集体康复训练在全髋置换高龄老人康复中的作用

Effect of the Group Therapy to rehabiliat tion of The Elder patients undergoing Total Hip Replacement

目的：通过集体康复训练，改善全髋置换高龄老人的心理状况和康复的主动性，提高患者康复的效果。方法：按随机分为个体组、集体组，每组30例全髋置换的高龄患者。2组均进行常规康复治疗，在治疗结束后，患者根据治疗师布置的锻炼内容开展自行康复。个体组：个体形式的自我功能锻炼。集体组：群体形式的集体功能锻炼。2组患者分别在治疗前、治疗后1个月、3个月进行 Harris和汉密尔顿抑郁量表（ HAMD）－17评定。在治疗3个月后还对2组发放调查表，了解2组患者在常规康复治疗与自行康复结束以后是如何支配闲置时间的。结果：治疗后1个月、3个月，在Harris与汉密尔顿抑郁量表（ HAMD）－17评分方面2组治疗前后均有提高，但集体组的评分明显高于个体组：Harris方面（P＜0．05），汉密尔顿抑郁量表（HAMD）－17方面（P＜0．05）。同时在闲置时间支配方面，患者自我锻炼的时间，集体组与个体组有明显差异，集体组的患者自我锻炼时间明显延长（P＜0．01），康复的主动性增强。结论：集体康复训练能够改善全髋置换高龄老人的心理状况、增强患者康复主动性与积极性，从而提高患者的康复疗效。

Objective：Improving the psychological status and rehabilitative motivation of the elderly patients undergoing total hip re -placement and enhancing the effect of rehabilitation through group therapy .Methods：To divided randomly into collective group and indi-vidual group （30 cases in each group） .Patients In two groups were treated with conventional treatment of rehabilitation .After treatment, according to therapist requirements , Self-help exercises in the collective group was done in form of group .After treatment of one month and three months ,each patients in two groups was evaluated the HARRIS and HAMD -17 .And when the patients had been treated for three months, Questionnaire stressed on how they spend their spare time handed to each participants .Results： After treatment of three months, there are significant differences in spare time distribution between the collective group and individual group .Patients in the col-lective group spent much longer time in doing functional activities and exercises than that of patients in the individual group （P〈0.01）. The psychological status and physical function of patients in collective group were significantly improved compared with that of patients in the individual group （HARRIS p〈0.05;HAMD-17 p〈0.05）.Conclusion：The group therapy was a helpful measure to improve reha-bilitative motivation and psychological condition of the elderly patients with total hip replacement and then further improved the effects of patient＆#39;s rehabilitation .