腰椎滑脫病人術前失能情形及其影響因素探討

Preoperative Disability and Its Influencing Factors in Patients With Lumbar Spondylolisthesis

背景：腰椎滑脫的病人在接受手術治療前，大多經歷長達數月至數年的不適症狀，且有不同程度的失能情形，探討失能情形之影響因素，有助於發展有效之預防措施。目的：探討腰椎滑脫病人術前失能情形的重要預測因子。方法：本研究採預測相關性研究設計，以方便取樣，於臺灣北部某醫學中心招募86位腰椎滑脫術前病人。以問卷進行資料收集，內容包括疼痛數字等級量表、修正版簡式老年憂鬱量表及歐氏失能量表。結果：研究對象平均失能指數為48.52（SD=16.14）分。多元線性迴歸分析結果顯示下背痛、憂鬱、年齡和性別為失能嚴重程度之重要預測因子，共可解釋40.9%之變異量。女性、年長、下背疼痛及憂鬱程度高的腰椎滑脫病人有較高的失能嚴重度。結論：實務應用女性、高齡、下背疼痛和憂鬱情緒的腰椎滑脫術前病人為失能的高危險群，應積極評估並給予適當的護理指導，以期得到較佳的生活品質。

Background: Patients with lumbar spondylolisthesis typically suffer from symptom discomfort and various degrees of disability for months or years prior to receiving surgical treatments. Knowing the factors that influence the disability status of these patients will help healthcare providers develop effective preventive measures. Purpose: To explore preoperative disability and its important predictive factors in patients with lumbar spondylolisthesis Methods: A predictive correlational design was used and a convenience sample of eighty-six lumbar spondylolisthesis preoperative patients were recruited from a medical center in northern Taiwan. Data were collected using a study questionnaire, which included the Oswestry disability index, the revised geriatric depression scale-short form, and a pain numeric rating scale. Results: The average disability index of the participants was 48.52 (SD = 16.14). The multiple linear regression analyses identified lower back pain, depression, age, and gender as significant predictors of preoperative disability, collectively explaining 40.9% of the variation in disability severity. Being female, being older, having a higher degree of lower back pain, and having depression were significantly associated with preoperative disability. Conclusions/Implications for Practice: The results of the present study indicate that lumbar spondylolisthesis patients who are older in age, female, currently experiencing lower back pain, and suffering from depression face a higher risk of preoperative disability. Patients in these at-risk categories should be assessed actively and provided with appropriate patient education in order to enhance their quality of life.