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腰椎显微椎间盘切除术术后的焦虑、恐惧与恐惧回避信念及治疗结果

ANXIETY, FEARS AND FEAR-AVOIDANCE BELIEFS AND THERAPEUTIC OUTCOME AFTER LUMBAR MICRODISCECTOMY.

作者信息

Pantelinac Slobodan P, Simić-Panić Dušica S, Devečerski Gordana V, Tomašević Todorović Snežana T

机构信息

University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.

Clinical Center of Vojvodina, Medical Rehabilitation Department, Novi Sad, Serbia.

出版信息

Acta Clin Croat. 2024 Apr;63(1):123-133. doi: 10.20471/acc.2024.63.01.15.

Abstract

Microdiscectomy is one of the surgical methods for the treatment of herniated intervertebral disc in patients with low back pain. The aim of the research was to evaluate the presence of psychological and cognitive-behavioral factors, including anxiety, fears and fear-avoidance beliefs of physical activity and work and their correlation with the pain and functional disability in patients after lumbar microdiscectomy and subsequent physical therapy. The research was performed on 198 patients (95 men and 103 women), mean age 50.20±10.26 years. The following questionnaires were used in the study: Spielberger Anxiety Inventory-State and Trait; Fear-Avoidance Beliefs Questionnaire (Physical activity and Work); for intensity of pain, visual analog scale and Oswestry Low Back Pain Disability Questionnaire. These assessments were carried out after microdiscectomy, as follows: just before rehabilitation treatment, and 1, 3 and 6 months after microdiscectomy. The pain and functional disability had significant correlations with the following factors: anxiety-state (p<0.01), anxiety-trait (p<0.01), fear/avoidance beliefs - physical activity (p<0.01) and fear/avoidance beliefs - work (p<0.01). The pain and functional disability in patients after lumbar microdiscectomy showed significant correlation with anxiety, fears and fear-avoidance beliefs. The mentioned psychological and cognitive-behavioral factors can predict the degree of functional recovery and indicate additional therapy after lumbar microdiscectomy.

摘要

显微椎间盘切除术是治疗下腰痛患者椎间盘突出症的手术方法之一。本研究的目的是评估心理和认知行为因素的存在情况,包括焦虑、恐惧以及对体育活动和工作的恐惧回避信念,及其与腰椎显微椎间盘切除术后及后续物理治疗患者的疼痛和功能障碍的相关性。该研究对198例患者(95例男性和103例女性)进行,平均年龄50.20±10.26岁。本研究使用了以下问卷:斯皮尔伯格状态焦虑量表和特质焦虑量表;恐惧回避信念问卷(体育活动和工作);用于评估疼痛强度的视觉模拟量表和奥斯威斯利下腰痛功能障碍问卷。这些评估在显微椎间盘切除术后进行,具体如下:康复治疗前、显微椎间盘切除术后1个月、3个月和6个月。疼痛和功能障碍与以下因素存在显著相关性:状态焦虑(p<0.01)、特质焦虑(p<0.01)、恐惧/回避信念——体育活动(p<0.01)和恐惧/回避信念——工作(p<0.01)。腰椎显微椎间盘切除术后患者的疼痛和功能障碍与焦虑、恐惧和恐惧回避信念显著相关。上述心理和认知行为因素可预测功能恢复程度,并提示腰椎显微椎间盘切除术后的额外治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2d/11827399/a9a614793fb5/acc-63-123-f1.jpg

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