Objective To explore the relationship between kinesiophobia, psychological resilience, and rehabilitation self-efficacy in postoperative patients with lumbar disc herniation (LDH) and constructing a nomogram prediction model for postoperative kinesiophobia. Methods LDH patients admitted to Shengjing Hospital of China Medical University between July 2021 and June 2024 were selected. Patients with LDH were assessed using a general information questionnaire, the Tampa Scale for Kinesiophobia, the Connor-Davidson Resilience Scale, and the Self-Efficacy for Rehabilitation Outcome Scale. Logistic regression was used to analyze the influencing factors of kinesiophobia in postoperative LDH patients, and a nomogram prediction model was constructed based on these factors. Results A total of 256 LDH patients were included. Among them, the average kinesiophobia score was (38.16±4.24) points, the average psychological resilience score was (55.36±4.26) points, and the average rehabilitation self-efficacy score was (96.06±6.06) points. Kinesiophobia was present in 149 patients (58.20%) after surgery. Kinesiophobia showed a negative correlation with both psychological resilience and rehabilitation self-efficacy (P<0.01). The results of multiple logistic regression analysis showed that, Age≥60 years, female gender, lack of pain guidance, low psychological resilience score, and low rehabilitation self-efficacy score were identified as independent risk factors for kinesiophobia in postoperative patients with lumbar disc herniation (P<0.05). The validation results of the nomogram model showed a C-index of 0.809, with the calibration curve approaching the ideal curve, and an area under the curve of 0.811. Conclusions Age ≥60 years, female gender, lack of pain guidance, low rehabilitation self-efficacy scores, and low rehabilitation self-efficacy scores were significantly associated with the risk of kinesiophobia in postoperative patients with LDH. The nomogram model constructed based on these factors demonstrated good predictive value for the occurrence of kinesiophobia in these patients.
目的 探討聯合腦卒中單元在老年腦卒中患者中應用研究。 方法 選擇2003年7月－2011年7月在我院住院的60歲以上的260例急性腦卒中患者，隨機分為聯合腦卒中單元組和普通病房治療組各130例，兩組均采用常規內科或手術治療，聯合腦卒中單元組除常規內科或手術治療外，入院后病情平穩24～48 h后偏癱患者給予運動康復訓練，吞咽障礙患者給予吞咽康復訓練，抑郁患者給予心理康復治療3個月。對聯合腦卒中單元/普通病房治療兩組患者在治療前及治療后分別采用改良的巴氏指數測定日常生活能力和漢密頓抑郁量表評分，并進行統計學分析。 結果 聯合腦卒中單元組改良的巴氏指數測定日常生活能力、漢密頓抑郁量表評分均有明顯改善，與普通病房治療組比較，差異有統計學意義（P＜0.05）。 結論 聯合腦卒中單元對老年腦卒中后偏癱、吞咽障礙、抑郁患者有明顯的干預作用，治療效果優于普通病房治療組。