Lu Yen-Mou, Chang Je-Ken, Lin Pin-Yu, Lue Yi-Jing
Department of Orthopaedics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Division of Pediatric and Spinal Orthopedics, Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
Healthcare (Basel). 2023 Jan 22;11(3):329. doi: 10.3390/healthcare11030329.
Arthroplasty for the hip/knee and surgeries for hip fractures are increasing worldwide. The aims of this study were to investigate changes in health-related quality of life (HRQOL) after surgery with an early mobility education program, and to explore their associations with pain and anxiety. Pain intensity and anxiety were assessed with the visual analogue scale (VAS) and Beck Anxiety Inventory (BAI), and HRQOL was assessed with the Short Form-36 (SF-36). The physical component summary (PCS) and mental component summary (MCS) and eight subscales of the SF-36 were calculated. At pre-operation, the patients suffered from moderate pain and mild anxiety, and their HRQOL scores were low (4.9, 7.8, 35.4, and 48.2 for the VAS, BAI, PCS, and MCS, respectively). The pain, anxiety, and HRQOL improved after surgery and had moderate to large effect sizes at 6-month follow-up (Glass's delta = 1.23, 0.88, 0.81, and 0.67 for VAS, BAI, PCS, and MCS, respectively). Pain and anxiety were strongly correlated to HRQOL at each stage, with the maximum correlation (r = -0.34 to -0.93) reached at 6-month follow-up. The surgery effectively improves HRQOL, as the reduced pain and anxiety lead to better physical and mental HRQOL.
髋关节/膝关节置换术以及髋部骨折手术在全球范围内日益增多。本研究的目的是调查早期活动教育计划手术后健康相关生活质量（HRQOL）的变化，并探讨其与疼痛和焦虑的关联。采用视觉模拟量表（VAS）和贝克焦虑量表（BAI）评估疼痛强度和焦虑，采用简明健康调查问卷（SF-36）评估HRQOL。计算SF-36的身体成分总结（PCS）、心理成分总结（MCS）以及八个子量表得分。术前，患者存在中度疼痛和轻度焦虑，其HRQOL得分较低（VAS、BAI、PCS和MCS分别为4.9、7.8、35.4和48.2）。术后疼痛、焦虑和HRQOL均有所改善，在6个月随访时效应量为中度至较大（VAS、BAI、PCS和MCS的格拉斯δ值分别为1.23、0.88、0.81和0.67）。在每个阶段，疼痛和焦虑与HRQOL均密切相关，在6个月随访时相关性最高（r = -0.34至-0.93）。手术有效改善了HRQOL，因为疼痛和焦虑的减轻带来了更好的身心健康相关生活质量。
