创伤性截肢患者术后早期残疾接受度的纵向研究 [中文引用][英文引用]

目的 了解创伤性截肢患者术后早期的残疾接受度现状，确定其影响因素，以制定针对性的临床护理干预策略。方法 采用便利抽样法，于 2023 年 2 月— 2024 年 2 月选取本市某三级甲等中医院骨伤科中心收治的 131 例创伤截肢患者作为研究对象，分别在患者截肢术后的 7d 内、1 个月及 3 个月采用一般资料调查表、残疾接受度量表（acceptance of disabilityscale-revised，ADS-R）和世界卫生组织残疾评定量表（World Health Organization disability assessment schedule 2.0，WHODAS 2.0）进行调查。纵向数据采用重复测量方差分析，变量间的相关性采用 Pearson 相关分析，采用多重线性回归分析功能状况与残疾接受度的相关性。结果 124 例患者完成研究。患者在 3 个时间点（术后 7d 内、1 个月、3 个月）的残疾接受度得分分别为（67.3±10.8）分、（72.7±10.4）分和（77.2±9.4）分，残疾接受度均呈中水平且逐渐上升趋势，各时间点得分两两比较均有统计学意义（均 P<0.05）；患者性别和截肢平面是残疾接受度的影响因素，残疾接受度得分与功能状况呈负相关。结论 创伤截肢患者术后早期残疾接受度中水平且随时间逐渐上升，临床需考虑性别、截肢平面对创伤截肢患者残疾接受度的影响和功能状况与残疾接受度的相关关系，参考患者残疾接受度的变化趋势，制定针对性干预策略，帮助患者提高残疾接受度以促进其康复。

Objective To examine the early acceptance of postoperative disability in patients with traumatic amputation and to identify the influencing factors, with the aim of developing tailored strategies for clinical nursing interventions. Methods A convenience sampling method was used to recruit 131 patients with traumatic amputation at a Tier-IIIA traditional Chinese medicine hospital in Foshan between February 2023 and February 2024. The patients were interviewed at 7 days, 1 month and 3 months after amputation using a general information questionnaire, the acceptance of disability scale-revised（ADS-R）and World Health Organization disability assessment schedule 2.0（WHODAS 2.0）. Longitudinal data were analysed using repeated-measures analysis of variance. Pearson correlation analysis was used to examine the correlations between disability acceptance score and functional status domain scores at different time points. Additionally, multiple linear regression analysis was performed to analyse the relationship between functional status and disability acceptance. Results Totally 124 patients finished the study. The scores of disability acceptance of patients at the three time points, at the seven days, one month, and three months after surgery, were 67.3±10.8, 72.7±10.4, and 77.2±9.4, respectively. Patients exhibited moderate disability acceptance across all the time points, with a gradual upward trend over time. Pairwise comparisons showed statistically significant differences between the three time points（P<0.05）. Gender and plane of amputation were the main factors influencing disability acceptance. Disability acceptance scores were negatively correlated with functional status. Conclusion Patients with traumatic amputation exhibit moderate early disability acceptance after surgery, which increases over time. In clinical practice, healthcare providers should tailor the relevant intervention strategies according to the effects of gender and plane of amputation on the disability acceptance as well as the associations between functional status and disability acceptance, in order to improve the disability acceptance of patients and promote the rehabilitation.