电话随访式延续护理对老年患者全髋关节置换术后生活质量和功能恢复的影响

Effect of nursing intervention by telephone interviews on life quality and functional recovery in the elderly with total hip replacement

目的探讨电话随访式延续护理对老年患者行髋关节置换术后生活质量和功能恢复的影响。方法选择2013年1月至2014年6月在我科接受全髋关节置换手术的老年（≥60岁）患者105例,按随机数字表法分为电话随访组49例和对照组56例。电话随访组患者在出院后1～6个月通过电话随访开展髋关节置换术后相关知识的健康教育,解答患者的健康问题。根据患者的健康情况,告知患者如何掌握适当的活动量、如何减少高危因素、怎样预防并发症的发生。对照组不进行主动的电话干预。所有患者在出院后1、3、6个月时进行随访。采用Harris评分对患者出院后的髋关节功能进行评价,采用SF-36健康调查量表对患者出院后的生活质量进行测量,记录患者出院后并发症的发生率。结果两组患者出院时和出院后1个月时Harris评分和SF-36量表评分差异无统计学意义（P〉0.05）;出院后第3、6个月时电话随访组Harris评分[（81.3±6.3）、（92.1±7.2）分]和SF-36量表评分[（631.5±106.2）、（695.1±107.3）分]明显高于对照组,差异有统计学意义（P〈0.05）。电话随访组患者在出院后并发症的发生率（并发症率为3/49,6.1%）明显低于对照组（并发症率为7/56,12.5%）,差异有统计学意义（P〈0.05）。结论电话随访式延续护理有助于患者的髋关节功能随访、降低并发症、提高患者生活质量,值得在护理工作中推广应用。

quality of life and Objective To determine the effect of nursing intervention by telephone interviews on the functional recovery in the elderly patients after total hip replacement. Methods A total of 105 elderly patients （ ≥60 years old） undergoing total hip replacement in our institute from January 2013 to June 2014 were recruited in this study. The patients were randomly divided into telephone interview group （n =49） and control group （n = 56）. The patients in the telephone interview group were given telephone interviews on the related knowledge of health education about the hip replacement, and their personal health problems would be resolved at the same time. According to the patient＇ s health status, the patients were informed through telephone interview on how to master the appropriate activity, reduce risk factors, and prevent the happening of the complications. However, the patients in the control group were not told these advises unless they went to visit a doctor. All of the patients were followed up for 1, 3 and 6 months after discharge. Harris scores were used to evaluate the hip function, and the SF-36 health survey scale was employed to assess the quality of life of the patients. Furthermore, the incidence of complications after discharge was recorded. Results There were no significant differences in Harris scores and SF-36 scale scores between the 2 groups on discharge and in 1 month after discharge （ P 〉 0.05 ）. However, significant differences were found in the scores in 3 and 6 months after discharge between them （ Harris score ： 81.3 ± 6.3 vs 92.1 ±7.2, SF-36 score： 631.5 ±106.2 vs 695.1 ±107.3, P 〈0.05）. Furthermore, the incidence of complications was significant lower in the telephone interview group （3/49, 6.1% ） than the control group （7/56, 12. 5%, P 〈 0. 05 ）. Conclusion Continuous nurse intervention by telephone support and counseling is helpful for the promotion of functional recovery, decrease of complications and improvement of patient＇ s quality of life in the postoperative phase after hip replacement, and is worth of population in nursing practice.