焦点解决模式联合互联网+延续护理对老年髋部骨折患者髋关节功能和生活质量的影响

张乐燕; 邵素芬; 谢阿群; 郑雪蕾; 骆国钢

doi:10.16766/j.cnki.issn.1674-4152.004067

焦点解决模式联合互联网+延续护理对老年髋部骨折患者髋关节功能和生活质量的影响

doi: 10.16766/j.cnki.issn.1674-4152.004067

温州市中西医结合医院创伤骨科，浙江温州 325000

基金项目:

浙江省中医药科技计划项目 2021ZB275

温州市基础性公益科研项目 Y2023881

详细信息

通讯作者:
郑雪蕾，E-mail：376798660@qq.com

中图分类号: R473.6 R683.3
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- 文章访问数: 25
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- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-06-05
- 网络出版日期: 2025-09-04

Effect of focus solution model combined with internet plus continuing nursing on the function and quality of life of hip fracture in the elderly

Department of Traumatology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的本研究在互联网+延续护理的基础上，联合焦点解决模式应用于老年髋部骨折患者，并分析该干预方案对患者髋关节功能和生活质量的影响，为提高术后康复效果提供参考。方法采用随机数字表法将2022年10月—2024年1月温州市中西医结合医院收治的100例老年髋部骨折患者分为观察组(50例)和对照组(50例)。对照组给予互联网+延续护理干预，观察组给予基于焦点解决模式联合互联网+延续护理干预，比较2组患者髋关节功能、疼痛情况、生活质量及并发症。结果观察组干预后的Harris髋关节功能评分(HHS)总分、各维度得分均高于对照组(P < 0.05)。干预1周、1个月及3个月时数字模拟量表(NRS)得分低于对照组(P < 0.05)。干预后，观察组简明健康状况调查量表(SF-36)除社会功能维度其他维度评分均高于对照组(P < 0.05)。观察组术后切口感染、脱位和静脉血栓并发症发生率低于对照组[2.00%(1/50) vs.14.00%(7/50)，χ²=4.891，P=0.027]。结论基于焦点解决模式联合互联网+延续护理应用于老年髋部骨折患者，有助于改善髋关节功能、减轻患者疼痛程度，可提高患者生活质量，并且能降低术后并发症发生率。
- 髋部骨折 /
- 焦点解决模式 /
- 互联网+ /
- 延续性护理 /
- 生活质量
Abstract: Objective On the basis of internet plus continuing nursing, this study applies the combined focus solution model to elderly patients with hip fracture, and analyzes the impact of this intervention program on hip function and quality of life of patients, so as to provide reference for improving postoperative rehabilitation effect. Methods According to the random number table method, 100 elderly patients with hip fracture in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from October 2022 to January 2024 were divided into observation group (n=50) and control group (n=50). The control group received internet plus continuing nursing intervention, and the observation group received the internet plus continuing nursing intervention based on focus solution model. The hip function, pain, quality of life and complications were compared between the two groups. Results The total score of Harris hip function score (HHS) and scores of all dimensions in the observation group were higher than those in the control group (P < 0.05). After 1 week, 1 month and 3 months of intervention, the scores of numerical rating scale (NRS) were lower than those of the control group (P < 0.05). After the intervention, the scores of short form health survey (SF-36) in the observation group were higher than those in the control group except social function (P < 0.05). The incidence of postoperative wound infection, dislocation and venous thrombosis complications in the observation group was lower than that in the control group, and the difference was statistically significant [2.00%(1/50) vs.14.00%(7/50), χ²=4.891, P=0.027]. Conclusion The application of focus solution model combined with internet plus continuous nursing in elderly patients with hip fracture after operation is helpful to improve hip joint function, relieve patients' pain, improve patients' quality of life, and reduce the probability of postoperative complications.
- Hip fracture /
- Focus solution mode /
- Internet plus /
- Continuous nursing /
- Quality of life

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表 1 2组老年髋部骨折患者一般资料比较

Table 1. Comparison of general data between the two groups of elderly patients with hip fracture

