摘要
目的 调查影响上肢假肢被弃用的因素.方法 通过病历查询2016年1月1日至2022年12月31日在广东省工伤康复医院适配上肢假肢的截肢者138例,选择适配后功能独立性评分提高者,采用电话或微信对126例进行问卷调查.依据Trinity截肢和假肢体验量表-修订版、健康调查简表(SF-36)和世界卫生组织生活质量量表简表设计假肢弃用原因问卷,将上肢假肢弃用原因归纳为截肢者因素、假肢适配因素、假肢训练因素以及周围环境和社会政策因素4个方面.结果 假肢总体弃用率为23.0%(29/126).弃用组与在用组间文化程度、截肢部位和残肢状况有显著性差异(χ2>6.808,P<0.05);假肢类型、假肢是否有功能、安装假肢期望值、假肢舒适性、穿脱方便性、操控灵敏性、假肢重量、外观满意度、假肢技师水平、假肢安装后的满意度和在用假肢满意度有显著性差异(χ2>13.083,P<0.05);假肢装配前的训练程度、安装假肢3个月后对功能性假肢掌握程度、日常生活能力训练、职业康复模拟训练有显著性差异(χ2>6.520,P<0.05);使用假肢参与社会活动意愿、社会人员对其穿戴假肢态度、家人对其使用假肢支持、工作状态、福利政策熟知情况、当前身体状况有显著性差异(χ2>13.152,P<0.01).结论 截肢者因素、假肢适配因素、假肢训练因素以及周围环境和社会政策因素都可能影响截肢者弃用假肢,有必要采取有针对性的措施加以改进.
Abstract
Objective To investigate the factors related to the abandonment of upper limb prostheses.Methods A total of 138 amputees fitting with upper limb prostheses at Guangdong Work Injury Rehabilitation Hospital from January 1st,2016 to December 31st,2022 were reviewed through case data,and those whose Functional In-dependence Measure scores improved after fitting were selected.A total of 126 amputees were investigated through telephone or WeChat with a questionnaire.The questionnaire was designed based on Trinity Amputation and Prosthesis Experience Scale-Revised,short form of Health Survey(SF-36)and World Health Organization Quality of Life Scale-Brief,and the items that may lead to the abandonment of upper limb prostheses were sum-marized in four factors:amputee,prosthetic fitting,prosthetic training,and environment and social policy.Results The overall abandonment rate was 23.0%(29/126).There was significant difference between the the amputee abandonment or using prostheses in educational levels,amputation levels and residual limb condition(χ2>6.808,P<0.05);types of prostheses,whether functional prostheses,expectation for prosthesis,comfort of the prosthe-ses,convenience of putting on and taking off,sensitivity of manipulation,weight of the prostheses,satisfaction with the appearance,skill levels of the prosthetist,the satisfaction after prosthesis installation and satisfaction with the prostheses in use(χ2>13.083,P<0.05);training levels before prosthesis assembly,the mastery of func-tional prostheses three months after prosthesis installation,training for activities of daily living,simulated train-ing for vocation(χ2>6.520,P<0.05);willingness to participate in social activities with prostheses,attitude of other persons towards their prostheses,support of family members,work status,familiarity with the policies of welfare,and the current physical condition(χ2>13.152,P<0.01).Conclusion Factors of amputee,prosthetic fitting,prosthetic training,and environment and social policy may relate to the abandonment of upper limb prostheses,which are needed to improve in an accurate way.
维普
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