羞耻如何与膝关节骨关节炎的临床和心理社会结果有关?
Jia Ying Yeo1, Chien Joo Lim2, Su-Yin Yang3
1Department of Rehabilitation Services, Yishun Health, National Healthcare Group, Singapore.
Clinical orthopaedics and related research
|December 3, 2024
概括
与慢性疾病相关的羞耻感会对膝关节骨关节炎 (OA) 的结果产生负面影响,功能恶化和痛苦增加. 早期的心理社会评估和羞耻感的管理对于改善患者福祉至关重要.
科学领域:
- 整形外科 整形外科 整形外科
- 心理学 心理学 心理学
- 公共卫生 公共卫生
背景情况:
- 膝关节关节炎 (OA) 是一种具有重大心理社会影响的残疾状况.
- 与慢性疾病相关的羞耻感是膝关节OA的关键因素,但其长期影响尚不清楚.
研究的目的:
- 为了确定较高的羞耻程度是否与膝盖OA患者的更糟糕的基线临床和心理社会结果相关.
- 评估基线羞耻与4个月和12个月后续随访结果之间的关联.
- 探索膝盖OA中的社会人口统计特征和羞耻水平之间的相关性.
主要方法:
- 一项从新加坡医院招募的220名膝关节OA患者 (平均年龄64岁,69%为女性) 的预后研究.
- 使用了慢性疾病相关的羞耻度量 (CISS),KOOS-12,PHQ-4,ASES-8和BFOM,在基线,4个月和12个月收集的数据.
- 统计分析包括斯皮尔曼相关性,线性回归和集群分析.
主要成果:
- 在所有时间点上,更高的基线羞耻感 (CISS分数) 与膝关节功能恶化 (KOOS-12),自我效能降低 (ASES-8),心理困扰增加 (PHQ-4) 和运动恐惧增加 (BFOM) 相相关.
- 较高的BMI与增加的羞耻程度有关.
- 失业的老年患者有较低的BMI和单侧关节炎,膝盖功能更好.
结论:
- 与慢性疾病相关的羞耻感与膝盖OA的较差的临床和心理社会结果有着适度的联系.
- 建议卫生保健专业人员进行常规的心理社会评估,以识别和管理羞耻.
- 针对BMI和羞耻度较高的个体的有针对性的支持,以及接受和承诺治疗等干预措施,可能会改善结果.
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