The Investigation Of Preoperative Mental Health Status Among The Arthritic With Artificial Joint Replacement Operation

Objectives:Through the psychological investigation and study on osteoarthritis patients in orthopedic surgery of the center hospital affiliated to Shenyang Medical University,we collecte and evaluate mental health status of patients who were ready for hip or knee arthroplasty. We also analyze the mental health status and distribution characteristics of osteoarthritis patients before the joint replacement, discussing the influence factors of the psychological status of osteoarthritis patients. Our study will provide valuable research basis to pertinent psychological nursing for osteoarthritis patients who were ready for hip or knee arthroplasty, and eventually contribute to further promote clinical rehabilitation after bone arthritis joint replacement. Methods:The investigation subjects were osteoarthritis patients in orthopedic surgery of the center hospital affiliated to Shenyang Medical University whom we collected from July/2015 to June/2016. The self-designed composite questionnaire, K10, depression self rating scale(SDS), anxiety self rating scale(SAS) and general population questionnaire. Questionnaires were finished by patients under the guidance of the unification investigators. Knee society score(KSS)scores and Harris scores were directly extracted from medical history data by unified training nurses. The SPSS 21.0 software was used to analyze the data, indexes were described by rate,Chi-Square test was used to compare rates of different groups and the influencing factors were analyzed by single factor and multiple factor non conditional Logistics regression analysis. Results:(1) This study included 222 osteoarthritis patients, including 136 hip replacement patients and 86 knee replacement patients. The average Harris score of hip arthroplasty patients was 47.13±8.40, and the average KSS score of knee arthroplasty patients was 52.93±5.89.(2) The average K10 score distribution in hip arthroplasty patients was 33.14±7.47, and there were 113 patients with possitive rate of K10, accounting for 83.09%. Age, family income per capita and paying method were correlated with the K10 possitive rate(P<0.05).The average K10 score of knee replacement patients was 26.34±8.75, and there were 41 patients with possive K10, accounting for 47.68%,age and payment method were related to K10 possitive rate(P<0.05). The result of the multivariate Logistic analysis showed that family income per capita and Harris score were associated with hip arthroplasty patients who were in preoperative stress levels(P<0.05). Age and KSS score were related to knee arthroplasty patients with preoperative stress levels(P<0.05).(3) We detected 46 hip arthroplasty patients who were with depression tendency, the positive prevalence was 52.21%, and different social demographic characteristics was not related to possitive rate of depression(P>0.05). There were 49 knee arthroplasty patients with depression and the possitive prevalence was 56.98%, and ethics and family income per capita were related to depression of patients with knee arthroplasty(P<0.05). The results of multivariate Logistic analysis showed that there were no statistical significance between hip arthroplasty patients and depression(P<0.05), but family income per capita was related to knee arthroplasty patients with depression(P<0.05).(4) There were 71 hip arthroplasty patients in the status of anxiety and the possitive rate was 52.21%, family income per capita and paying method were statistical significance(P<0.05). There were 38 knee arthroplasty patients in anxiety and the positive prevalence was 44.19%. Family income per capita and paying method were related to anxiety in patients with knee arthroplasty(P<0.05).The results of multivariate Logistic analysis showed that family income per capita, paying method and Harris score were related to hip arthroplasty patients with preoperative anxiety levels(P<0.05). Family income per capita have statistical significance in knee arthroplasty patients with preoperative anxiety levels(P<0.05). Conclusion:The leval and the positive rates of general mental health status, anxiety tendency and depression tendency were higher in osteoarthritis patients in orthopedic surgery. The influencing factors of hip and knee osteoarthritis patients' mental health status were family income per capita, paying method and Harris score. For patients with osteoarthritis joint replacement, we should assess their psychological status routinely, and give drugs or targeted psychological intervention once necessary.