| 李佳雪,张远,侯国梁,等.人工髋关节置换术后患者家庭支持与康复锻炼依从性的纵向关系研究.骨科,2026,17(2): 153-159. |
| 人工髋关节置换术后患者家庭支持与康复锻炼依从性的纵向关系研究 |
| A longitudinal study on the relationship between family support and compliance with rehabilitation exercises in patients after artificial hip arthroplasty |
| 投稿时间：2025-07-27 |
| DOI：10.3969/j.issn.1674-8573.2026.02.011 |
| CN KeyWords: 人工髋关节置换术 家庭支持 康复锻炼依从性 交叉滞后模型 潜变量增长模型 |
| EN KeyWords: Artificial hip arthroplasty Family support Rehabilitative exercise adherence Cross-lagged model Latent variable growth model |
| Fund Project:“天山英才”医药卫生高层次人才培养计划（TSYC202301B091） |
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| CN Abstract: |
| 目的 探讨人工髋关节置换术后患者家庭支持与其康复锻炼依从性的相互预测关系及其各自随时间的变化趋势，为提高患者康复锻炼依从性提供理论依据。方法 2024年8月至12月，采用便利抽样法选取新疆乌鲁木齐四所三级甲等医院行初次人工髋关节置换术的316例患者为调查对象，采用一般资料调查表、家庭支持量表（PSS-Fa）、骨科病人功能锻炼依从性量表（FECS-OP），分别于出院前1~2 d（T1）、术后3个月（T2）、术后6个月（T3）进行调查，使用交叉滞后模型和潜变量增长模型进行数据分析。结果 交叉滞后模型显示，T1家庭支持正向预测T2康复锻炼依从性（β=0.223，P＜0.001），T2家庭支持正向预测T3康复锻炼依从性（β=0.188，P＜0.001）；同时，T1康复锻炼依从性正向预测T2家庭支持（β=0.372，P＜0.001），T2康复锻炼依从性正向预测T3家庭支持（β=0.224，P＜0.001)。无条件线性潜变量增长模型显示，家庭支持的发展程度（S=-0.310，P=0.001）和康复锻炼依从性的发展速度（S=-1.959，P＜0.001）均呈下降趋势。平行潜变量增长模型显示，家庭支持的初始水平可预测康复锻炼依从性的初始水平（β=0.907，P＜0.001）及发展速度（β=0.341，P＜0.05），家庭支持的发展速度可正向预测康复锻炼依从性的发展速度（β=0.737，P＜0.001）。结论 该研究证实人工髋关节置换术后患者家庭支持及康复锻炼依从性随时间的发展逐渐降低，家庭支持是康复锻炼依从性发展过程中的重要促进因素，而良好的康复锻炼依从性也可正向强化家庭支持。建议医护人员应早期积极引导患者及家属一同参与康复锻炼的计划与实施，动态关注在不同康复阶段患者和家属的参与情况，并制定精准化干预策略，从而有效提升患者的康复锻炼依从性。 |
| EN Abstract: |
| Objective To explore the development trajectories of family support and rehabilitation exercise compliance in patients after artificial hip arthroplasty and the predictive relationship between them, providing a theoretical basis for improving patients' compliance with rehabilitation exercises. Methods From August to December 2024, a convenience sampling method was used to select 316 patients who underwent primary artificial hip arthroplasty in four tertiary hospitals in Urumqi, Xinjiang. The General Information Questionnaire, Perceived Social Support from Family Scale, and Functional Exercise Compliance Scale for Orthopedic Patients were used to conduct surveys on the patients 1-2 days before discharge, 3 months after surgery, and 6 months after surgery. Cross-lagged models and latent growth models were used for data analysis. Results The cross-lagged model showed that during the three follow-up periods, T1 family support positively predicts T2 compliance with rehabilitation exercises (β=0.223, P＜0.001), and T2 family support predicts T3 compliance with rehabilitation exercises (β=0.188, P＜0.001); compliance with rehabilitation exercises also significantly positively predicts family support: T1 compliance with rehabilitation exercises positively predicts T2 family support (β=0.372, P＜0.001), and T2 compliance with rehabilitation exercises positively predicts T3 family support (β=0.224, P＜0.001). The unconditional linear latent growth model showed that both family support (S=-0.310, P＜0.001) and rehabilitation exercise compliance (S=-1.959, P＜0.001) showed a trend. The parallel latent growth model showed that the initial level of family support could predict the initial level of rehabilitation exercise compliance (β=0.907, P＜0.001) and the development speed (β=0.341, P＜0.05), and the development speed of family support could positively predict the development speed of exercise compliance (β=0.737, P＜0.001). Conclusion This study confirmed that both family support and rehabilitation exercise compliance in patients after artificial hip arthroplasty gradually decreased over time. Family support is an important promoting factor in the development process of rehabilitation exercise compliance, and good rehabilitation exercise compliance can also positively reinforce family support. It is suggested that medical staff should guide patients and their families to participate in the planning and implementation of rehabilitation exercises early, continuously pay attention to the conditions of patients and their families at different stages, and formulate personalized intervention strategies to effectively improve patients' compliance. |
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