保护动机理论在老年骨质疏松性脊柱骨折患者中的应用

Application of protection motivation theory in elderly patients with osteoporotic spinal fractures

目的 探讨保护动机理论对老年骨质疏松性脊柱骨折跌倒风险、跌倒发生率及自我效能的影响.方法 2015年2月—2016年8月整群选取无锡市第二人民医院老年骨质疏松性脊柱骨折患者94例,应用随机数字表分为对照组46例和观察组48例,对照组应用常规护理,观察组加行保护动机干预.采用跌倒风险测评量表（FRAQ）、骨质疏松自我效能量表（OSES）比较干预前后两组患者的跌倒风险性评分和自我效能,统计并比较两组跌倒发生率.结果 干预6个月后,观察组跌倒发生率为2.08%（1/48）,对照组跌倒发生率为13.04%（6/46）,两组比较差异有统计学意义（χ2=4.094,P〈0.05）.干预后6个月,观察组跌倒风险性评分为（36.46±3.08）分,低于对照组;摄钙效能分量表（44.98±2.84）分、运动效能分量表（48.54±2.85）分,高于对照组;差异均有统计学意义（t值分别为3.817、4.946、8.186;P〈0.05）.结论 应用保护动机理论干预可有效减低骨质疏松性脊柱骨折患者跌倒风险和发生率,提高患者摄钙效能及运动效能,值得推广.

Objective To explore the effects of protection motivation theory on fall risk caused by senile osteoporotic spinal fracture, fall incidence and self-efficacy.Methods A total of 94 cases of senile osteoporotic spinal fracture in Wuxi Second People＆#39;s Hospital from February 2015 to August 2016 were selected and divided into the control group （46 cases） and the observation group （48 cases） according to the random number table. Patients in the control group used routine nursing care, while patients in the observation group received additional protection motivation intervention. The fall risk assessment questionnaire （FRAQ） and osteoporosis self-efficacy scale （OSES） were used to compare the fall risk score, self-efficacy and the incidence of fall of the two groups before and after the intervention.Results At 6 months after the intervention, the incidence of fall was 2.08%（1/48） in the observation group and 13.04%（6/46） in the control group. The difference between two groups was statistically significant （χ2=4.094,P〈0.05）. The fall risk score in the observation group was （36.46±3.08） %, which was significantly lower than that in the control group; calcium uptake efficiency score （44.98±2.84） and exercise self-efficacy scale score （48.54±2.85） in the observation group were significantly higher than those in the control group （t=3.817, 4.946, 8.186;P〈0.05）.Conclusions Application of protection motivation theory intervention can effectively reduce the risk and the incidence of fall in patients with osteoporotic vertebral fracture and improve the calcium uptake efficiency and exercise self-efficacy. It is worthy of promotion.