整合干预模式对青少年特发性脊柱侧弯患者心理及躯体功能的影响

The effects of integrated intervention model on mental health literacy and physical function in adolescents with idiopathic scoliosis

摘要

目的探讨线上科普联合线下Schroth功能训练整合干预模式对提升青少年特发性脊柱侧弯(AIS)患者心理健康素养和躯体功能恢复的效果。方法 选取中国中医科学院西苑医院济宁医院接受脊柱侧弯干预的患者22例。将研究对象随机分为对照组(n=11)和试验组(n=11)。对照组接受常规的护理方案,试验组在接受常规护理的基础上,开展线上科普联合线下Schroth功能训练。于干预前和8周干预后采用青少年通用心理健康素养量表(UMHL-A)、脊柱侧凸研究学会22项(Scoliosis Research Society-22,SRS-22)量表和脊柱X射线正片评定心理健康素养状况和脊柱恢复情况。结果 干预8周后,试验组结局指标较干预前显著改善,且改善幅度均显著优于对照组(均P＜0.05);试验组SRS-22总分由干预前(91.18±3.37)分提升至(99.18±7.78)分,两组间差值比较差异具有统计学意义(t=3.129,P＜0.01);试验组脊柱主弯Cobb角由干预前(15.45±3.91)°减小至(10.59±4.50)°,平均矫正4.86°,两组差值比较差异具有统计学意义(t=2.401,P＜0.05);试验组UMHL-A得分由干预前(38.36±2.11)分提升至(43.73±3.38)分,两组差值比较差异具有统计学意义(t=2.894,P＜0.05)。结论 线上科普联合线下功能训练这一整合干预模式有助于提升AIS患者的心理健康素养和躯体功能恢复的效果。

Abstract

Objective To explore the effects of an integrated intervention model combining online science popularization with offline Schroth functional training on improving mental health literacy and physical function recovery in adolescents with idiopathic scoliosis (AIS). Methods Twenty-two patients undergoing scoliosis treatment at Jining Hospital,Xiyuan Hospital,China Academy of Chinese Medical Sciences,were randomly assigned to a control group (n=11) and an experimental group (n=11).The control group received routine care,while the experimental group received the integrated intervention of online science popularization combined with offline Schroth functional training in addition to routine care.The Universal Mental Health Literacy Scale for Adolescents (UMHL-A),the Scoliosis Research Society-22 (SRS-22) questionnaire,and spinal X-rays were used to assess mental health literacy and spinal recovery at baseline and after 8 weeks of intervention. Results After 8 weeks of intervention,the outcome indicators of the experimental group showed significant improvement compared with baseline,and the extent of improvement was significantly greater than that in the control group (all P＜0.05);The total SRS-22 score of the experimental group increased from 91.18±3.37 at baseline to 99.18±7.78,with a highly statistically significant difference between groups (t=3.129,P＜0.01);The Cobb angle of the major curve of the experimental group decreased from (15.45±3.91)° at baseline to (10.59±4.50)°,with an average correction of 4.86°,showing a statistically significant difference between groups (t=2.401,P＜0.05);The UMHL-A score increased from 38.36±2.11 at baseline to 43.73±3.38,with a statistically significant difference between groups (t=2.894,P＜0.05). Conclusion The integrated intervention model of online science popularization combined with offline functional training helps to enhance mental health literacy and promote physical function recovery in AIS patients.

关键词

青少年特发性脊柱侧弯 / 心理健康素养 / 随机对照试验 / 线上科普 / Schroth疗法 / 康复护理

Key words

Adolescent idiopathic scoliosis / Mental health literacy / Randomized controlled trial / Online science popularization / Schroth therapy / Rehabilitation nursing

