回授法健康教育应用于膝关节镜下交叉韧带重建术术后功能康复锻炼的研究

Effect of health education based on the teach-back method in postoperative functional recovery among patients with arthroscopic cruciate ligament reconstruction

目的探讨回授法健康教育对膝关节镜下交叉韧带重建术术后功能康复的影响。方法选取2014年1月—2017年12月行膝关节镜下交叉韧带重建术患者50例,除脱落患者,入组观察组24例和对照组22例。对照组在常规护理的基础上给予常规健康教育,即口头宣教、发放健康教育指导手册、监督住院期间及出院后功能锻炼。观察组在常规护理的基础上进行回授法健康教育。于干预前、术后2周、1个月、3个月、6个月对患者进行功能训练知识水平测评,并使用Lysholm膝关节功能评分量表评估膝关节功能。于干预后3、6个月采用一般自我效能感量表(GSES)评估患者自我效能,并评价患者功能锻炼依从性。结果观察组术后2周、1个月、3个月、6个月功能训练知识水平评分均高于对照组(P <0. 01),观察组术后1、3、6个月Lysholm膝关节功能评分均高于对照组(P <0. 01)。观察组术后3、6个月GSES评分及功能锻炼依从性均优于对照组(P <0. 01)。结论基于回授法的健康教育模式能有效提高膝关节交叉韧带重建术术后患者功能锻炼的知识掌握程度、自我效能感、锻炼依从性,从而促进膝关节功能的恢复。

Objective To explore the application efficacy of health education based on teach-back method in postoperative functional recovery among patients with arthroscopic cruciate ligament reconstruction. Methods Totally 55 patients who underwent arthroscopic cruciate ligament reconstruction were randomly divided into two groups. Excluding the patients lost to follow-up, there were 24 cases in the observation group and 22 cases in the control group. In the control group, the routine nursing and conventional health education （face-to-face education, education handbook） were carried out. In the observation group, the routine nursing and health education based on the teach-back method were implemented. The knowledge of functional exercise and Lysholm knee scoring scale were assessed before and 2 weeks、1 month、3 months and 6 months after the surgery. The general self-efficacy （GSES） and functional exercise compliance were observed at 3 and 6 months after the surgery. Results Compared with the control group, the observation group had higher knowledge level of functional exercise at various time points after surgery respectively（ P 〈0.01）. The score of Lysholm knee scoring scale in the observation group was higher than that in the control group at 1, 3 and 6 months after operation（ P 〈0.01）. Compared with the control group, the observation group had higher score of GSES and compliance rate of functional exercise at 3 and 6 months after the surgery, respectively （ P 〈0.01）. Conclusion The health education based on teach-back method can effectively improve the knowledge of functional exercise, self-efficacy and exercise compliance in patients with arthroscopic cruciate ligament reconstruction, in order to promote the postoperative recovery of knee function.