| 张红玉,白雪竹,唐小娟,孔得宇,王雨生.老年髋部骨折患者术后目标导向性训练自我效能发展轨迹及其对下肢深静脉血栓的影响[J].老年医学与保健,2026,32(3):447-452 |
| 老年髋部骨折患者术后目标导向性训练自我效能发展轨迹及其对下肢深静脉血栓的影响 |
| Developmental trajectory of self-efficacy in elderly patients with hip fractures undergoing postoperative goal-oriented rehabilitation training and its effects on deep venous thrombosis in lower extremities |
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| DOI：10.3969/j.issn.1008-8296.2026.03.022 |
| 中文关键词: 髋骨折 目标导向性训练 自我效能 下肢深静脉血栓 |
| 英文关键词: hip fractures goal-directed rehabilitation training self-efficacy deep vein thrombosis |
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| 中文摘要: |
| 目的 探讨老年髋部骨折患者术后目标导向性康复训练自我效能的发展轨迹及其与下肢深静脉血栓的关联性.方法 回顾性分析2022 年5 月至2024 年3 月我院收治的87 例老年髋部骨折患者,根据自我效能发展轨迹分为提升组、波动组、下降组3 组.采用潜类别增长模型、Logistic 回归及 Cox 比例风险回归模型进行统计学分析.结果 术后 1 周、1 个月、3 个月和6 个月老年髋部骨折患者自我效能得分相关性均有统计学意义(P<0.05).提升组与波动组得分呈升高趋势,下降组得分呈递减趋势(均 P<0.01).术后1 周,波动组和下降组患者血小板、D-二聚体水平均高于提升组(P<0.01),凝血酶原时间、活化部分凝血活酶时间、凝血酶时间水平低于提升组(P<0.01).日常锻炼情况、经济状况及术后1 周凝血指标均是自我效能轨迹的影响因素.Cox 模型显示,自我效能发展轨迹对深静脉血栓风险的影响在不同年龄、性别、日常锻炼情况及经济状况中存在差异,女性、年龄≥70 岁、从不锻炼及低收入患者自我效能下降组的深静脉血栓风险升高(均 P<0.05).结论 目标导向性康复训练自我效能术后整体呈上升趋势,但存在不同发展轨迹,其中下降组自我效能降低,深静脉血栓发生风险加剧. |
| 英文摘要: |
| Objective To explore the developmental trajectory of self-efficacy in elderly patients with hip fractures undergoing postoperative goal-oriented rehabilitation training and its association with deep venous thrombosis(DVT)in the lower extremities.Methods A retrospective analysis was conducted on 87 elderly patients with hip fractures admitted between May 2022 and March 2024.The patients were divided into improvement group,fluctuation group and decline group according to their developmental trajectories.Statistical analysis was performed including latent class growth models,Logistic regression,and Cox proportional hazards regression models.Results There were statistically significant correlations in self-efficacy scores among elderly patients with hip fractures at 1 week,1 month,3 months,and 6 months after surgery(P<0.05).The scores in the improvement group and the fluctuation group showed an increasing trend,while the decline group showed a decreasing trend(all P<0.01).At 1 week after surgery,platelet counts and D-dimer levels in the fluctuation and decline groups were higher than those in the improvement group(P<0.01),while prothrombin time,activated partial thromboplastin time,and thrombin time were lower than those in the improvement group(P<0.01).Daily exercise status,economic status,and coagulation parameters at 1 week after surgery were all identified as influencing factors for the self-efficacy trajectories.Cox model demonstrated that the impact of developmental trajectories on the risk of DVT varied significantly across subgroups defined by age,gender,daily exercise status,and economic status.The elevated risk of DVT in the decline group was more pronounced among female patients,those aged≥70 years,individuals who never exercised,and those with low income(all P<0.05).Conclusion The self-efficacy of goal-oriented rehabilitation training after surgery shows an overall upward trend,but there are different developmental trajectories.The self-efficacy of the declining group decreases,and the risk of DVT increases. |
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