一项关于生活目标特征和目标调整能力对下肢截肢后长期心理社会适应重要性的前瞻性研究。

A prospective study of the importance of life goal characteristics and goal adjustment capacities in longer term psychosocial adjustment to lower limb amputation.

机构信息

1School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.

出版信息

Clin Rehabil. 2014 Feb;28(2):196-205. doi: 10.1177/0269215513497736. Epub 2013 Aug 14.

DOI:10.1177/0269215513497736

PMID:23945162

Abstract

OBJECTIVE

To explore the life goal characteristics and goal adjustment capacities of persons with lower limb amputation on admission to rehabilitation, and to examine their efficacy as predictors of psychosocial outcomes six months post discharge.

DESIGN

Prospective, descriptive.

SETTING

Two specialist inpatient rehabilitation facilities in Ireland.

SUBJECTS

A consecutive sample of 64 patients with lower limb amputation.

MAIN MEASURES

On admission to rehabilitation, life goal characteristics (goal importance, goal disturbance) were assessed using the Goal Facilitation Index and goal adjustment capacities (goal disengagement, goal re-engagement) were measured using the Goal Adjustment Scale. The Beck Depression Inventory-II and the Trinity Amputation and Prosthesis Experience Scales-Revised assessed depressive symptomatology and psychosocial adjustment to amputation at six months post discharge.

RESULTS

The highest average importance ratings were assigned to goals associated with interpersonal relationships, independence and subjective well-being. Goals related to physical limitations and disruptions in daily activities received the highest hindrance ratings. Goal importance (β = -0.33) and goal disengagement (β = -0.29) on admission significantly predicted depressive symptomatology six months post discharge (P ≤ 0.05). Goal importance (β = 0.32), goal disturbance (β = -0.26), and goal re-engagement (β = -0.21) on admission significantly predicted general adjustment to lower limb amputation at six months post discharge (P ≤ 0.05), while goal importance (β = -0.32) and goal disturbance (β = 0.30) significantly predicted social adjustment (P ≤ 0.05).

CONCLUSIONS

Life goal characteristics and goal adjustment capacities on admission to rehabilitation predicted psychosocial outcomes six months post discharge among individuals with lower limb amputation.

摘要

目的

探讨入院时下肢截肢患者的生活目标特征和目标调整能力，并研究其作为出院后 6 个月心理社会结局预测因子的效能。

设计

前瞻性、描述性。

地点

爱尔兰两家专科住院康复机构。

受试者

连续纳入的 64 例下肢截肢患者。

主要观察指标

在入院康复时，使用目标促进指数评估生活目标特征（目标重要性、目标困扰），使用目标调整量表评估目标调整能力（目标脱离、目标再投入）。出院后 6 个月，使用贝克抑郁量表第 2 版和三位一体截肢和假体体验量表修订版评估抑郁症状和对截肢的心理社会适应情况。

结果

对人际关系、独立和主观幸福感相关目标的重要性评分最高。与身体限制和日常生活活动中断相关的目标获得的困扰评分最高。入院时的目标重要性（β=-0.33）和目标脱离（β=-0.29）显著预测出院后 6 个月的抑郁症状（P≤0.05）。入院时的目标重要性（β=0.32）、目标困扰（β=-0.26）和目标再投入（β=-0.21）显著预测出院后 6 个月的下肢截肢总体适应情况（P≤0.05），而目标重要性（β=-0.32）和目标困扰（β=0.30）显著预测社会适应情况（P≤0.05）。