出院后电话随访对人工髋关节置换术后患者康复效果的影响

The effect of postdischarge telephone intervention on rehabilitation in patients receiving hip replacement

目的探讨电话随访辅以家庭成员督导的护理干预对人工髋关节置换术后患者出院后不同时段遵医行为及髋关节功能康复效果的影响。方法249例人工髋关节置换术后患者根据出院日期分为干预组和对照组。干预组患者在出院后3～7d、1个月、3个月由干预小组通过电话随访形式，根据不同时段患者关节与肌肉功能恢复情况进行个体化的健康教育与指导，包括肢体关节与肌力的锻炼、日常生活注意事项及定期检查等，同时每半个月对家庭督导员进行电话随访，了解患者功能锻炼、日常生活注意事项等遵医情况。对照组实施常规出院指导和随访方式。在出院时、出院后1、3、6个月，采用自设遵医行为问卷，对所有患者进行调查；在出院时和出院后6个月，采用Harris评分标准对患者髋关节功能进行调查。结果两组患者出院时和出院1个月时遵医行为问卷得分的差异无统计学意义（P〉0．05）；出院3个月、6个月的遵医行为问卷得分差异有统计学意义（P＜0．05），干预组遵医行为问卷得分高于对照组。出院时两组患者Harris评分差异无统计学意义（P〉0．05），出院后6个月两组Harris评分差异有统计学意义（P＜0．05），干预组Harris得分高于对照组。结论电话随访联合家庭督导员的护理干预有助于提高人工髋关节置换术后出院患者遵医行为和改善髋关节功能。

Objective To explore the effect of postdischarge telephone intervention with both patients and family caregivers to improve patients compliance with doctors＇ advice and promote the rehabilitation of patients after hip replacement. Method Totally 249 participants were assigned to an experimental group and a control group according to the discharge date. The patients in the experimental group received the first telephone intervention 3 to 7 days after discharge and the next two call one month,three months after discharge and their family caregivers received telephone intervention every half month. The telephone intervention contents include exercise,cautions in daily life and regular examination. The patients in the control group received routine health education and follow-up. All participants were investigated by the questionnaire of compliance with doctors＇ advice on the discharge day and one month,three months,six months after discharge. The Harris Hip Score of patients was assessed on discharge day and six months after discharge. Results There were no significant difference between the scores of patient＇s compliance with doctors＇ advice in two groups on discharge day and one month after discharge,and the scores in the experimental group were significantly higher than those in the control group three months,six months after discharge（P〈0.05）. There were no significant difference between the Harris Hip Score of patients in two groups when they were discharged,and the Harris Hip Score in the experimental group was significantly higher than that in the control group six months after discharge（P〈0.05）. Conclusion Telephone intervention with both patients and family caregivers can improve patients＇ compliance with doctors＇ advice and promote their hip joint function rehabilitation.