[1]黄忍,王星,李志军,等.青少年特发性脊柱侧弯的诊治进展[J].中国临床解剖学杂志,2016,34(4):472-475.DOI:10.13418/j.issn.1001-165x.2016.04.025.
[2]Hong JY,Suh SW,Park HJ,et al.Correlations of adolescent idiopathic scoliosis and pectus excavatum[J].J Pediatr Orthop,2011,31(8):870-874.DOI:10.1097/BPO.0b013e31822da7d5.
[3]崔明星.青少年特发性脊柱侧弯病因学研究现状[J].广西医科大学学报,2013,30(2):326-328.DOI:10.3969/j.issn.1005-930X.2013.02.062.
[4]Negrini S,Donzelli S,Aulisa AG,et al.2016 SOSORT guidelines:orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth[J].Scoliosis Spinal Disord,2018,13:3.DOI:10.1186/s13013-017-0145-8.
[5]邱贵兴,庄乾宇.青少年特发性脊柱侧弯的流行病学研究进展[J].中华医学杂志,2006,86(11):790-792.DOI:10.3760/j:issn:0376-2491.2006.11.019.
[6]叶启彬.调控脊柱侧弯椎体两侧的不对称应力是治疗脊柱侧弯的关键[J].中国矫形外科杂志,2013,21(1):5-6.DOI:10.3977/j.issn.1005-8478.2013.01.01.
[7]Mordecai SC,Dabke HV.Efficacy of exercise therapy for the treatment of adolescent idiopathic scoliosis:a review of the literature[J].Eur Spine J,2012,21(3):382-389.DOI:10.1007/s00586-011-2063-4.
[8]Lee H,Choi J,Hwang JH,et al.Health-related quality of life of adolescents conservatively treated for idiopathic scoliosis in Korea:a cross-sectional study[J].Scoliosis Spinal Disord,2016,11:11.DOI:10.1186/s13013-016-0071-1.
[9]Kuru T,Yeldan I·,Dereli EE,et al.The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis:a randomised controlled clinical trial[J].Clin Rehabil,2016,30(2):181-190.DOI:10.1177/0269215515575745.
[10]Lenke LG,Betz RR,Harms J,et al.Adolescent idiopathic scoliosis:a new classification to determine extent of spinal arthrodesis[J].J Bone Joint Surg Am,2001,83(8):1169-1181.
[11]Jorm AF,Korten AE,Jacomb PA,et al."Mental health literacy":a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment[J].Med J Aust,1997,166(4):182-186.DOI:10.5694/j.1326-5377.1997.tb140071.x.
[12]郭恒,盛小添,笪姝,等.心理健康素养的概念、测量及影响因素[J].中国健康教育,2017,33(10):918-922.DOI:10.16168/j.cnki.issn.1002-9982.2017.10.013.
[13]石芝喜,王楚怀,张焕金,等.青少年特发性脊柱侧凸运动治疗专家共识(2025)[J].中国康复医学杂志,2026,41(1):4-14.DOI:10.3969/j.issn.1001-1242.2026.01.002.
[14]Asher M,Min Lai S,Burton D,et al.The reliability and concurrent validity of the scoliosis research society-22 patient questionnaire for idiopathic scoliosis[J].Spine (Phila Pa 1976),2003,28(1):63-69.DOI:10.1097/00007632-200301010-00015.
[15]Li M,Wang CF,Gu SX,et al.Adapted simplified Chinese (mainland) version of Scoliosis Research Society-22 questionnaire[J].Spine (Phila Pa 1976),2009,34(12):1321-1324.DOI:10.1097/BRS.0b013e31819812b7.
[16]O′Connor M,Casey L,Clough B.Measuring mental health literacy-a review of scale-based measures[J].J Ment Health,2014,23(4):197-204.DOI:10.3109/09638237.2014.910646.
[17]Kågström A,Pešout O,Kučera M,et al.Development and validation of a universal mental health literacy scale for adolescents (UMHL-A)[J].Psychiatry Res,2023,320:115031.DOI:10.1016/j.psychres.2022.115031.
[18]彭申立,王斐娟.青少年心理健康素养量表中文版在中学生中的信效度检验[J].中国临床心理学杂志,2024,32(4):865-869.DOI:10.16128/j.cnki.1005-3611.2024.04.026.
[19]Cohen S,Wills TA.Stress,social support,and the buffering hypothesis[J].Psychol Bull,1985,98(2):310-357.
[20]Cobb S.Presidential Address-1976.Social support as a moderator of life stress[J].Psychosom Med,1976,38(5):300-314.DOI:10.1097/00006842-197609000-00003.
[21]White CA,Uttl B,Holder MD.Meta-analyses of positive psychology interventions:the effects are much smaller than previously reported[J].PLoS One,2019,14(5):e0216588.DOI:10.1371/journal.pone.0216588.

基金资助

教育部人文社会科学研究青年基金项目(25YJCZH288);2024年山东省大学生创新创业项目(cx2024208z);山东省人文社会科学课题