女性人工股関節全置換術患者が主観的に評価する歩容とその影響要因

Subjective Evaluation of Gait by Female Subjects Undergoing Total Hip Arthroplasty and Factors Influencing Gait in These Patients

要旨

　本研究の目的は，女性人工股関節全置換術（total hip arthroplasty：以下THA）患者が主観的に評価する歩容に影響する要因とその影響の強さを明らかにすることである．THA術前と術後の女性患者112名に調査を実施し，歩容を目的変数，各影響要因を説明変数として，ステップワイズ重回帰分析にて検討した．その結果，THA患者が主観的に評価する歩容に影響する要因は，疼痛（β＝0.420），脚長差（β＝−0.271），歩行能力（β＝0.240），自尊感情（β＝0.131）の4項目が認められ，これらの変数で分散の57.9％が説明された．したがって，THA患者の主観に沿ったリハビリテーションの動機付けや，回復意欲向上への看護介入として，患者が主観的に評価する歩容を理解するために，疼痛，脚長差，歩行能力，自尊感情をアセスメントする必要性が示唆された．

　This study was carried out to identify the factors influencing a subjective evaluation of gait by female subjects undergoing total hip arthroplasty (hereafter THA), and to understand the extent to which each of these factors affects gait in these patients. A survey was administered to 112 female patients before and after THA. A stepwise multiple regression analysis was performed using gait as dependent variable and factors influencing gait as explanatory variables. The following factors were found to influence the subjective evaluation of gait by female subjects undergoing THA: pain (β＝0.420), leg length discrepancy (LLD) (β＝−0.271), walking ability (β＝0.240) and self-esteem (β＝0.131). These variables explained 57.9% of the variance. Findings from the present research suggest that a proper understanding of a subjective evaluation of gait requires the evaluation of pain, LLD, walking ability, and self-esteem of each patient. This understanding will, in turn, help us motivate THA patients for their rehabilitation taking into account their subjective concerns, which at the same time will allow us to provide nursing interventions that encourage patients to become more active in their own recovery process.