摘要
目的 调查回肠造口患者久坐行为、运动依从性,为制定针对性运动干预提供参考.方法 选取2018年8月至2023年8月行腹腔镜低位直肠前切除联合预防性回肠造口 144例患者为研究对象,术后3个月调查其久坐行为和运动依从性.结果 144例患者平均每日久坐时间(7.94±1.76)h,63.8％(92/144)患者久坐时间≥8 h/d;平均运动依从性得分(32.24±8.32)分,平均依从率54.29％±13.85％;久坐行为与运动依从性呈负相关(r=-0.222,P＜0.05).单因素分析显示:年龄、肿瘤分期、慢性病史、NRS 2002评分、主要照顾者、造口适应性、衰弱、既往运动习惯均为影响患者久坐的重要因素(均P＜0.05);多因素Logistic回归分析显示:造口适应性与运动依从性、年龄、主要照顾者、既往运动习惯为术后久坐的独立影响因素(均P＜0.05).联合上述因素构建受试者工作特征曲线,曲线下面积为0.806(95％CI:0.729～0.883),敏感度、特异性分别为72.8％、80.8％.结论 生存管理中的运动干预对提高回肠造口患者健康相关生活质量至关重要.
Abstract
Objective To investigate the correlation between sedentary behavior and exercise compliance in ileostomy patients for developing targeted exercise intervention.Methods Patients undergoing laparoscopic low anterior rectal resection combined with prophylactic ileostomy from Aug 2018 to Aug 2023 were enrolled in this study by convenience sampling method.A survey was conducted at 3 months after surgery to investigate their sedentary behavior and exercise compliance.Results The daily sedentary time of 144 patients was(7.94±1.76)h,and 63.8％(92/144)of patients had sedentary time ≥8 h/d.The exercise compliance score was 32.24±8.32 and the total adherence rate was 54.29％±13.85％.Sedentary behavior was inversely correlated with exercise rehabilitation compliance(r=-0.222,P＜0.05).Univariate analysis revealed that age,tumor stage,chronic medical history,NRS 2002 score,main caregiver,ostomy adaptability,frailty,previous exercise habits were important influencing factors of sedentary behavior(all P＜0.05).Multivariate Logistic regression analysis indicated that stoma adaptability and exercise compliance,age,primary caregiver,and previous exercise habits were independent factors affecting postoperative sedentary behavior(all P＜0.05).Combining the above factors to construct the receiver operating characteristic curve yielded an area under the curve of 0.806(95％CI:0.729-0.883),with an sensitivity and specificity of 72.8％,80.8％,respectively.Conclusion Exercise intervention in survivorship management is essential for enhancing the health-related quality of life in patients with ileostomy.
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