OBJECTIVE: To investigate the current status of kinesiophobia after lumbar fusion surgery in patients with lumbar disc herniation (LDH) and to analyze its influencing factors. METHODS: A total of 489 LDH patients who underwent lumbar fusion surgery in our hospital from January 2021 to December 2022 and effectively filled out the tampa scale for kinesiophobia (TSK) and other questionnaires on the first day after surgery were collected as the study subjects, the current status of kinesiophobia in LDH patients after lumbar fusion surgery were investigated using the TSK. The LDH patients were grouped into a kinesiophobia group (n=221) and a non kinesiophobia group (n=268) based on whether there was kinesiophobia after lumbar fusion surgery. The self-designed general data questionnaires were used to collect data, and Logistic regression was applied to analyze independent risk factors for kinesiophobia after lumbar fusion surgery in the LDH patients. RESULTS: In the study, 221 out of the 489 LDH patients (45.19%) had kinesiophobia after lumbar fusion surgery. Univariate analysis showed that there were statistically significant differences between the phobic group and the non phobic group in terms of gender, education level, course of disease, whether there was hypoproteinemia, pain level, self-efficacy, social support, whether there was anxiety, and whether there was depression (P < 0.05). There were no statistically significant differences in terms of age, body mass index, monthly family income, marital status, residence, medical expense payment form, whether there was hypertension, whether there was diabetes, whether there was cardiovascular and cerebrovascular disease, whether there was respiratory disease, whether there was surgery experience, whether there was anemia, work conditions, and responsibility segments (P>0.05). Male (95%CI: 3.289-10.586, P < 0.001), education level below undergraduate level (95%CI: 6.533-45.162, P < 0.001), severe pain (95%CI: 10.348-72.025, P < 0.001), moderate pain (95%CI: 6.247-37.787, P < 0.001), low self-efficacy (95%CI: 4.238-15.095, P < 0.001), and medium self-efficacy (95%CI: 2.804-8.643, P < 0.001) were influencing factors for kinesiophobia after lumbar fusion surgery in the patients with LDH (P < 0.05). CONCLUSION The incidence of kinesiophobia after lumbar fusion surgery in patients with LDH is high, and its influencing factors include gender, education level, pain level, and self-efficacy.
Humans ; Spinal Fusion/psychology* ; Intervertebral Disc Displacement/psychology* ; Lumbar Vertebrae/surgery* ; Male ; Female ; Middle Aged ; Phobic Disorders/etiology* ; Surveys and Questionnaires ; Adult ; Risk Factors ; Aged ; Fear ; Kinesiophobia

Objective:To explore the chain mediation role of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness.Methods:From February to March 2024, a convenience sampling method was used to select 763 nurses from ClassⅢ Grade A hospitals in Wenzhou as research subjects. Data were collected using a General Information Questionnaire, the Occupational Embeddedness Scale for Nurses (OESN), the Nursing Professional Values Scale-Revised (NPVS-R), the Nurses' Career Planning Questionnaire (NCPQ), and the Career Success Scale for Nurses (CSSN). Pearson correlation analysis was performed to examine the correlations among the scores of OESN, NPVS-R, NCPQ, and CSSN. The AMOS 21.0 software was used to construct a structural equation model to explore the chain mediation role of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness.Results:A total of 763 questionnaires were collected, with 749 valid responses, resulting in an effective recovery rate of 98.17%. The average scores for the 749 nurses were as follows: OESN (60.29±7.65), NPVS-R (108.99±11.82), NCPQ (42.98±4.44), CSSN (73.57±8.34). All four scale scores were positively correlated with each other ( P<0.05). The chain mediation effect of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness was established, with the total indirect effect accounting for 46.04% (0.302/0.656) of the total effect and the chain mediation effect of career development planning and career success accounting for 10.21% (0.067/0.656) . Conclusions:The level of occupational embeddedness among nurses needs further improvement. Nurses' professional values not only directly influence their level of occupational embeddedness but also affect their career development planning, which in turn impacts their career success, ultimately exerting an indirect effect on occupational embeddedness. Nursing managers should strengthen nurses' professional values, assist them in formulating clear career development plans, and provide timely feedback and recognition of career success.

Objective:To analyze the clinical value of high-frequency color Doppler ultrasound in the detection of axillary lymph node metastasis in breast cancer.Methods:The clinical data of 60 patients with breast cancer who received treatment in Hangzhou Hospital, Zhejiang Medical & Health Group between March 2017 and March 2019 were retrospectively analyzed. Based on pathological results, 34 patients with breast cancer who had axillary lymph node metastasis were included in the observation group, and 26 patients without axillary lymph node metastasis were included in the control group. Both groups of patients underwent high-frequency color Doppler ultrasound examination. Ultrasound image characteristics, distribution of blood flow within the lymph nodes, and grading of blood flow signals were compared between the two groups, and ultrasound diagnosis results were analyzed.Results:Detection rate of cortical thickening, detection rate of lymph node long-diameter to lymph node short-diameter ratio > 2, detection rate of blurred lymph node borders, and detection rate of calcified foci within lymph nodes in the observation group were 55.9% (19/34), 58.8% (20/34), 61.8% (21/34), 52.9% (18/34), respectively, which were significantly higher than those in the control group [11.5% (3/26), 26.9% (7/26), 19.2% (5/26), 7.7% (2/26), χ2 = 12.48, 6.06, 10.85, 13.57, all P < 0.05]. The percentage of peripheral type blood flow distribution in the observation group was significantly higher than that in the control group and the percentage of portal type blood flow distribution in the observation group was significantly lower than that in the control group (both P < 0.05). The percentage of grade 2 blood flow signal in the observation group was significantly lower than that in control group, and the percentage of grade 3 blood flow signal in the observation group was significantly higher than that in the control group (both P < 0.05). The sensitivity, specificity, misdiagnosis rate and missed diagnosis rate of ultrasound in the detection of axillary lymph node metastasis in breast cancer were 88.2% (30/34), 73.1% (19/26), 26.9% (7/26), and 11.8% (4/34), respectively. Conclusion:High-frequency color Doppler ultrasonography in the detection of breast cancer axillary lymph node metastasis has ideal accuracy, and its diagnostic results are of high reference value.

Objective To investigate the functional disability of lumbar disc herniation (LDH) patients and to analyze influencing factors.Methods A total of 260 LDH patients treated in the 2nd Affiliated Hospital of Wenzhou Medical University from November 2015 to April 2016, were selected by convenience sampling method and evaluated by Oswestry low back pain-disability index-Chinese vision (ODI-C) about their functional disability, with the results analyzed by single factor analysis, Pearson correlation and hierarchical regression analysis.Results 216 valid questionnaires were regained, which showed that ODI-C scores of all the 216 LDH patients were (26.00±11.83) points. It was shown in single factor analysis that age, course of disease and surgery influenced the patients′ functional disability. It was shown in Pearson correlation analysis that interference of the pain degree or the pain, on the patients′ life was positively correlated with the patients ODI-C score, and so was their condition of depression (r=0.765, 0.725, 0.708;P<0.05). It was shown in regression analysis that, after control of demographic variables, interference of the pain degree or the pain, on the patients′ life, and the condition of depression, were independent influencing factors of functional disability of LDH patients, which accounted for 39.7% of the amount of variability.Conclusions Functional disability is common in LDH patients, which can be reduced by relieving their pain and depression.