帕金森病患者功能锻炼依从性及影响因素分析
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摘要
目的了解帕金森病(PD)患者功能锻炼的依从性及其影响因素。方法选取在攀钢集团总医院神经内科就诊的108例PD患者,采用一般资料调查表、简易精神状态检查表、汉密尔顿抑郁量表、汉密尔顿焦虑量表和功能锻炼依从性问卷进行调查,采用多重线性回归模型分析PD患者功能锻炼依从性的影响因素。结果 108例PD患者的功能锻炼依从性得分为(36.88±4.62)分,身体锻炼依从、锻炼监测依从、寻求建议依从和注意事项依从4个维度的得分分别为(15.65±1.92)、(9.61±1.48)、(5.67±1.08)和(5.95±1.18)分。多重线性回归分析结果显示,学历(β'=0.748)、患病时间(β'=-0.252)、Hoehn-Yahr分期(β'=-0.677)、接受康复指导(β'=0.293)、生活自理程度(β'=0.313)、主要照顾者(β'=0.182)、认知功能障碍(β'=0.745)、抑郁(β'=0.588)和焦虑(β'=0.520)是PD患者功能锻炼依从性的影响因素(均P<0.05)。结论 PD患者的功能锻炼依从性较差;患者学历、患病时间、Hoehn-Yahr分期、接受康复指导、生活自理程度、主要照顾者、认知功能障碍、抑郁和焦虑是功能锻炼依从性的影响因素。
Objective To explore the compliance of functional exercise and related factors in patients with Parkinson's disease(PD). Methods A total of 108 PD patients were selected from Department of Neurology of General Hospital of Panzhihua Iron and Steel Group. An anonymous survey was conducted with general questionnaire, Mini-Mental State Examination,Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and functional exercise compliance questionnaire.Multivariate linear regression model was used to analyze the influencing factors for the scores o f functional exercise compliance in PD patients. Results The total score of functional exercise compliance of 108 PD patients was 36.88 ±4.62.The scores of compliance of physical exercise, exercise monitoring, seeking advice and tips for attention were 15.65 ±1.92,9.61±1.48,5.67±1.08 and 5.95±1.18,respectively. The results of multivariate linear regression analysis showed that educational background(β' =0.748), duration of illness(β'=-0.252),Hoehn-Yahr stage(β'=-0.677),rehabilitation guidance(β'=0.293),self-care ability(β'=0.313), primary caregiver(β' =0.182), cognitive dysfunction(β' =0.745), depression(β' =0.588)and anxiety(β' =0.520)could affect the compliance of functional exercise among PD patients(all P<0.05). Conclusion The compliance of functional exercise among PD patients was at low level, with educational background, duration of illness,Hoehn-Yahr stage, rehabilitation guidance, self-care ability, primary caregiver, cognitive dysfunction, depression and anxiety as the influencing factors.
Objective To explore the compliance of functional exercise and related factors in patients with Parkinson's disease(PD). Methods A total of 108 PD patients were selected from Department of Neurology of General Hospital of Panzhihua Iron and Steel Group. An anonymous survey was conducted with general questionnaire, Mini-Mental State Examination,Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and functional exercise compliance questionnaire.Multivariate linear regression model was used to analyze the influencing factors for the scores o f functional exercise compliance in PD patients. Results The total score of functional exercise compliance of 108 PD patients was 36.88 ±4.62.The scores of compliance of physical exercise, exercise monitoring, seeking advice and tips for attention were 15.65 ±1.92,9.61±1.48,5.67±1.08 and 5.95±1.18,respectively. The results of multivariate linear regression analysis showed that educational background(β' =0.748), duration of illness(β'=-0.252),Hoehn-Yahr stage(β'=-0.677),rehabilitation guidance(β'=0.293),self-care ability(β'=0.313), primary caregiver(β' =0.182), cognitive dysfunction(β' =0.745), depression(β' =0.588)and anxiety(β' =0.520)could affect the compliance of functional exercise among PD patients(all P<0.05). Conclusion The compliance of functional exercise among PD patients was at low level, with educational background, duration of illness,Hoehn-Yahr stage, rehabilitation guidance, self-care ability, primary caregiver, cognitive dysfunction, depression and anxiety as the influencing factors.
引文
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[13]李姿慧,吴梦蝶,李琪,等.汉密尔顿焦虑量表和焦虑自评量表在功能性消化不良伴焦虑状态中的应用[J].长春中医药大学学报,2018,34(4):787-790.
[14]岳丽春,唐浪娟,谌秘,等.帕金森病患者自我健康管理问卷的研制及信效度检验[J].中国全科医学, 2016, 19(27):3341-3345.
[15]胡爽爽,宋永霞,洪静芳.乳腺癌患者术后功能锻炼依从性影响因素的研究进展[J].中华护理杂志,2014,49(7):854-858.
