| Objective1.To investigate the status quo of self-regulated fatigue,self-efficacy and social participation in elderly patients three months after total knee replacement.2.To explore the relationship between self-regulated fatigue,self-efficacy and social participation in elderly patients with total knee replacement,and to study the mediating role of self-regulated fatigue and social participation in order to provide theoretical basis for promoting the early return to society in elderly patients with total knee replacement.MethodsA total of 192 patients who underwent total knee replacement in the Department of Joint surgery in a third-class A hospital in Dalian,Liaoning Province from November2021 to October 2022 were selected as the research objects.The cross-sectional research method was adopted,and the general situation questionnaire,self-participation questionnaire,self-regulation fatigue scale and general self-efficacy scale were used for the investigation.The data were checked by two persons and sorted into Excel.Descriptive analysis,T-test,Stepwise regression analysis and Pearson correlation analysis were conducted on the data by SPSS26.0.Amos28.0 was used to construct a structural equation model to analyze the relationship among self-regulation fatigue,self-efficacy and social participation.Results1.Three months after total knee replacement in elderly patients,the score of selfregulation fatigue was(43.28±6.37);Self-efficacy score(20.08±5.81);Social participation score(42.52±8.96).2.This study found a positive correlation between self-regulated fatigue and social participation three months after total knee replacement in elderly patients.Was negatively correlated with self-efficacy.There was a significant negative correlation between self-efficacy and social participation.3.Age,average monthly family income and living status(P<0.05)were the influencing factors of social participation in elderly patients with total knee replacement.Stepwise regression analysis showed that living status,self-efficacy and self-regulation fatigue were the main influencing factors of social participation in elderly total knee replacement patients(P<0.05),together accounting for 39% of the variation.4.Results of mediating effect test: The mediating effect of self-efficacy between self-regulatory fatigue and social participation in elderly total knee replacement patients was a partial mediating effect,accounting for 26.66% of the total effect.5.AMOS was used to construct the structural equation model,and the fitting indexes were CMIN/DF=1.612,GFI=0.967,CFI=0.981,AGFI=0.925,IFI=0.981,RMSEA=0.057,respectively.The model fit was good and the model was acceptable.Applying Bootstrap to test the mediation effect,95% confidence intervals of total effect,direct effect and indirect effect didn’t include 0.Therefore,self-efficacy played a partial mediating role in the relationship between self-regulation fatigue and social participation.Conclusion1.The social participation of elderly total knee replacement patients is at a medium level and needs to be improved.Age,living condition and average monthly family income are the general influencing factors of patients’ social participation.Patients’ selfregulated fatigue was at a moderate level,and the higher the level of self-regulated fatigue,the lower the level of social participation.The level of patients’ self-efficacy needs to be improved.The higher the level of patients’ self-efficacy,the higher the degree of their social participation.2.Self-efficacy plays a partial mediating role between self-regulatory fatigue and social participation in elderly total knee replacement patients,and indirectly affects the level of social participation of patients.Clinical nurses should develop personalized intervention measures according to the main influencing factors to help elderly total knee replacement patients improve their level of social participation,so as to obtain better rehabilitation effects. |
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