老年腰椎间盘突出患者希望水平的影响因素及心理干预的临床观察

Clinical observation of influencing factors of hope level and psychological intervention in elderly patients with lumbar disc her-niation

中文关键词: 老年  腰椎间盘突出症  希望水平  心理干预  干预效果

英文关键词: elderly  lumbar disk herniation  hope level  psychological intervention  intervention effect

中文摘要:

      目的 观察老年腰椎间盘突出(LDH)患者希望水平的影响因素以及心理干预的效果.方法 回顾性选取2023年1月—2024年12月安徽中医药大学第二附属医院诊疗的160例老年LDH患者,根据希望水平为高水平组(n=94)和中低水平组(n=66).采用单因素和多因素Logistic回归分析探讨其影响因素,受试者工作特征(ROC)曲线分析相关因素的预测价值.将中低水平组的患者随机分为对照亚组(n=33)与干预亚组(n=33),对照亚组接受常规干预,干预亚组在对照亚组基础上提供心理干预.比较干预前后2组患者的希望水平、焦虑抑郁情况、心理弹性和睡眠质量.结果 家庭每月人均收入、社会支持、慢性疼痛自我效能感、医疗付费方式和腰椎功能评分是老年LDH患者希望水平的危险因素;5者联合的ROC曲线下面积(AUC)为0.875.中低水平组患者进行心理干预后,干预亚组患者希望水平、焦虑抑郁情况、心理弹性、睡眠质量和腰椎功能评分的干预效果均优于对照亚组,差异均有统计学意义(P＜0.05).结论 家庭每月人均收入、社会支持、慢性疼痛自我效能感、医疗付费方式和腰椎功能评分是老年LDH患者希望水平的影响因素,心理干预能够提升老年LDH患者的临床治疗效果.

英文摘要:

      Objective To explore the influencing factors of hope level in elderly patients with lumbar disc herniation(LDH)and the effects of psychological intervention.Methods A total of 160 elderly LDH patients treated in Second Affilia-ted Hospital of Anhui University of Chinese Medicine from January 2023 to December 2024 were selected.According to their hope level,they were divided into high-level group(n=94)and medium-low level group(n=66).Univariate and multivari-ate Logistic regression analyses were used to explore the influencing factors,and receiver operating characteristic(ROC)curve analysis was applied to evaluate the predictive value of related factors.Patients in the medium-low-level group were randomly divided into control subgroup(n=33)and intervention subgroup(n=33).The control subgroup received conventional inter-vention,while the intervention subgroup received additional psychological intervention on the basis of the control subgroup.Hope levels,anxiety and depression,psychological resilience,and sleep quality were compared between the two subgroups be-fore and after the intervention.Results Monthly household income per capita,social support,chronic pain self-efficacy,medical payment method and lumbar function score were independent risk factors for hope level in elderly LDH patients.The area under the ROC curve(AUC)of the combination of these five factors was 0.875.Compared with the control subgroup,the intervention subgroup showed significantly better outcomes in hope level,anxiety and depression,psychological resilience,sleep quality,and lumbar function score after psychological intervention,with statistically significant differences(P＜0.05).Conclusion Monthly household income per capita,social support,chronic pain self-efficacy,medical payment method,and lumbar function score are influencing factors of hope level in elderly LDH patients.Psychological intervention can improve the clinical treatment efficacy in these patients.