HBM模式对老年髋关节置换术后髋关节功能、依从性及效能感影响研究

Effects of HBM model on the function of hip joint,compliance and efficacy in aged patients with hip replacement

目的:探究健康信念(HBM)模式的应用对老年髋关节置换术(THA)后髋关节功能、依从性及效能感的影响。方法:选取2013年2月至2015年2月于我院行THA的125例老年患者作为本次研究的对象,依据患者的护理方式分为HBM组和对照组,分别行HBM模式和常规护理模式。观察两组患者手术前后的髋关节功能、效能感的改变情况,并对患者术后参与康复训练的依从性进行评价。结果:术后3个月HBM组Harris评分、Barthel指数均高于对照组,差异有统计学意义(t=8.28、7.07,P<0.01),HBM组的GSES评分高于对照组且差异有统计学意义(t=7.22,P<0.01)。HBM组患者术后第1天、第10天早期训练依从性等级均显著高于对照组(P<0.01或0.05)。术后第1天HBM组焦虑评分低于对照组且差异有统计学意义(t=12.58,P<0.01),术后第10天HBM组的焦虑和抑郁评分均低于对照组,差异均有统计学意义(t=23.17、10.77,P<0.01)。结论:HBM护理模式能够显著改善老年THA患者术后的髋关节功能,提升自我效能感和依从性,对患者康复效果的提高有重要意义。

Objective： To explore the effects of health belief（ HBM） on the function of hip joint,compliance and efficacy in aged patients with hip replacement（ THA）. Methods： From February 2013 to February 2015 125 cases of elderly patients with THA in our hospital were divided into HBM group and control group according to the nursing method with HBM and routine nursing. Observed the changes of the function and the efficacy of the two groups before and after surgery,and evaluated the compliance of patients with rehabilitation training. Results： 3 months after the operation,HBM group＇s Harris score and Barthel index were higher than those of the control group,the difference was statistically significant（ t = 8. 28,7. 07,P〈0. 01）. 3 months after the operation,the GSES score of HBM group was higher than that of the control group,and the difference was statistically significant（ t = 7. 22,P〈0. 01）. Postoperative day 1,day 10 compliance levels in HBM group were significantly higher than those of control group（ P〈0. 01 or 0. 05）. Anxiety score of HBM group on postoperative day 1 was lower than that of the control group,and the difference was statistically significant（ t = 12. 58,P〈0. 01）. Postoperative anxiety and depression score on 10 days HBM group were lower than the control group,the differences were statistically significant（ t =23. 17,10. 77,P〈0. 01）. Conclusion： HBM nursing mode can improve the function of the hip joint,self efficacy and compliance of elderly patients with THA,and it has important significance to improve the rehabilitation effect.