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创伤重症监护人群中与康复管理自我效能相关的因素:一项前瞻性队列研究。

Factors associated with self-efficacy for managing recovery in the trauma intensive care population: a prospective cohort study.

作者信息

Connolly Fiona R, Aitken Leanne M, Tower Marion, Macfarlane Bonnie

机构信息

Clinical Nurse, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

出版信息

Injury. 2014 Jan;45(1):272-8. doi: 10.1016/j.injury.2013.05.005. Epub 2013 Jun 6.

Abstract

OBJECTIVE

The aim of this paper was to identify factors associated with self-efficacy for managing recovery in the trauma intensive care population.

INTRODUCTION

Injury accounts for 6.5% of disease burden in Australia, with similar levels being reported in other developed countries. While some studies regarding self-efficacy have identified a relationship to patient recovery post acute injury, others have been inconclusive. This study will identify factors associated with self-efficacy for managing recovery in the trauma intensive care population.

METHODS

A prospective cohort study of patients aged ≥ 18 years, admitted to a metropolitan tertiary hospital in South East Queensland between June 2008 and August 2010 for the acute treatment of injury. Demographic, injury, acute care and psychosocial factors were considered. The primary outcome was self-efficacy measured by the 6-item self-efficacy scale (SES) 1 and 6 months post hospital discharge. All factors significant (p<0.10) on univariate analysis were included in multivariable modelling where p<0.05 was considered significant.

RESULTS

A total of 88 patients were included. The mean self-efficacy score at 1 and 6 months was similar (6.8 vs 6.9 respectively). Self-efficacy at 1 month, psychological distress (K-10) Score and illness perception (K10) Score accounted for 68.4% (adjusted R(2)) of the variance in 6 month self-efficacy (F3,75)=57.17, p<0.001. Illness perception was the strongest contributor to 6 month self-efficacy (beta=-0.516), followed by psychological distress (beta=-0.243) and self-efficacy at 1 month (beta=0.205).

CONCLUSION

Significant factors associated with self-efficacy for managing recovery at 6 months included 1 month self-efficacy, illness perception and psychological distress. To promote patient recovery, screening patients at 1 month in order to commence relevant interventions could be beneficial.

摘要

目的

本文旨在确定与创伤重症监护人群康复管理自我效能感相关的因素。

引言

在澳大利亚,伤害占疾病负担的6.5%,其他发达国家也报告了类似水平。虽然一些关于自我效能感的研究已经确定了其与急性损伤后患者康复之间的关系,但其他研究尚无定论。本研究将确定与创伤重症监护人群康复管理自我效能感相关的因素。

方法

对2008年6月至2010年8月间因急性损伤入住昆士兰州东南部一家大都市三级医院的18岁及以上患者进行前瞻性队列研究。考虑了人口统计学、损伤、急性护理和心理社会因素。主要结局是出院后1个月和6个月通过6项自我效能量表(SES)测量的自我效能感。单变量分析中所有具有显著意义(p<0.10)的因素都纳入多变量模型,其中p<0.05被视为具有显著意义。

结果

共纳入88例患者。1个月和6个月时的平均自我效能感得分相似(分别为6.8和6.9)。1个月时的自我效能感、心理困扰(K-10)得分和疾病认知(K10)得分占6个月时自我效能感方差的68.4%(调整R²)(F3,75=57.17,p<0.001)。疾病认知是6个月时自我效能感的最强影响因素(β=-0.516),其次是心理困扰(β=-0.243)和1个月时的自我效能感(β=0.205)。

结论

与6个月时康复管理自我效能感相关的显著因素包括1个月时的自我效能感、疾病认知和心理困扰。为促进患者康复,在1个月时对患者进行筛查以便开始相关干预可能有益。

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