COVID-19大流行對膝骨關節炎老人術前健康相關生活品質的衝擊

Impact of the COVID-19 Pandemic on Health-Related Quality of Life in Older Adults With Preoperative Knee Osteoarthritis

背景：膝骨關節炎（knee osteoarthritis）是全球老人常見的疾病，COVID-19疫情下生活品質受影響。
目的：本研究目的探討COVID-19疫情下，膝骨關節炎老人等待膝關節置換術前的關節炎嚴重度與健康相關生活品質現況及生活品質預測因子。
方法：採橫斷式相關性研究設計，方便取樣，2020年6月至2021年6月於中部某區域教學醫院骨科病房收案。測量工具包含關節炎嚴重度量表（Western Ontario and McMaster Universities Osteoarthritis Index）、健康相關生活品質量表。統計分析以皮爾森積差相關分析、獨立t檢定及單因子變異數分析基本屬性、關節炎嚴重度與生活品質相關性，多元逐步迴歸分析其生活品質預測因子。
結果：本研究共收案60位，平均年齡70歲。膝骨關節炎嚴重度平均分數為70.45分。男性、有共病症及每月可支配收入越多者，生理範疇生活品質比較差。然而，膝蓋疼痛、僵硬及身體功能受限越嚴重，心理範疇生活品質越佳。
結　論／實務應用COVID-19大流行期間，老人膝骨關節炎的嚴重度會影響術前的生活品質。臨床人員應及早偵測出並提供照護介入以改善術前生活品質。

Background: Knee osteoarthritis is prevalent in older adults worldwide. Quality of life was negatively affected by the COVID-19 pandemic.
Purpose: This study was designed to examine osteoarthritis severity and health-related quality of life (QOL) in older adults with knee osteoarthritis before total knee replacement during the COVID-19 pandemic and to identify the related predictors of QOL.
Methods: This cross-sectional correlation study involved convenience sampling in the orthopedic ward of a regional teaching hospital in central Taiwan from June 2020 to June 2021 using the Western Ontario and McMaster Universities Arthritis Index and the SF-36v2 Health Survey. The data were analyzed using Pearson’s correlation coefficient analysis, independent samples t test, and one-way analysis of variance to determine correlations among demographic variables, osteoarthritis severity, and QOL. The predictors of QOL were examined using stepwise multiple linear regression analysis.
Results: A total of 60 older adults diagnosed with knee osteoarthritis were sampled. The average age was 70 years and the average osteoarthritis severity score was 70.45. Being male, having comorbidities, and having a relatively high level of monthly disposable income were associated with poorer QOL. Moreover, more severe knee pain, stiffness, and physical dysfunction were associated with better psychological QOL.
Conclusions/ Implications for Practice: During the COVID-19 pandemic, the severity of knee osteoarthritis affects preoperative quality of life in older adults. Clinicians should detect signs of pain and physical dysfunction in these patients in advance and intervene in a timely manner to improve their QOL before surgery.