a Department of Rehabilitation , Nagoya University Hospital , Nagoya , Japan.
b Department of Vascular Surgery and Surgery , Nagoya University Hospital , Nagoya , Japan.
Disabil Rehabil. 2018 May;40(10):1114-1118. doi: 10.1080/09638288.2017.1287962. Epub 2017 Feb 21.
Open surgery is performed to treat abdominal aortic aneurysm (AAA), although the subsequent surgical stress leads to worse physical status. Preoperative self-efficacy has been reported to predict postoperative physical status after orthopedic surgery; however, it has not been sufficiently investigated in patients undergoing abdominal surgery. The purpose of the present study is to investigate the correlation between preoperative self-efficacy and postoperative six-minute walk distance (6MWD) in open AAA surgery.
Seventy patients who underwent open AAA surgery were included. Functional exercise capacity was measured using preoperative and 1 week postoperative 6MWD. Self-efficacy was preoperatively measured using self-efficacy for physical activity (SEPA). The correlations of postoperative 6MWD with age, height, BMI, preoperative 6MWD, SEPA, Hospital Anxiety and Depression Scale (HADS) score, operative time, and blood loss were investigated using multivariate analysis.
Single regression analysis showed that postoperative 6MWD was significantly correlated with age (r = -0.553, p ≤ 0.001), height (r = 0.292, p = 0.014), Charlson's comorbidity index (r = -0.268, p = 0.025), preoperative 6MWD (r = 0.572, p ≤ 0.001), SEPA (r = 0.586, p ≤ 0.001), and HADS-depression (r = -0.296, p = 0.013). Multiple regression analysis showed that age (p = 0.002), preoperative 6MWD (p = 0.013), and SEPA (p = 0.043) score were significantly correlated with postoperative 6MWD.
Self-efficacy was an independent predictor for postoperative 6MWD after elective open AAA surgery. This suggests the importance of assessing not only physical status but also psychological factors such as self-efficacy. Implications for Rehabilitation Preoperative self-efficacy has been limited to reports after orthopedic surgery. We showed that preoperative self-efficacy predicted postoperative 6MWD after AAA surgery. Treatment to improve self-efficacy might be useful in patients receiving AAA surgery in rehabilitation.
开腹手术用于治疗腹主动脉瘤（AAA），但随后的手术应激会导致身体状况恶化。术前自我效能已被报道可预测矫形手术后的术后身体状况；然而，在接受腹部手术的患者中，这方面的研究还不够充分。本研究旨在探讨开腹 AAA 手术中术前自我效能与术后 6 分钟步行距离（6MWD）之间的相关性。
共纳入 70 例行开腹 AAA 手术的患者。使用术前和术后 1 周的 6MWD 测量功能性运动能力。术前使用身体活动自我效能量表（SEPA）测量自我效能。使用多元分析探讨术后 6MWD 与年龄、身高、BMI、术前 6MWD、SEPA、医院焦虑抑郁量表（HADS）评分、手术时间和失血量的相关性。
单回归分析显示，术后 6MWD 与年龄（r=-0.553，p≤0.001）、身高（r=0.292，p=0.014）、Charlson 合并症指数（r=-0.268，p=0.025）、术前 6MWD（r=0.572，p≤0.001）、SEPA（r=0.586，p≤0.001）和 HADS 抑郁（r=-0.296，p=0.013）呈显著相关。多元回归分析显示，年龄（p=0.002）、术前 6MWD（p=0.013）和 SEPA（p=0.043）评分与术后 6MWD 显著相关。
术前自我效能是择期开腹 AAA 手术后 6MWD 的独立预测因子。这表明，评估身体状况的重要性不仅在于评估身体状况，还在于评估自我效能等心理因素。
术前自我效能仅局限于矫形手术后的报道。我们表明，术前自我效能预测 AAA 手术后的术后 6MWD。在接受 AAA 手术的患者中，改善自我效能的治疗可能有用。