项目	对照组(n=50)	观察组(n=50)	统计量	P值
性别[例(%)]			0.407^a	0.523
男性	35(70.00)	32(64.00)
女性	15(30.00)	18(36.00)
年龄(x±s, 岁)	72.36±6.24	73.02±6.33	0.525^b	0.601
BMI(x±s)	22.51±2.19	22.48±2.23	0.096^b	0.924
吸烟[例(%)]	12(24.00)	14(28.00)	0.208^a	0.648
骨折部位[例(%)]			0.544^a	0.762
转子下	3(6.00)	5(10.00)
股骨粗隆间	21(42.00)	20(40.00)
股骨颈	26(52.00)	25(50.00)
骨折至入院时间(x±s, h)	36.12±10.03	35.86±10.76	0.125^b	0.901
手术方式[例(%)]			0.088^a	0.766
内固定术	7(14.00)	6(12.00)
关节置换	43(86.00)	44(88.00)
手术时间(x±s, min)	80.12±16.48	81.36±17.20	0.368^b	0.714
髋骨骨折侧[例(%)]			0.372^a	0.542
左侧	31(62.00)	28(56.00)
右侧	19(38.00)	22(44.00)
注：^a为χ²值，^b为t值。

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表 2 2组老年髋部骨折患者干预前后HHS评分比较(x±s，分)

Table 2. Comparison of HHS score between the two groups of elderly patients with hip fracture before and after intervention (x±s, points)

组别	例数	疼痛		畸形		关节活动度		功能		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	干预前	干预后
对照组	50	26.92±5.28	31.03±6.07^b	2.40±0.56	2.63±0.60	2.52±0.48	2.80±0.61^b	32.19±5.42	34.08±5.38	64.03±6.31	70.54±7.16^b
观察组	50	27.05±5.24	33.78±6.02^b	2.38±0.57	2.89±0.63^b	2.50±0.51	3.08±0.71^b	32.24±5.39	38.16±5.87^b	64.17±6.48	77.91±7.22^b
统计量		0.124^a	5.672^c	0.177^a	4.125^c	0.202^a	5.270^c	0.046^a	6.278^c	0.109^a	10.823^c
P值		0.902	0.019	0.860	0.038	0.840	0.022	0.963	0.014	0.913	0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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表 3 2组老年髋部骨折患者干预前后NRS评分比较(x±s，分)

Table 3. Comparison of NRS score between the two groups of elderly patients with hip fracture before and after intervention (x±s, points)

组别	例数	干预前	干预1周	干预1个月	干预3个月
对照组	50	4.02±0.24	3.26±0.29^a	2.54±0.32^ab	2.30±0.35^abc
观察组	50	3.98±0.22	3.03±0.28^a	2.28±0.34^ab	2.01±0.32^abc
F值		0.788	6.777	3.606	3.977
P值		0.458	0.002	0.031	0.026
注：与干预前比较，^aP < 0.05；与干预1周比较，^bP < 0.05；与干预1个月比较，^cP < 0.05；NRS为数字模拟量表。

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表 4 2组老年髋部骨折患者干预前后SF-36评分比较(x±s，分)

Table 4. Comparison of SF-36 score between the two groups of elderly patients with hip fracture before and after intervention (x±s, points)

组别	例数	生理功能		精神健康		生理职能		躯体疼痛
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
对照组	50	66.50±7.59	75.30±9.21^b	52.39±6.04	67.23±6.84^b	62.03±7.48	78.36±8.24^b	62.41±8.76	78.32±9.14^b
观察组	50	67.03±7.64	83.25±9.47^b	53.12±6.01	78.31±7.12^b	61.78±7.39	86.20±8.33^b	63.05±9.02	84.30±9.35^b
统计量		0.348^a	8.206^c	0.606^a	12.302^c	0.168^a	8.328^c	0.360^a	5.950^c
P值		0.729	< 0.001	0.546	0.025	0.867	< 0.001	0.720	0.017

组别	例数	社会功能		活力		情感职能		总体健康
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
对照组	50	43.20±6.75	60.23±7.24^b	51.36±6.04	69.20±7.12^b	54.13±6.25	68.19±7.15^b	60.21±7.04	75.03±8.21^b
观察组	50	44.03±6.64	62.18±7.35^b	52.12±5.98	75.16±7.33^b	55.06±6.31	73.01±7.38^b	61.14±6.97	86.12±9.76^b
统计量		0.620^a	2.354^c	0.632^a	8.624^c	0.740^a	7.304^c	0.664^a	11.254^c
P值		0.537	0.106	0.529	< 0.001	0.461	0.005	0.508	0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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表 5 2组老年髋部骨折患者并发症发生率比较[例(%)]

Table 5. Comparison of the incidence of complications between the two groups of elderly patients with hip fracture [cases (%)]

组别	例数	切口感染	脱位	静脉血栓	总发生
对照组	50	3(6.00)	2(4.00)	2(4.00)	7(14.00)
观察组	50	1(2.00)	0(0.00)	0(0.00)	1(2.00)
注：2组并发症总发生率比较，χ²=4.891，P=0.027。

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