摘要
目的探讨脊柱骨折合并衰弱患者术后症状群组成及变化轨迹,并分析其影响因素,为开展临床护理提供参考。方法采用纵向调查方法,便利抽样法选取2021年1月至2023年12月南通市某医院骨科收治的脊柱骨折合并衰弱患者171例作为研究对象。采用一般资料调查表、记忆症状评估量表于术后1个月、3个月、6个月对患者进行调查。使用探索性因子分析术后各时间点症状群,潜类别增长模型识别症状群变化轨迹,二元Logistic回归分析症状群轨迹类别预测因素。结果调查对象术后存在3种症状群,分别为围手术期症状群、情感症状群、疲乏症状群,累积方差贡献率依次为64.54%、70.39%、78.19%。潜类别增长模型识别患者术后症状群存在两种变化轨迹:轻症状快速降低型58例占33.92%,重症状稳定下降型113例占66.08%。年龄(OR=0.352,P<0.05)、大专以上文化程度(OR=2.333,P<0.05)、慢性病种类≥4种(OR=0.151,P<0.05)是患者术后症状群轨迹类别预测因素。结论脊柱骨折合并衰弱患者术后有3种症状群,各症状群总体呈降低趋势,但仍存在异质性。医护人员应准确识别术后症状群轨迹类别,及时调整干预方案,提高症状管理水平。
Objective To explore the composition of postoperative symptom clusters and longitudinal trajectories of patients with spinal fracture and frailty,and analyze their influencing factors to provide reference for clinical nursing care.Methods A longitudinal survey method was adopted to select a total of 171 patients with spinal fracture and frailty admitted to the orthopedics department of a hospital in Nantong from January 2021 to December 2023 by convenient sampling method.Patients were surveyed using the patient general information questionnaire and Revised Memorial Symptom Assessment Scale at 1 month,3 months and 6 months after surgery.Exploratory factor analysis was used to analyze symptom clusters at different time points after surgery,and the latent category growth model was conducted to identify the trajectory of symptom cluster changes,and binary Logistic regression was used to analyze the predictive factors of symptom cluster trajectory categories.Results The subjects had 3 types of symptom clusters after surgery,namely perioperative symptom cluster,emotional symptom cluster,and fatigue symptom cluster,with cumulative variance contributions of 64.54%,70.39%,and 78.19%,respectively.The latent class growth model identified 2 types of symptom clusters after surgery:58 cases of rapid decrease in mild symptoms,accounting for 33.92%,and 113 cases of stable decrease in severe symptoms,accounting for 66.08%.Age(OR=0.352,P<0.05),education level(OR=2.333,P<0.05),and chronic disease type(OR=0.151,P<0.05)were predictors of the postoperative symptom cluster trajectory.Conclusion Patients with spinal fracture and frailty have three symptom clusters after surgery.The overall symptom clusters show a decreasing trend,but there is still heterogeneity.Medical staff should accurately identify the postoperative symptom cluster trajectory categories,adjust the intervention plan in time,and improve the level of symptom management.
作者
闫虹
胡秀晶
张萱
吴桂华
张燕飞
YAN Hong;HU Xiujing;ZHANG Xuan;WU Guihua;ZHANG Yanfei(Department of Orthopedic,Affiliated Nantong Hospital of Shanghai University/The Sixth People's Hospital of Nantong,Nantong 226000,China;Department of Orthopedic,Navy 905 Hospital of People's Liberation Army,Shanghai 200052,China;Department of Geriatric Medicine,Navy 905 Hospital of People's Liberation Army,Shanghai 200052,China;Department of Geriatric Medicine,Affiliated Nantong Hospital of Shanghai University/The Sixth People's Hospital of Nantong,Nantong 226000,China)
出处
《护理管理杂志》
2025年第5期417-422,共6页
Journal of Nursing Administration
基金
江苏省老年健康科研项目(LKZ2023018)。
关键词
脊柱骨折
衰弱
症状群
护理
轨迹类别
纵向研究
影响因素
spinal fracture
frailty
symptom cluster
nursing
trajectory category
longitudinal study
influencing factor
