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中国大陆脊髓损伤患者的残疾轨迹:心理社会资源和疾病因素能预测轨迹吗?

Disability trajectories individuals with spinal cord injury in mainland China: do psychosocial resources and diseases factors predict trajectories?

作者信息

Huang Hui, Chen Mengmeng, Ding Peipei, Xia Xiaoxiao, Dai Qing, Feng Linsheng, Xu Li, Shu Junmei, Li Lunlan

机构信息

Department of Nursing, The Second Hospital of Nanjing, Nanjing, China.

School of Nursing, Anhui Medical University, Hefei, China.

出版信息

Spinal Cord. 2025 Jan;63(1):1-8. doi: 10.1038/s41393-024-01040-2. Epub 2024 Oct 8.

DOI:10.1038/s41393-024-01040-2
PMID:39379498
Abstract

STUDY DESIGN

Observational cohort study.

OBJECTIVE

To identify classes of disability trajectories from 1 month post-injury (acute hospital) to 6 months post-injury (individuals with SCI individuals who stay in rehabilitation setting or back in the community), and to investigate whether psychosocial resources and disease factors can predict disability trajectory.

SETTING

Spinal surgery in three Class III hospitals. Hospitals in China are divided into three classes (Class I, II and III).

METHODS

All the participants were submitted to WHO Disability Assessment Schedule (WHO-DAS 2.0) at three times; and personal data anamnesis, level of hope, level of PTSD, level of social support were recorded at first time. All the data collected by the master's students who participated in this study.

RESULTS

Two disability trajectories were identified using the latent class growth model: the continuous high disability group (N = 196, 93.3%) and the low starting point stabilization group (N = 14, 6.7%). Complete injury(ASIA-A) with SCI and more depression in the stable condition after SCI surgery were more likely to be classified as having higher disability than those with a lower disability trajectory. Occupation, annual family income, hope, social support, and Post-traumatic Stress Disorder (PTSD) cannot predict individuals belonging to trajectory classes.

CONCLUSION

These findings emphasize the importance of ASIA and depression in the early recovery stage after SCI and support the opinion that strengthening psychological nursing and rehabilitation management at an early stage after SCI will benefit individuals with a lower disability trajectory.

摘要

研究设计

观察性队列研究。

目的

确定从受伤后1个月(急性医院)到受伤后6个月(脊髓损伤患者在康复机构或回到社区)的残疾轨迹类别,并调查心理社会资源和疾病因素是否能预测残疾轨迹。

地点

三家三级医院的脊柱外科手术。中国的医院分为三个等级(一级、二级和三级)。

方法

所有参与者在三个时间点接受世界卫生组织残疾评定量表(WHO-DAS 2.0)评估;首次记录个人数据、回忆、希望水平、创伤后应激障碍水平、社会支持水平。所有数据由参与本研究的硕士研究生收集。

结果

使用潜在类别增长模型确定了两种残疾轨迹:持续高残疾组(N = 196,93.3%)和低起点稳定组(N = 14,6.7%)。脊髓损伤完全性损伤(ASIA-A)且脊髓损伤手术后稳定状态下抑郁程度较高的患者比残疾轨迹较低的患者更有可能被归类为残疾程度较高。职业、家庭年收入、希望、社会支持和创伤后应激障碍(PTSD)不能预测属于轨迹类别的个体。

结论

这些发现强调了ASIA和抑郁在脊髓损伤后早期恢复阶段的重要性,并支持了在脊髓损伤后早期加强心理护理和康复管理将使残疾轨迹较低的个体受益的观点。

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