个案管理护理模式在髋关节置换术病人快速康复中的应用研究

Application Study of case management nursing model in rapid rehabilitation of hip arthroplasty patients

目的:研究个案管理护理模式在髋关节置换术病人快速康复中的应用效果。方法:选取2019年5月—2020年5月于深圳市宝安区石岩人民医院骨关节外科接受髋关节置换术的病人92例,按照随机抽签法等分为试验组和对照组。对照组实施常规护理干预,试验组在对照组基础上实施个案管理护理模式干预。比较两组病人干预前后心理状况、手术前后髋关节功能、干预前后自我管理能力、住院时间以及医疗费用等方面的差异。结果:干预后两组病人焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于干预前,且试验组病人SAS、SDS评分明显低于对照组(均P<0.05)。术后1个月、6个月、12个月两组病人Harris髋关节功能评分均高于术前,且试验组病人Harris髋关节功能评分明显高于对照组(均P<0.05)。干预后两组病人健康自我管理能力测定量表(AHSMSRS)各项评分均高于干预前,且试验组病人AHSMSRS各项评分明显高于对照组(均P<0.05)。试验组病人住院时间明显短于对照组,住院费用明显少于对照组(均P<0.05)。结论:个案管理护理模式可明显改善髋关节置换术病人的心理状态,促进髋关节功能恢复,提高自我管理能力,缩短住院时间,节省住院费用,有利于病人早日康复。

Objective:To study the application effect of case management nursing model in rapid rehabilitation of hip arthroplasty patients.Methods:A total of 92 patients who underwent hip arthroplasty in the department of orthopedics and arthroplasty of Shiyan people′s hospital of Bao′an district of Shenzhen city from May 2019 to May 2020 were selected and equally divided into experimental group and control group according to random drawing method.The patients in control group received routine nursing intervention,the patients in experimental group received case management nursing intervention on the basis of the routine nursing intervention.The psychological status before and after intervention,hip function before and after surgery,self-management ability before and after intervention,hospital stay time and medical expenses differences were compared between the two groups.Results:After intervention,the scores of Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)in two groups were lower than those before intervention,and the scores of SAS and SDS in experimental group were significantly lower than those in control group(all P<0.05).After 1 month,6 months and 12 months,Harris hip function scores in two groups were higher than those before surgery,and Harris hip function scores in experimental group were significantly higher than those in control group(all P<0.05).After intervention,the scores of Adult Health Self-Management Ability Scale(AHSMSRS)in two groups were higher than before intervention,and the scores of AHSMSRS in experimental group were significantly higher than those in control group(all P<0.05).The hospitalization duration in the experimental group was significantly shorter than that in the control group,and the hospitalization cost was significantly lower than that in the control group(all P<0.05).Conclusions:Case management nursing model can obviously improve the mental state of hip arthroplasty patients,promote recovery of hip function,improve self-management ability,shorten hospitalization time,save hospitalization costs,and facilitate patients to recover at soon as possible.