女性変形性股関節症患者の術前後の歩容の自己評価と心理社会的側面の検討—人工股関節全置換術患者と低侵襲寛骨臼骨切り術患者の比較

Pre- and Post-Surgery Gait Self-Assessments and the Psychosocial Aspects of Female Hip Osteoarthritis Patients: Comparison of Total Hip Arthroplasty Patients and Spherical Periacetabular Osteotomy Patients

要旨

目的：女性変形性股関節症患者の術前後の歩容の自己評価と心理社会的側面を，人工股関節全置換術（THA）患者と低侵襲寛骨臼骨切り術（SPO）患者の2つの視点から比較し検討した．

方法：術後6〜12ヶ月の女性THA患者とSPO患者に無記名自記式質問紙調査を行い，術前と術後の歩容の自己評価と心理社会的側面を比較した．

結果：THA患者70名，SPO患者10名から回答を得た．THA患者とSPO患者の歩容の自己評価はともに術前より術後に改善した．術前の歩容の自己評価と関連したのは，THA患者は跛行への思いと杖歩行への思い，抑うつであった．術後の歩容の自己評価と関連したのは，THA患者は自尊感情と抑うつ，公的自己意識，全体的健康感で，SPO患者は全体的健康感のみであった．

結論：女性変形性股関節症患者の歩容の自己評価をアセスメントすることは心理社会的側面の支援の一助となると示唆された．術式によって関係する心理社会的側面の項目には違いがあり，各々の時期や特徴に合わせたケアの必要性が考えられた．

Purpose: This study examined gait self-assessments and the psychosocial aspects of female patients with hip osteoarthritis pre- and post-surgery, comparing perspectives from patients with total hip arthroplasty (THA) and patients with Spherical Periacetabular Osteotomy (SPO).

Method: An anonymous self-response questionnaire survey was conducted with female THA patients and female SPO patients 6 to 12 months post-surgery and the self-assessment and psychosocial aspects of the patients' gaits pre- and post-surgery were compared.

Results: Responses were received from 70 THA patients and 10 SPO patients. For both THA and SPO patients, gait self-assessments were significantly higher post-surgery. The pre-surgery gait self-assessments were related to feelings of claudication, a feeling about walking with the aid of a stick, and depression in THA patients. The post-surgery gait self-assessments were related to self-esteem, depression, public self-consciousness, and general health perceptions (GH) in THA patients, and overall GH in SPO patients.

Conclusion: This suggested that assessing the gait self-assessment of female patients with hip osteoarthritis would help to provide psychosocial supports. However, there were differences in the psychosocial factors that relate to gait self-assessment. This suggests that it is necessary for care to be adapted to the period of time in relation to surgery and the characteristics of each patient.