Wu Yuan-Peng, Xu Gui, Wang Zhen
Department of Hand and Foot Surgery, Dongying People's Hospital, Dongying 257091, Shandong Province, China.
World J Psychiatry. 2025 Sep 19;15(9):106196. doi: 10.5498/wjp.v15.i9.106196.
Postoperative anxiety, depression, irritability, and even fear in patients with intertrochanteric femoral fractures may hinder recovery, compromise treatment efficacy, and impede rehabilitation.
To investigate the correlations among anxiety, depression, sense of coherence (SOC), and post-traumatic growth (PTG) in patients who underwent intertrochanteric femoral fracture surgery to improve clinical management strategies and outcomes.
This study carefully selected 211 patients who received surgical treatment for intertrochanteric femoral fractures and were admitted to Dongying People's Hospital from March 2022 to March 2024. Anxiety and depression in these patients were assessed with the anxiety and depression subscales of the Hospital Anxiety and Depression Scale (HADS), respectively. SOC was evaluated using the 13-item SOC scale (SOC-13), which encompasses three key dimensions: Comprehensibility, manageability, and meaningfulness. PTG was assessed with the Chinese version of PTG Inventory (CPTGI), covering five distinct dimensions: Personal strength, appreciation of life, relating to others, new possibilities, and spiritual change. The Pearson correlation coefficient was used to meticulously analyze the associations among HADS-Anxiety, HADS-Depression, SOC-13, and CPTGI. Further, univariate and multivariate analyses were conducted to identify factors that affect PTG in patients who underwent intertrochanteric femoral fracture surgery.
The collected data demonstrated that 67.30% and 60.66% of the 211 patients experienced anxiety and depression, respectively, with overall anxiety levels ranging from mild to moderate and depression levels being mild. The mean SOC-13 score was 55.73 ± 8.81 points, indicating a generally low SOC level. The average CPTGI score was 54.93 ± 9.92 points, demonstrating a relatively low PTG level. Notably, both HADS-Anxiety and HADS-Depression scores were significantly negatively correlated with CPTGI, whereas SOC-13 scores were significantly positively correlated with CPTGI. Univariate and multivariate analyses identified the presence of comorbidities [odds ratio (OR) = 2.747, = 0.003], monthly household income (OR = 3.292, < 0.001), and exercise habits (OR = 4.651, < 0.001) as independent predictors of PTG in patients.
The results of this study indicate a significant negative correlation of anxiety and depression with PTG in patients after intertrochanteric femoral fracture surgery, whereas a significant positive association exists between SOC and PTG. This study helps more comprehensively understand the psychological status and recovery processes of such patients, thereby potentially providing valuable information for clinical practice and psychological interventions.
股骨粗隆间骨折患者术后的焦虑、抑郁、易怒甚至恐惧可能会阻碍康复，影响治疗效果，妨碍功能恢复。
探讨股骨粗隆间骨折手术患者焦虑、抑郁、心理一致感（SOC）与创伤后成长（PTG）之间的相关性，以改善临床管理策略和治疗效果。
本研究精心选取了2022年3月至2024年3月在东营市人民医院接受股骨粗隆间骨折手术治疗的211例患者。分别采用医院焦虑抑郁量表（HADS）的焦虑和抑郁分量表评估这些患者的焦虑和抑郁情况。使用包含可理解性、可管理性和有意义性三个关键维度的13项心理一致感量表（SOC-13）评估心理一致感。采用中文版创伤后成长量表（CPTGI）评估创伤后成长，该量表涵盖个人力量、对生活的欣赏、与他人的关系、新的可能性和精神变化五个不同维度。采用Pearson相关系数细致分析HADS焦虑、HADS抑郁、SOC-13和CPTGI之间的关联。此外，进行单因素和多因素分析以确定影响股骨粗隆间骨折手术患者创伤后成长的因素。
收集的数据显示，211例患者中分别有67.30%和60.66%经历了焦虑和抑郁，总体焦虑水平为轻度至中度，抑郁水平为轻度。SOC-13量表的平均得分为55.73±8.81分，表明心理一致感水平普遍较低。CPTGI量表的平均得分为54.93±9.92分，表明创伤后成长水平相对较低。值得注意的是，HADS焦虑和HADS抑郁得分均与CPTGI显著负相关，而SOC-13得分与CPTGI显著正相关。单因素和多因素分析确定合并症（比值比[OR]=2.747，P=0.003）、家庭月收入（OR=3.292，P<0.001）和运动习惯（OR=4.651，P<0.001）是患者创伤后成长的独立预测因素。
本研究结果表明，股骨粗隆间骨折手术后患者的焦虑和抑郁与创伤后成长显著负相关，而心理一致感与创伤后成长显著正相关。本研究有助于更全面地了解此类患者的心理状态和康复过程，从而可能为临床实践和心理干预提供有价值的信息。
