基于行动研究法的健康教育对全髋关节置换术患者术后康复的影响

邓莹; 潘卫宇; 左珊珊; 单单单

doi:10.16766/j.cnki.issn.1674-4152.002822

基于行动研究法的健康教育对全髋关节置换术患者术后康复的影响

doi: 10.16766/j.cnki.issn.1674-4152.002822

1.
河南省人民医院护理部, 河南郑州 450000
2.
河南省人民医院骨科
3.
河南省人民医院国际医疗中心
4.
河南省人民医院麻醉围手术期医学科

基金项目:

河南省医学科技攻关计划(联合共建)项目 LHGJ20190582

详细信息

通讯作者:
邓莹，E-mail：dengying96917@163.com

中图分类号: R49 R687.4
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- 文章访问数: 127
- HTML全文浏览量: 36
- PDF下载量: 6
- 被引次数: 0
出版历程
- 收稿日期: 2022-04-21
- 网络出版日期: 2023-04-07

Effects of health education based on action research method on the postoperative rehabilitation of patients with total hip replacement

1.
Nursing Department, Henan Provincial People' s Hospital, Zhengzhou, Henan 450000, China

摘要

摘要: 目的探究基于行动研究法的健康教育对全髋关节置换术(THR)患者心理弹性、康复依从性、自护能力及术后髋关节功能康复的影响。方法采用随机数字表法将2019年1月—2022年1月河南省人民医院行THR的100例患者分为研究组(50例)与对照组(50例)，分别接受基于行动研究法的健康教育与常规健康教育，干预至出院后3个月。干预前、干预后3个月分别通过心理弹性量表(CD-RISC)、Harris髋关节评分表对2组患者心理弹性、髋关节恢复情况进行评估，统计2组术后不同时间点康复依从情况、干预后1个月并发症发生情况，干预后3个月行自我护理能力测试量表(ESCA)测定。结果研究组干预后3个月CD-RISC与ESCA各项评分及干预后1个月、3个月Harris评分均明显高于对照组(均P < 0.05)；研究组术后1周、1个月、3个月完全依从率分别为88.00%、68.00%、54.00%，均明显高于对照组的50.00%、40.00%、28.00%(均P < 0.05)；研究组干预后1个月并发症总发生率(4.00%)明显低于对照组(22.00%，P < 0.05)。结论基于行动研究法的健康教育能有效提高THR患者术后心理弹性与自护能力，增强其康复依从性，减少并发症，有利于髋关节恢复。
- 全髋关节置换术 /
- 行动研究法 /
- 健康教育 /
- 术后康复
Abstract: Objective To explore the effect of health education based on action research method on mental resilience, rehabilitation compliance, self-care ability and postoperative hip functional rehabilitation of patients with total hip replacement (THR). Methods A total of 100 patients who received THR in Henan Provincial People' s Hospital from January 2019 to January 2022 were divided into study group (n=50) and control group (n=50) by the random number table method. They received action research method-based health education and routine health education respectively, and the intervention lasted for 3 months after discharge. Mental resilience and hip recovery of patients in the two groups were evaluated by using the Conner Davidson resilience scale (CD-RISC) and Harris hip rating scale before the intervention and after 3 months of intervention. The rehabilitation compliance of the two groups at different postoperative time points and complications after 1 month of intervention were analysed, and exercise self-care agency (ESCA) was performed after 3 months of intervention. Results The CD-RISC and ESCA scores of the study group were significantly higher than those of the control group after 3 months of intervention, as well as Harris scores after 1 and 3 months of intervention (all P < 0.05). The complete compliance rates of the study group at 1 week, 1 month and 3 months after surgery were 88.00%, 68.00% and 54.00%, respectively, which were significantly higher than those of the control group at 50.00%, 40.00% and 28.00% (all P < 0.05). The total incidence of complications after 1 month of intervention in the study group was 4.00%, which was lower than that in the control group (22.00%, P < 0.05). Conclusion Health education based on the action research method can improve the postoperative mental resilience and self-care ability of patients with THR, enhance their rehabilitation compliance, reduce complications and promote the recovery of hip joint.
- Total hip replacement /
- Action research method /
- Health education /
- Postoperative rehabilitation