[16]陈敏,孙涛,张小乔,等.心理干预对帕金森病伴抑郁患者的疗效及生活质量的影响[J].神经损伤与功能重建,2018,13(4):213-214.
[17]曹冰莹,那建华,龚丽.帕金森病手术后患者主要照顾者健康相关需求的质性研究[J].中国康复理论与实践,2016,22(9):1107-1109.
[18] ATTERBURY E M, WELMAN K E. Balance training in individuals with Parkinson's disease:therapist-supervised vs.home-based exercise programme[J]. Gait&Posture, 2017, 55:138-144.
[19] COSENTINO C, NUNEZ Y, TORRES L. Frequency of non-motor symptoms in Peruvian patients with Parkinson's disease[J]. Arquivos De Neuro-psiquiatria, 2013, 71(4):216-219.
[20] SOURANI D,EITAN R,GORDON N,et al. The habenula couples the dopaminergic and the serotonergic systems:application to depression in Parkinson's disease[J]. European Journal of Neuroscience,2012,36(6):2822-2829.
[21]李金虹,钱进,富欣然,等.帕金森病患者焦虑及抑郁与其他症状关系的研究[J].中国全科医学,2016,19(17):2002-2006.
[2]刘疏影,陈彪.帕金森病流行现状[J].中国现代神经疾病杂志,2016,16(2):98-101.
[3]侯杰,尹安春,曲晓彤,等.帕金森病康复运动训练现状与展望[J].护理研究(中旬版),2015,29(12):4357-4360.
[4]于梅,李连涛,董同宝,等.强化核心肌力训练对帕金森病康复的效果[J].广东医学,2015,36(1):77-79.
[5]宋金辉,王普清,罗韵文,等.减重步行训练配合节律性听觉刺激及视觉刺激对帕金森病患者步态的影响[J].中国现代医学杂志,2015,25(7):87-91.
[6]崔立玲,于洋,王,等. Valpar训练系统对帕金森病患者的疗效[J].中国康复理论与实践,2018,24(7):767-772.
[7]沈周,朱玉连,蒋雨平,等.康复管理结合运动疗法对帕金森病患者步行及平衡功能的作用[J].中国临床神经科学,2011, 19(4):387-392.
[8]刘利,谢雯,陈丽,等.运动训练对帕金森病非运动症状的改善作用研究[J].中国实用神经疾病杂志,2017,20(24):40-43.
[9]中华医学会神经病学分会帕金森病及运动障碍学组.中国帕金森病的诊断标准(2016版)[J].中华神经科杂志,2016,49(4):268-271.
[10]沈吉康,叶民,刘卫国,等.帕金森病非运动症状的临床研究[J].临床神经病学杂志,2010,23(4):251-253.
[11]周小炫,谢敏,陶静,等.简易智能精神状态检查量表的研究和应用[J].中国康复医学杂志,2016,31(6):694-696,706.
[12]赵世苗,秦国兴,陈军良,等.基于评估的治疗管理模式对抑郁症患者的疗效研究[J].预防医学,2016,28(5):469-472.
[13]李姿慧,吴梦蝶,李琪,等.汉密尔顿焦虑量表和焦虑自评量表在功能性消化不良伴焦虑状态中的应用[J].长春中医药大学学报,2018,34(4):787-790.
[14]岳丽春,唐浪娟,谌秘,等.帕金森病患者自我健康管理问卷的研制及信效度检验[J].中国全科医学, 2016, 19(27):3341-3345.
[15]胡爽爽,宋永霞,洪静芳.乳腺癌患者术后功能锻炼依从性影响因素的研究进展[J].中华护理杂志,2014,49(7):854-858.
[16]陈敏,孙涛,张小乔,等.心理干预对帕金森病伴抑郁患者的疗效及生活质量的影响[J].神经损伤与功能重建,2018,13(4):213-214.
[17]曹冰莹,那建华,龚丽.帕金森病手术后患者主要照顾者健康相关需求的质性研究[J].中国康复理论与实践,2016,22(9):1107-1109.
[18] ATTERBURY E M, WELMAN K E. Balance training in individuals with Parkinson's disease:therapist-supervised vs.home-based exercise programme[J]. Gait&Posture, 2017, 55:138-144.
[19] COSENTINO C, NUNEZ Y, TORRES L. Frequency of non-motor symptoms in Peruvian patients with Parkinson's disease[J]. Arquivos De Neuro-psiquiatria, 2013, 71(4):216-219.
[20] SOURANI D,EITAN R,GORDON N,et al. The habenula couples the dopaminergic and the serotonergic systems:application to depression in Parkinson's disease[J]. European Journal of Neuroscience,2012,36(6):2822-2829.
[21]李金虹,钱进,富欣然,等.帕金森病患者焦虑及抑郁与其他症状关系的研究[J].中国全科医学,2016,19(17):2002-2006.