基于时机理论的综合护理方案在全膝关节置换术患者中的应用

朱雪凤; 翁惠英

doi:10.16766/j.cnki.issn.1674-4152.003697

基于时机理论的综合护理方案在全膝关节置换术患者中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003697

朱雪凤^,,
翁惠英

湖州市第一人民医院骨科，浙江湖州 313000

基金项目:

浙江省医药卫生科技计划项目 2023KY1179

详细信息

通讯作者:
朱雪凤，E-mail：zxf2624062624@163.com

中图分类号: R473.6 R687.4
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- 文章访问数: 26
- HTML全文浏览量: 10
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2024-03-11

Application of comprehensive nursing plan based on timing theory in patients with total knee arthroplasty

ZHU Xuefeng^,,
WENG Huiying

Department of Orthopedics, Huzhou First People' s Hospital, Huzhou, Zhejiang 313000, China

摘要

摘要: 目的以时机理论为指导，根据全膝关节置换术患者不同时期需求，制定综合护理干预方案，旨在优化护理质量，促进患者早日康复。方法选取2022年6月—2023年6月在湖州市第一人民医院拟进行全膝关节置换术治疗的患者共108例，采用随机数字表法将其分为对照组和试验组，每组均54例。对照组给予常规护理和随访，试验组开展基于时机理论的综合护理干预，持续干预6个月，比较2组康复锻炼依从性、自我护理能力(ESCA)和膝关节功能量表(HSS)评分。结果试验组术后6个月康复锻炼依从性(主动学习依从、心理依从和身体依从)评分高于对照组(P<0.05)；ESCA中的自我护理技能和健康知识水平维度评分及总分高于对照组(P<0.05)；HSS评分中的功能、肌力、活动度、稳定性维度评分和总分分别为(18.98±3.70)分、(9.44±2.11)分、(17.45±3.09)分、(9.34±2.07)分、(85.78±5.67)分，均高于对照组[(14.23±2.45)分、(7.37±1.56)分、(15.23±3.44)分、(7.90±1.43)分、(74.29±5.62)分, t=17.866、19.091、16.789、23.451、19.231，P<0.05]。结论基于时机理论的综合护理对提高全膝关节置换患者术后康复锻炼依从性，增强自我护理能力，改善膝关节功能具有积极作用。
- 全膝关节置换术 /
- 综合护理 /
- 时机理念 /
- 依从性 /
- 膝关节功能
Abstract: Objective Under the guidance of timing theory, according to the needs of total knee replacement patients in different periods, a comprehensive nursing intervention plan is developed to optimize the quality of nursing and promote the early recovery of patients. Methods A total of 108 patients who were to undergo total knee arthroplasty in Huzhou First People' s Hospital from June 2022 to June 2023 were selected and divided into control group and experimental group by random number table method, with 54 patients in each group. The control group was given routine nursing and follow-up, and the experimental group was given comprehensive nursing intervention based on timing theory for 6 months. The rehabilitation exercise compliance, exercise of self-care agency scale (ESCA) and hospital for special surgery (HSS) scores of the two groups were compared. Results The scores of rehabilitation exercise compliance (active learning compliance, psychological compliance and physical compliance) of experimental group were higher than those of control group at 6 months after operation (P < 0.05). The dimension scores and total scores of self-care skills and health knowledge level in ESCA were higher than those in control group (P < 0.05). The scores of function, muscle strength, mobility and stability in HSS were (18.98±3.70) points, (9.44±2.11) points, (17.45±3.09) points, (9.34±2.07) points and (85.78±5.67) points, respectively, which were higher than those in the control group [(14.23±2.45) points, (7.37±1.56)points, (15.23±3.44) points, (7.90±1.43) points, (74.29±5.62) points, t=17.866, 19.091, 16.789, 23.451, 19.231, P < 0.05]. Conclusion Comprehensive nursing based on timing theory plays a positive role in improving postoperative rehabilitation exercise compliance, enhancing self-care ability and improving knee function of total knee replacement patients.
- Total knee replacement /
- Comprehensive nursing /
- Timing theory /
- Compliance /
- Knee joint function
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图 1 时机理念下的综合护理干预图

Figure 1. Comprehensive nursing intervention diagram based on the timing concept

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表 1 2组全膝关节置换术患者一般资料比较

Table 1. Comparison of general data between two groups of patients with total knee arthroplasty

