行动研究法在血友病患者膝关节置换术后功能锻炼策略制定中的应用

The application of action research method in developing rehabilitation strategy for hemophilia patients with Total Knee Arthroplasty

目的 :构建血友病患者膝关节置换术后功能锻炼策略,以期减少出血发生率和改善膝关节活动度,提高护理质量。方法 :以行动研究法为理论框架,综合应用文献研究、专家会议等方法收集、分析资料。便利选取2015年至2017年收治的132例血友病患者为研究对象,采用出血发生率和膝关节活动度对行动研究的效果进行评价。结果 :通过对第1个阶段持续被动关节活动器(CPM)辅助锻炼法的优化,患者出血发生率明显下降,膝关节活动度明显增加,与之前比较差异均具有统计学意义(P<0.05);通过第2个阶段三期主动运动法的构建,患者膝关节活动度明显增加,与第一阶段CPM辅助锻炼法比较差异具有统计学意义(P<0.05)。结论 :行动研究法是解决多学科合作、复杂问题的有效方法,本研究基于行动研究法形成了血友病患者膝关节置换术后功能锻炼策略,该方法可适用于临床实践,以提高护理质量。

Objective: To develop the rehabilitation strategy and improve bleeding and range of motion(ROM) in hemophilia patients with Total Knee Arthroplasty(TKA). Methods: The action research method was performed as the framework. The literature research, expert meetings were applied to collect and analyze data. Totally 132 hemophilia patients were included. The incidence of bleeding and the ROM were analyzed. Results: After the application of optimization of CPM program, the incidence of bleeding was significantly reduced and the ROM was significantly increased(P<0.05). After the application of construction of 3 phases active exercise, the ROM was significantly increased(P<0.05). Conclusion: Action research is an effective method to solve multidisciplinary cooperation and complex problems. Based on action research, rehabilitation strategy for hemophilia patients with TKA are developed. It is expected to apply the rehabilitation strategy to clinical practice to improve the quality of nursing care.