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表 1 2组全髋关节置换术患者一般资料比较

Table 1. Comparison of general data of total hip replacement patients between 2 groups

组别	例数	性别(男/女，例)	年龄(x±s，岁)	疾病类型(股骨头坏死/股骨颈骨折/骨性关节炎，例)	部位(左髋/右髋，例)	教育程度(中专或以上/初高中/小学，例)
研究组	50	27/23	65.39±3.84	25/12/13	23/27	15/20/15
对照组	50	25/25	66.14±4.02	22/13/15	26/24	14/22/14
统计量		0.160^a	0.954^b	0.374^a	0.360^a	0.164^a
P值		0.689	0.343	0.829	0.548	0.921
注：^a为χ²值，^b为t值。

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表 2 2组全髋关节置换术患者CD-RISC评分对比(x ±s，分)

Table 2. CD-RISC score comparison between two groups of patients with total hip replacement(x ±s, scores)

组别	例数	坚韧		乐观		自强		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
研究组	50	35.36±4.00	43.82±4.95^a	10.12±1.17	14.05±1.83^a	21.74±3.89	27.38±3.21^a	67.22±6.34	85.25±5.43^a
对照组	50	36.15±4.78	39.96±4.57^a	10.24±1.65	12.51±2.36^a	22.03±3.92	25.67±2.93^a	68.42±6.03	78.14±5.38^a
t值		0.896	4.047	0.419	3.646	0.371	2.782	0.970	6.577
P值		0.372	＜0.001	0.676	＜0.001	0.711	0.007	0.335	＜0.001
注：与同组干预前比较，^aP < 0.05。

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表 3 2组全髋关节置换术患者术后不同时间点完全依从情况比较[例(%)]

Table 3. Comparison of complete compliance at different time points after total hip replacement between 2 groups [cases (%)]

组别	例数	术后1 d	术后1周	术后1个月	术后3个月
研究组	50	24(48.00)	44(88.00)	34(68.00)	27(54.00)
对照组	50	17(34.00)	25(50.00)	20(40.00)	14(28.00)
χ²值		2.026	16.877	7.891	6.986
P值		0.155	< 0.001	0.005	0.008

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表 4 2组全髋关节置换术患者干预后3个月ESCA评分对比(x ±s，分)

Table 4. Comparison of ESCA scores of total hip replacement patients in 2 groups at 3 months after intervention(x ±s, scores)

组别	例数	自我责任	自我概念	护理技能	健康认知
研究组	50	20.20±2.03	28.70±2.36	44.21±2.35	62.97±3.85
对照组	50	17.54±2.18	25.13±2.69	40.82±2.56	58.00±3.46
t值		6.314	7.054	6.898	6.789
P值		< 0.001	< 0.001	< 0.001	< 0.001

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表 5 2组全髋关节置换术患者干预后Harris评分对比(x ±s，分)

Table 5. Comparison of Harris scores in 2 groups of total hip replacement patients after intervention(x ±s, scores)

组别	例数	干预后1个月	干预后3个月
研究组	50	50.02±3.16	83.35±4.17
对照组	50	42.25±3.61	75.04±4.68
t值		11.452	9.374
P值		< 0.001	< 0.001

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表 6 2组全髋关节置换术患者并发症发生情况对比[例(%)]

Table 6. Comparison of complications in two groups of total hip replacement patients[cases (%)]

组别	例数	压疮	感染	静脉血栓	关节挛缩	合计
研究组	50	1(2.00)	0	1(2.00)	0	2(4.00)
对照组	50	5(10.00)	1(2.00)	3(6.00)	2(4.00)	11(22.00)
注：2组并发症总发生率比较，χ²=7.162，P=0.007。

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