for SER. Univariate analysis showed no statistically significant differences in TSK-17 scores according to sex, age, educational level, marital status, occupational status, number of children, payment method, comorbidities, fracture type, replaced joint, surgical type, surgical approach, or operative duration(all P>0.05). Patients with postoperative complications had a higher TSK-17 score than those without postoperative complications(P＜0.05). Pearson correlation analysis showed that the TSK-17 score of patients was positively correlated with the PCS score and negatively correlated with the SER score(all P＜0.05). Mediation analysis indicated that the postoperative basophobia of patients played a partial mediating role between pain catastrophizing and self-efficacy, with the effect accounting for 35.80%. Conclusion: Basophobia plays a partial mediating role between the self-efficacy and pain catastrophizing of patients after HA surgery. Therefore, assessment and intervention of basophobia and related psychological factors should be strengthened during postoperative rehabilitation.

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