Razmjou Helen, Finkelstein Joel A, Yee Albert, Holtby Richard, Vidmar Marjan, Ford Michael
Helen Razmjou, MSC, PhD(C): Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre; Department of Physical Therapy, University of Toronto, Toronto, Ontario.
Physiother Can. 2009 Winter;61(1):38-45. doi: 10.3138/physio.61.1.38. Epub 2009 Feb 13.
The purpose of this study was to determine the relationship between patient expectations for improvement following primary total knee arthroplasty (TKA) and patient preoperative characteristics.
This was a cross-sectional analysis of preoperative expectations. Expectations for improvement were evaluated in six distinct domains. The baseline factors used as independent variables were age, gender, presence of comorbidity, sub-domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; pain, stiffness, physical limitation related to lower extremity), and SF-36 physical and mental health component scores. Stepwise logistic regression analysis was applied to examine the relationships between dependent and independent variables.
The study cohort consisted of 236 candidates for TKA (154 women and 82 men, mean age 67, SD = 9.98). Expectations were high on average. Presence of comorbidity was associated with expectations of pain relief. Preoperative mental health was related to expectations for a return to activities of daily living; age, gender, physical health, and mental health were related to expectations for improved leisure, recreational, and sports activities. Preoperative physical health was related to expectations for potential return to full recovery. No baseline factors were associated with expectations for improved range of motion or for providing care to and interacting with others.
Expectations related to recovery from surgery appeared to have distinct dimensions and were associated with patient baseline characteristics.
本研究旨在确定初次全膝关节置换术(TKA)后患者对改善的期望与患者术前特征之间的关系。
这是一项关于术前期望的横断面分析。在六个不同领域评估了对改善的期望。用作自变量的基线因素包括年龄、性别、合并症的存在、西安大略和麦克马斯特大学骨关节炎指数(WOMAC;疼痛、僵硬、与下肢相关的身体限制)的子领域,以及SF-36身体和心理健康成分得分。应用逐步逻辑回归分析来检验自变量和因变量之间的关系。
研究队列由236名TKA候选者组成(154名女性和82名男性,平均年龄67岁,标准差=9.98)。平均而言,期望较高。合并症的存在与疼痛缓解的期望相关。术前心理健康与恢复日常生活活动的期望相关;年龄、性别、身体健康和心理健康与改善休闲、娱乐和体育活动的期望相关。术前身体健康与潜在恢复到完全康复的期望相关。没有基线因素与改善活动范围或照顾他人及与他人互动的期望相关。
与手术恢复相关的期望似乎有不同的维度,并且与患者的基线特征相关。