妊娠期腰背痛影响因素的结构方程模型研究

发布时间：2018-06-04 03:56

本文选题：妊娠期 + 腰背痛　；参考：《杭州师范大学》2017年硕士论文

【摘要】：背景:妊娠期腰背痛是一种以疼痛为主诉的综合征,是在妊娠期出现的、没有前期腰部疾病基础的一种孕妇自感的腰、骶部疼痛或不适感,可伴有下肢的放射痛,且在妊娠中晚期疼痛程度尤为剧烈。作为孕妇常见的不适症状之一,腰背痛导致躯体功能和睡眠障碍,降低孕妇生活质量,增加不良分娩结局和产后抑郁的风险,孕妇病休带来社会经济损失,且对健康产生长期影响,而当前对妊娠期腰背痛尚无针对性的干预方法。通过妊娠期腰背痛影响因素研究的文献回顾,发现影响妊娠期腰背痛的因素众多,采用单因素分析、多因素分析等传统的统计学方法,难以全面探寻其影响因素和影响因素间的相互关系。目的:本研究以健康生态学模型为理论依据,基于国内外文献的综合回顾,构建妊娠期腰背痛孕妇影响因素模型,对妊娠期腰背痛孕妇健康问题开展深入的调查研究,为制订针对性的干预策略提供科学依据。方法:本研究为描述性研究,便利选取妊娠期腰背痛孕妇共420名作为研究对象。研究工具包括一般情况问卷、疼痛评估量表、孕期身体活动量表、社会支持评定量表和罗兰莫里斯功能障碍量表。调查问卷共计发放420份,回收389份,回收率为92.6%。采用Excel表格建立数据库,用SPSS19.0软件进行统计处理,采用Amos软件对妊娠期腰背痛的各维度影响因素进行结构方程模型拟合。结果:(1)本研究中妊娠期腰背痛孕妇疼痛最剧烈时疼痛数字评分均值为4.53,最轻微时均值为2.42,24小时平均疼痛均值为2.46。孕中、晚期腰背疼痛程度评分分别为2.52±1.28和2.88±1.55,差异具有统计学意义。功能障碍RMDQ评分为8.80±6.00,其中轻度功能障碍50.4%(评分1~7分),中度为37.8%(评分8~17分),重度为11.8%(评分18~24分)。(2)影响妊娠期腰背痛的因素包括个人特质、个人行为、社会家庭网络和工作生活条件四个维度,其影响标准化总效果值分别为0.347、-0.122、-0.144和0.363。结论:总体来说妊娠期腰背疼痛程度水平处于轻、中度;妊娠期腰背痛孕妇功能障碍中、重度程度者占有一定的比例,应引起重视。孕期身体活动多为低强度,缺乏中、高强度活动;妊娠期腰背痛孕妇社会支持水平偏低,低于国内其他健康孕妇社会支持总分。影响妊娠期腰背痛的因素包括个人特质、个人行为、工作生活条件和社会家庭网络等多方面的因素,可以直接或者通过功能障碍间接影响孕妇的疼痛程度,其中个人特质和工作生活条件两个维度影响最大,同时各影响因素之间存在相关性。
[Abstract]:Background: low back pain during pregnancy is a kind of syndrome with pain as the main complaint, which occurs during pregnancy. There is no basis for preterm waist disease in pregnant women with self-sensed waist, sacral pain or discomfort, which can be accompanied by radiation pain of lower extremities. And in the third trimester of pregnancy, the degree of pain is especially acute. As one of the common symptoms of discomfort in pregnant women, low back pain leads to somatic function and sleep disorders, reduces the quality of life of pregnant women, increases the risk of adverse outcome of childbirth and postpartum depression, and brings social and economic losses. And has a long-term impact on health, but the current low back pain in pregnancy there is no targeted intervention. Based on the literature review of the factors influencing low back pain during pregnancy, we found that there are many factors influencing low back pain in pregnancy. Traditional statistical methods, such as single factor analysis and multivariate analysis, are used. It is difficult to fully explore the relationship between its influencing factors and influencing factors. Objective: based on the theory of health ecology model and the comprehensive review of literatures at home and abroad, a model of influencing factors of pregnant women with low back pain during pregnancy was established to investigate the health problems of pregnant women with low back pain during pregnancy. To provide scientific basis for the formulation of targeted intervention strategies. Methods: a total of 420 pregnant women with low back pain during pregnancy were selected as descriptive study. The research tools included the General situation questionnaire, the pain Assessment scale, the pregnancy physical activity scale, the Social support rating scale and the Roland Morris dysfunction scale. A total of 420 questionnaires were distributed, 389 were recovered, and the recovery rate was 92.6. The database was established with Excel table, the statistical processing was done by SPSS19.0 software, and the structural equation model of influencing factors of low back pain during pregnancy was fitted by Amos software. Results in this study, the mean score of the number of pain in the pregnant women with low back pain was 4.53 when the pain was the most severe, and 2.42g / 24 hours with the mean of 2.466.Results the mean value of pain in pregnant women with low back pain was 4.53 and 2.42g / 24 hours respectively. In pregnancy, the scores of LBP were 2.52 卤1.28 and 2.88 卤1.55, respectively, and the difference was statistically significant. The RMDQ score of dysfunction was 8.80 卤6.00, among which 50.4 points (score 1 ~ 7), 37. 8% (score 8 ~ 17), 11. 8% (score 18 ~ 24 min. 2) in mild dysfunction affected personal traits and personal behavior, respectively, during pregnancy, and the main factors affecting low back pain during pregnancy were: 1 ~ 7, 37. 8% (score 8 ~ 17) and 11. 8% (score 18 ~ 24). There are four dimensions of social family network and working and living conditions, and the total effect values of the influence standardization are 0.347 ~ 0.122 ~ (-0.144) and 0.363 respectively. Conclusion: in general, the level of lumbar and back pain in pregnancy is mild to moderate, and in pregnant women with low back pain, serious degree occupies a certain proportion and should be paid attention to. Pregnancy physical activity is mostly low intensity, lack of medium and high intensity activity; pregnant women with low back pain pregnant women's social support level is low, lower than the total score of other healthy pregnant women in China. Factors affecting low back pain during pregnancy include personal traits, personal behavior, working and living conditions, and social and family networks, which can directly or indirectly affect the degree of pain in pregnant women, either directly or indirectly through dysfunction. The two dimensions of personal trait and work-life condition have the greatest influence, and there are correlations among the factors.
【学位授予单位】：杭州师范大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.71

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