[Clinical study of psychological changes and post traumatic stress disorder in elderly patients with hip fracture]

Zhonghua Wai Ke Za Zhi. 2020 Mar 1;58(3):209-212. doi: 10.3760/cma.j.issn.0529-5815.2020.03.008.
[Article in Chinese]

Abstract

Objective: To explore the psychological state and affected factors of elderly patients with hip fractures. Methods: A retrospective analysis of 156 elderly hip fracture patients(>65 years) admitted to the Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University from January 2016 to August 2019 was performed. General and psychological information were collected by questionnaire.General information included age, gender, education, whether surgery, length of stay.SCL-90, a self-assessment scale, was chosen as the psychological test to analyzed the elderly hip fracture patients' psychological status during hospitalization and the norms of SCL-90 in Chinese which were established in 1986 were used as the control group. The prognostic factors were examined by univariate and multivariate analysis. Results: Somatization, interpersonal sensitivity, depression, anxiety, paranoid factor scores, and total scores of the elderly hip fracture patients were significantly higher than control group(all P=0.00).Univariate analysis and logistic regression analysis showed that non-surgery treatment and more than 10 days of hospitalization were independent prognostic factors that affected the psychological state of elderly hip fracture patients (all P=0.00). Conclusion: Elderly patients hospitalized with osteoporosis and hip fractures are prone to have negative emotional and psychological changes.The length of hospitalization and the choice of treatment can affect patients' psychological state, suggesting that effective psychological intervention is necessary.

目的: 探讨影响老年髋部骨折患者心理状态的因素。 方法: 对哈尔滨医科大学附属第一医院骨科2016年1月至2019年8月住院治疗的156例老年(年龄>65岁)髋部骨折患者行问卷调查,收集患者的一般资料和心理测试结果。一般资料包括年龄、性别、学历、是否手术、住院时间;心理测试采用SCL-90症状自评量表,以1986年中国健康成人SCL-90常模作为对照组,分析患者住院期间的心理状态。采用单因素分析和Logistic多元回归分析筛选影响老年髋部骨折患者心理状态的独立预后因素。 结果: 156例老年髋部骨折患者SCL-90评分躯体化、人际敏感、抑郁、焦虑、偏执因子分及总分均高于常模,差异均有统计学意义(P值均=0.00);单因素和多因素分析结果显示,未行手术治疗、住院时间≥10 d是引起老年髋部骨折患者的心理状态变化的独立预后因素(P=0.00)。 结论: 因髋部骨折住院的老年患者容易出现负性情绪心理变化,而住院时间长短及是否选择手术影响患者心理状态变化,应给予患者充分、有效的心理干预。.

Keywords: Elderly; Hip fracture; Influencing factors; Osteoporosis; Psychological state assessment.

MeSH terms

  • Aged
  • China
  • Hip Fractures / complications
  • Hip Fractures / psychology*
  • Hospitalization
  • Humans
  • Osteoporosis*
  • Retrospective Studies
  • Stress Disorders, Post-Traumatic / etiology*