Abstract:

Objective　To analyze the current status of self-transcendence level in patients with knee osteoarthritis after knee joint replacement surgery, and explore the influencing factors of patients' self-transcendence level. Methods　A total of 133 patients who were diagnosed with knee osteoarthritis and planned to undergo knee joint replacement surgery in Zhengzhou Orthopaedic Hospital from May 2021 to February 2024 were included as the study subjects, including 56 males and 77 females, aged (63.56±5.12) years, with a body mass index of (24.51±3.27) kg/m² and a course of disease of (55.58±12.12) months, 82 cases of single knee and 51 cases of both knees. The score of Self-Transcendence Scale (STS) on the 7th day after surgery was recorded, and the factors influencing the level of patients' postoperative self-transcendence were analyzed. Independent sample t test, one-way analysis of variance, and multiple linear regression analysis were used for statistical analysis. Results　The STS score of the 133 patients with knee osteoarthritis after knee joint replacement surgery was (38.04±5.26) points, among them 123 patients were at a low level, accounting for 92.48% (123/133). The STS score of the patients with >55 months of disease course was lower than that of the patients with ≤55 months of disease course [(35.06±4.12) points vs. (42.39±3.37) points] (t=10.816, P<0.001); the STS score of the patients with acute pain after surgery was lower than that of the patients without acute pain [(36.17±5.61) points vs. (39.02±4.81) points] (t=3.066, P=0.003); the STS score of the patients with self-perceived burden after surgery was lower than that of the patients without self-perceived burden [(36.68±5.17) points vs. (38.71±5.20) points] (t=2.118, P=0.036); the STS score of the patients with low social support was lower than that of the patients with good social support [(35.66±4.97) points vs. (39.77±4.79) points] (t=4.804, P<0.001). Linear regression analysis found that disease course, postoperative acute pain, self-perceived burden, and social support were all influencing factors of self-transcendence in patients with knee osteoarthritis after knee joint replacement surgery (all P<0.05), and the linear regression equation was obtained: Y_{STS score} = 43.588 -6.558X_{disease course} -1.377X_{postoperative acute pain} -1.541X_{self-perceived burden} -1.589X_{social support}. Conclusions　The self-transcendence in patients with knee osteoarthritis after knee joint replacement surgery is generally at a low level, which may be related to the patients' disease course, postoperative acute pain, self-perceived burden, and social support level. For patients with long disease course, postoperative acute pain, heavy self-perceived burden, and low social support level, clinical attention should be paid to and reasonable interventions should be carried out.

Key words:

Knee osteoarthritis, Knee joint replacement surgery, Self-transcendence, Self-perceived burden, Social support

摘要：

目的　分析膝骨关节炎患者膝关节置换术后自我超越水平，探讨其影响因素。方法　纳入2021年5月至2024年2月郑州市骨科医院确诊膝骨关节炎并拟行膝关节置换术的133例患者作为研究对象，男56例，女77例，年龄（63.56±5.12）岁，体重指数（24.51±3.27）kg/m²，病程（55.58±12.12）个月，单膝82例，双膝51例。记录患者术后第7天自我超越水平［自我超越量表（Self-Transcendence Scale，STS）］，分析患者术后自我超越水平的影响因素。统计学方法采用独立样本t检验、单因素方差分析、多元线性回归分析。结果　133例膝骨关节炎患者膝关节置换术后STS评分为（38.04±5.26）分，其中123例患者处于低水平，占92.48%（123/133）。病程>55个月患者的STS评分低于病程≤55个月患者［（35.06±4.12）分比（42.39±3.37）分］（t=10.816，P<0.001）；术后存在急性疼痛患者的STS评分低于无急性疼痛患者［（36.17±5.61）分比（39.02±4.81）分］（t=3.066，P=0.003）；术后有自我感受负担患者的STS评分低于无自我感受负担患者［（36.68±5.17）分比（38.71±5.20）分］（t=2.118，P=0.036）；社会支持低下患者的STS评分低于社会支持良好患者［（35.66±4.97）分比（39.77±4.79）分］（t=4.804，P<0.001）。线性回归分析发现，病程、术后急性疼痛、自我感受负担、社会支持均是膝骨关节炎患者膝关节置换术后自我超越的影响因素（均P<0.05），得到线性回归方程：Y_STS评分=43.588-6.558X_病程-1.377X_{术后急性疼痛}-1.541X_{自我感受负担}-1.589X_社会支持。结论　膝骨关节炎患者膝关节置换术后自我超越普遍处于低水平，可能与患者病程、术后急性疼痛、自我感受负担、社会支持水平有关；对于病程长、术后伴急性疼痛、自我感受负担重、社会支持低下的患者，应引起临床重视，展开合理干预。

关键词:

膝骨关节炎, 膝关节置换, 自我超越, 自我感受负担, 社会支持