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骨质疏松性椎体压缩骨折术后早期患者的健康相关生活质量、心理弹性和社会支持之间的关联:一项纵向研究

Associations among health-related quality of life, mental resilience and social support in patients early after surgery for osteoporotic vertebral compression fractures: a longitudinal study.

作者信息

Wang Anqi, Wu Cui, Tang Di, Zhao Jianghan, Yang Shuo, Fang Hai Qin, Jiang Liying

机构信息

Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Department of Non-Communicable Disease, Shanghai Baoshan Center of Disease Prevention and Control, Baoshan, Shanghai, China.

出版信息

BMJ Open. 2025 Apr 9;15(4):e084781. doi: 10.1136/bmjopen-2024-084781.

Abstract

OBJECTIVE

This study aims to explore the profile of health-related quality of life (HRQoL) of postoperative osteoporotic vertebral compression fracture (OVCF) patients through a longitudinal investigation, especially in the early postoperative phase, discern the effect of mental resilience and social support on postoperative HRQoL and further explore the mechanisms by which mental resilience exerts influences on HRQoL.

DESIGN

This longitudinal observational study was conducted to examine the HRQoL of OVCF patients during the early postoperative period. Data collection occurred at three distinct time points: baseline assessment on postoperative day 1 (T1), followed by subsequent evaluations at 1 month (T2) and 3 months (T3) postsurgery.

SETTING

Zhoupu Hospital, in Shanghai, China.

PARTICIPANTS

A total of 155 postoperative OVCF patients completed the baseline survey, with 150 and 140 participants completing the follow-up at T2 and T3.

OUTCOME MEASURES

Primary end-point variables were HRQoL, mental resilience and social support. Secondary end-point outcomes included demographic data and disease-related information.

RESULTS

The baseline data indicated that the average age of participants was 69.6 years, ranging from 53 to 92 years, with females accounting for 69.0%. There was no significant difference in demographic characteristics, such as age, gender and other factors, between the follow-up and the lost (p>0.05). Although the level of HRQoL, mental resilience and social support still remain at relatively lower levels at three separate times, they gradually elevated with time. Both mental resilience (r=0.293, p<0.01) and social support (r=0.257, p<0.01) demonstrated significant positive correlations with HRQoL. Multiple linear regression analysis at T3 identified smoking history (β=-0.137, p<0.001), gender (β=-0.154, p<0.001) and diabetes (β=0.126, p=0.001) as independent factors for postoperative HRQoL. Longitudinal mediation analysis suggests that social support exerted an indirect effect on HRQoL through mental resilience (β=1.017, p<0.001).

CONCLUSIONS

Mental resilience and social support are strongly intertwined with HRQoL of OVCF patients after surgery in the early postoperative stage. Notably, social support exerts its beneficial effects on HRQoL through enhanced mental resilience in this critical postoperative period. Targeted interventions should be implemented to optimise social support networks and cultivate psychological resilience, which may substantially improve postoperative HRQoL outcomes.

摘要

目的

本研究旨在通过纵向调查探讨骨质疏松性椎体压缩骨折(OVCF)术后患者的健康相关生活质量(HRQoL)概况,尤其是在术后早期,识别心理弹性和社会支持对术后HRQoL的影响,并进一步探讨心理弹性影响HRQoL的机制。

设计

本纵向观察性研究旨在检查OVCF患者术后早期的HRQoL。数据收集在三个不同时间点进行:术后第1天(T1)的基线评估,随后在术后1个月(T2)和3个月(T3)进行后续评估。

地点

中国上海周浦医院。

参与者

共有155例OVCF术后患者完成了基线调查,150例和140例参与者分别在T2和T3完成了随访。

观察指标

主要终点变量为HRQoL、心理弹性和社会支持。次要终点结果包括人口统计学数据和疾病相关信息。

结果

基线数据显示,参与者的平均年龄为69.6岁,范围从53岁到92岁,女性占69.0%。随访组和失访组在年龄、性别等人口统计学特征方面无显著差异(p>0.05)。尽管HRQoL、心理弹性和社会支持水平在三个不同时间点仍处于相对较低水平,但它们随时间逐渐升高。心理弹性(r=0.293,p<0.01)和社会支持(r=0.257,p<0.01)均与HRQoL呈显著正相关。T3时的多元线性回归分析确定吸烟史(β=-0.137,p<0.001)、性别(β=-0.154,p<0.001)和糖尿病(β=0.126,p=0.001)为术后HRQoL的独立影响因素。纵向中介分析表明,社会支持通过心理弹性对HRQoL产生间接影响(β=1.017,p<0.001)。

结论

在术后早期阶段,心理弹性和社会支持与OVCF患者术后的HRQoL密切相关。值得注意的是,在这个关键的术后时期,社会支持通过增强心理弹性对HRQoL产生有益影响。应实施有针对性的干预措施,优化社会支持网络并培养心理弹性,这可能会显著改善术后HRQoL结果。

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