探讨烧伤患者伤后功能锻炼现状及影响烧伤患者出院后功能锻炼的因素。

选择2017年12月至2018年6月在上海交通大学医学院附属瑞金医院灼伤整形科住院的符合入选标准的烧伤瘢痕整形患者60例，采用方便抽样法，根据患者入院前功能锻炼情况将60例患者分为功能锻炼组(n＝28)和非功能锻炼组(n＝32)。采用自制问卷调查表对患者进行功能锻炼现状调查，收集患者的年龄、居住地、付费方式、文化程度、职业、家庭月收入等基本资料，对患者进行社会支持评定量表(SSRS)评分，包括主观支持、客观支持和对社会支持的利用度3个维度。数据比较采用t检验、χ²检验，Logistic回归分析。

调查问卷共发放60份，回收有效问卷60份，回收率100%。功能锻炼组28例患者中，入院前坚持每日锻炼次数大于6次的仅8例(28.6%)，患者功能锻炼的方法为主动活动和被动活动，功能锻炼信息主要来自医护、电视或网络、亲朋好友及其他。功能锻炼组患者社会客观支持、主观支持，对社会支持的利用度、SSRS总评分分别为(11.6±4.0)、(25.3±6.2)、(7.9±2.1)、(46.5±10.0) 分，与非功能锻炼组(9.6±2.3)、(22.1±4.5)、(22.1±4.5)、(39.2±10.8) 分比较，差异均有统计学意义(t＝2.48、3.29、4.17、3.32，P值均小于0.05)。对2组患者年龄、文化程度、居住地、付费方式、职业和家庭月收入比较，结果显示患者的年龄、文化程度、职业以及家庭月收入对其进行功能锻炼有一定的影响(χ²＝0.032、2.672、0.342、0.893，P＝0.021、0.017、0.031、0.004)，而与其居住地、付费方式无关(χ²＝1.973、0.931，P＝1.377、4.091)。对影响患者功能锻炼的因素进行Logistic回归分析，结果显示文化程度、职业以及家庭月收入对患者进行功能锻炼有一定的影响(P值均小于0.05)，而患者年龄、居住地、付费方式对患者功能锻炼没有影响(P值均大于0.05)。

医务工作者应针对不同年龄层、不同文化层次及不同收入水平的患者进行个体化宣教，促使患者更好地进行烧伤后功能锻炼。

To investigate the status quo of post-injury functional exercise in burn patients and the factors influencing the functional exercise of burn patients after discharge.

Sixty patients with burn scar plastic surgery who were admitted to the Department of Burns and Plastic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from December 2017 to June 2018 were divided into functional exercise group (n=28) and non-functional exercise group (n=32) according to the functional exercise before admission by the convenience sampling method. A self-made questionnaire was used to investigate the status quo of functional exercise in patients, and basic data such as age, residence, payment method, education level, occupation and monthly family income were collected. Social support rating scale (SSRS), including subjective support, objective support and utilization degree of social support, was used to score patients. Data were compared using t test, chi-square test, and Logistic regression analysis.

A total of 60 questionnaires were distributed and 60 valid questionnaires were returned, with a recovery rate of 100%. Among the 28 patients in the functional exercise group, only 8 patients (28.6%) who insisted on exercising more than 6 times per day before admission. The methods of patients functional exercise were active activities and passive activities. The functional exercise information mainly came from medical care, television or internet, friends and relatives and others. In the functional exercise group, patients with social objective support, subjective support, utilization degree of social support, and SSRS total scores were (11.6±4.0), (25.3±6.2), (7.9±2.1), and (46.5±10.0) points, respectively, those in the non-functional oxercise group were (9.6±2.3), (22.1±4.5), (22.1±4.5), and (39.2±10.8) points, the differences were statistically significant (t=2.48, 3.29, 4.17, 3.32; with P values below 0.05). Comparing the age, education level, place of residence, payment method, occupation and monthly family income of the two groups, the results showed that the patient′s age, education level, occupation and monthly family income had certain effects on their functional exercise (χ²=0.032, 2.672, 0.342, 0.893; P=0.021, 0.017, 0.031, 0.004), and it has nothing to do with the place of residence and payment method (χ²=1.973, 0.931; P=1.377, 4.091). Logistic regression analysis was conducted on the factors influencing patients′ functional exercise, and the results showed that education level, occupation and monthly family income had certain influences on patients′ functional exercise (with P values below 0.05), while age, place of residence and payment method had no influence on patients′ functional exercise (with P values above 0.05).

Medical workers should conduct individualized education for patients of different ages, different cultural levels and different income levels, so that patients can better perform post-burn functional exercise.