Analysis of effects of mental load and self-efficacy on postoperative rehabilitation in elderly patients with lumbar disc herniation
Objective To investigate the effects of mental load and self-efficacy on postoperative rehabilitation in elder-ly patients with lumbar disc herniation(LDH).Methods A total of 108 elderly LDH patients who underwent percutaneous endoscopic lumbar discectomy in First People's Hospital of Huai'an City from May 2022 to May 2023 were selected as the sub-jects.Their compliance behavior,mental load,self-efficacy,and lumbar vertebral function were evaluated with the Compliance Questionnaire,Subjective Workload Assessment Technique(SWAT),Chronic Pain Self-efficacy Scale(CPSS),and Oswe-stry Disability Index(ODI),respectively.The scores of SWAT,CPSS and ODI of patients with different compliance behav-iors were compared.Binary Logistic regression analysis was used to analyze the relationship between SWAT score,CPSS score and compliance with postoperative rehabilitation.The correlation analysis was used to analyze the relationship between SWAT score,CPSS score and postoperative improvement of lumbar vertebral function.Results The effective rate of questionnaire re-covery in this study was 97.22% (105/108).The total score of compliance behavior of 105 elderly LDH patients was(55.04±8.96)points,including 54 cases in the compliance group(total compliance behavior score＞54 points)and51 ones in the non-compliance group(total compliance behavior score≤54 points).SWAT score and postoperative ODI score of the compliance group were lower than those of the non-compliance group(t =19.906,4.869,P＜0.05).The scores of pain man-agement,physical function and response to symptoms,and total score of CPSS of the compliance group were higher than those of the non-compliance group(t =5.552,4.650,3.864,6.020,all P＜0.05).There were statistically significant difference in education level and spouse condition between the two groups(P＜0.05).Binary Logistic regression analysis found that high SWAT score(OR =5.140,95% CI:2.082-12.687)was a risk factor for postoperative non-compliance behavior in elderly LDH patients(P＜0.05).High CPSS score(OR =3.888,95% CI:1.690-8.944),high education level(OR =3.068,95% CI:1.474-6.386)and having spouse(OR =2.257,95% CI:1.037-4.914)were protective factors for postoperative non-com-pliance behavior(P＜0.05).Correlation analysis results showed that SWAT score was positively correlated with postoperative ODI score(r =0.735,P＜0.05),while CPSS score was negatively correlated with postoperative ODI score(r =-0.681,P＜0.05).Conclusion The heavier the mental load of elderly LDH patients,the worse their compliance behavior and the worse the improvement of lumbar function after surgery.Patients with better self-efficacy,higher education level or having spouse have relatively better compliance behavior.Besides,patients with better self-efficacy also have better lumbar vertebral function after surgery,which is worthy of clinical attention.
elderlylumbar disc herniationcompliance behaviormental loadself-efficacylumbar vertebral function
国家科技期刊平台
NSTL
万方数据
维普
