School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China.
University of Health and Rehabilitation Sciences, No. 17, Shandong Road, Shinan district, Qingdao City, Shandong Province, China.
BMC Musculoskelet Disord. 2024 Aug 2;25(1):619. doi: 10.1186/s12891-024-07744-z.
Social participation is an important index of rehabilitation and social reintegration in patients after total knee arthroplasty (TKA). However, most existing studies focus on improving patients' functioning and activities, with only a few examining the social participation among patients after TKA. Therefore, the study aims to investigate the heterogeneity of social participation in patients three months after TKA and analyze subgroup influencing factors, to promote functional exercise and postoperative follow-up in specific patients.
This cross-sectional study recruited 255 patients who underwent TKA in a Tertiary Hospital in Jinan City, China, from March to July 2022. Three months after having undergone TKA, participants' data were collected using the Numeric Pain Rating Scale, the Chinese version of the Tampa Scale of Kinesiophobia, the 10-item Kessler Psychological Distress Scale, Hospital for Special Surgery Knee-rating Scale, and Impact on Participation and Autonomy Questionnaire. Latent profile analysis was used to identify categories of patients' social participation. Multiple logistic regression analysis was used to analyze the influencing factors of the different subgroups.
Three months after TKA, the patients were divided into three subgroups: low social participation group (17.9%), moderate social participation group (40.8%), and high social participation group (41.3%). The vast majority of patients who underwent TKA exhibited moderate-to-high level of social participation. The multiple logistic regression analysis results showed that age, degree of pain, knee function, and kinesiophobia were the influencing factors of the potential profiles of social participation in patients three months after TKA (p < 0.05).
These results support a distinct categorical feature of social participation among patients three months after undergoing TKA. Medical staff need to provide targeted guidance according to the potential classification characteristics of social participation to improve the level of social participation and promote rehabilitation of patients.
社会参与是全膝关节置换术（TKA）后患者康复和重返社会的一个重要指标。然而，大多数现有研究侧重于改善患者的功能和活动，只有少数研究关注 TKA 后患者的社会参与。因此，本研究旨在探讨 TKA 后 3 个月患者社会参与的异质性，并分析亚组影响因素，以促进特定患者的功能锻炼和术后随访。
本横断面研究纳入了 2022 年 3 月至 7 月在中国济南市一家三级医院接受 TKA 的 255 名患者。TKA 后 3 个月，使用数字疼痛评分量表、中文版 Tampa 运动恐惧量表、10 项 Kessler 心理困扰量表、美国特种外科医院膝关节评分量表和参与和自主问卷收集参与者的数据。采用潜在剖面分析识别患者社会参与的类别。采用多因素逻辑回归分析分析不同亚组的影响因素。
TKA 后 3 个月，患者分为低社会参与组（17.9%）、中社会参与组（40.8%）和高社会参与组（41.3%）。绝大多数接受 TKA 的患者表现出中高水平的社会参与。多因素逻辑回归分析结果显示，年龄、疼痛程度、膝关节功能和运动恐惧是 TKA 后 3 个月患者社会参与潜在模式的影响因素（p<0.05）。
这些结果支持 TKA 后 3 个月患者社会参与具有明显的分类特征。医务人员需要根据社会参与的潜在分类特征提供有针对性的指导，以提高社会参与水平，促进患者康复。