组别	例数	性别(男/女，例)	年龄(x±s，岁)	BMI (x±s)	受教育时间(x±s，年)	婚姻状况(已婚/ 离异或丧偶，例)	医疗费用支付方式(医保/自费，例)	合并基础疾病(0种/ 1种/2种及以上，例)
试验组	54	24/30	63.67±5.10	23.12±4.10	8.45±2.01	39/15	44/10	8/31/15
对照组	54	21/33	64.56±6.01	22.19±3.56	8.33±1.95	42/12	41/13	10/27/17
统计量		0.343^a	0.830^b	1.259^b	0.315^b	0.444^a	0.497^a	0.623^a
P值		0.558	0.409	0.210	0.754	0.505	0.481	0.732
注：^a为χ²值，^b为t值。

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表 2 2组全膝关节置换术患者康复锻炼依从性比较(x±s, 分)

Table 2. Comparison of rehabilitation exercise compliance between 2 groups of total knee replacement patients(x±s, points)

组别	例数	主动学习依从性		心理依从性		身体依从性
组别	例数	出院时	术后6个月	出院时	术后6个月	出院时	术后6个月
试验组	54	8.11±2.13	17.33±3.24^b	17.09±2.34	30.23±5.11^b	6.45±1.42	12.16±2.14^b
对照组	54	7.69±1.47	12.04±2.16^b	16.21±3.50	20.31±3.68^b	5.99±1.24	9.37±2.01^b
统计量		1.193^a	18.345^c	1.536^a	19.576^c	1.793^a	16.923^c
P值		0.236	<0.001	0.128	<0.001	0.076	<0.001
注：^a为t值，^c为F值；与同组出院时比较，^bP<0.05。

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表 3 2组全膝关节置换术患者自我护理能力比较(x±s，分)

Table 3. Comparison of self-care ability between 2 groups of total knee replacement patients(x±s, points)

组别	例数	自护责任感		自我概念		自我护理技能		健康知识水平		总分
组别	例数	入院时	术后6个月	入院时	术后6个月	入院时	术后6个月	入院时	术后6个月	入院时	术后6个月
试验组	54	15.66±4.23	16.24±3.22	47.23±5.09	47.19±4.22	30.15±4.17	41.78±5.33^b	35.67±6.10	48.90±6.13^b	128.71±14.22	154.11±10.17^b
对照组	54	15.79±3.29	16.59±4.17	46.88±6.23	47.04±7.88	30.65±6.13	35.80±4.71^b	36.99±7.88	43.23±5.17^b	130.11±10.57	142.66±9.23^b
统计量		0.178^a	1.488^c	0.320^a	1.113^c	0.496^a	16.567^c	0.973^a	20.091^c	0.581^a	6.126^c
P值		0.859	0.345	0.750	0.456	0.621	<0.001	0.333	<0.001	0.563	<0.001
注：^a为t值，^c为F值；与同组出院时比较，^bP<0.05。

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表 4 2组全膝关节置换术患者膝关节功能比较(x±s，分)

Table 4. Comparison of knee joint function between 2 groups of total knee arthroplasty patients(x±s, points)

组别	例数	疼痛		功能		肌力		活动度
组别	例数	入院时	术后6个月	入院时	术后6个月	入院时	术后6个月	入院时	术后6个月
试验组	54	12.23±2.03	20.90±4.14^b	9.34±1.45	18.98±3.70^b	3.56±0.52	9.44±2.11^b	9.45±1.24	17.45±3.09^b
对照组	54	11.78±2.47	20.35±3.22^b	9.27±2.09	14.23±2.45^b	3.77±0.98	7.37±1.56^b	9.39±1.07	15.23±3.44^b
统计量		1.034^a	1.771^c	0.202^a	17.866^c	1.391^a	19.091^c	0.269^a	16.789^c
P值		0.303	0.113	0.840	＜0.001	0.167	＜0.001	0.788	＜0.001

组别	例数	稳定性		屈曲畸形				总分
组别	例数	入院时	术后6个月	入院时		术后6个月		入院时	术后6个月
试验组	54	4.23±1.11	9.34±2.07^b	5.67±1.11		9.67±1.33^b		44.48±4.56	85.78±5.67^b
对照组	54	3.98±0.57	7.90±1.43^b	5.89±1.30		9.21±1.56^b		44.08±6.27	74.29±5.62^b
统计量		1.472^a	23.451^c	0.946^a		1.649^c		0.379^a	19.231^c
P值		0.144	＜0.001	0.346		0.202		0.705	＜0.001
注：^a为t值，^c为F值；与同组出院时比较，^bP＜0.05。

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