中老年乡镇居民全髋关节置换术后居家康复效果的影响因素

Study on influencing factors of home rehabilitation after total hip arthroplasty in middle-aged and elderly township residents

目的了解乡镇中老年患者全髋关节置换术后居家康复效果及其影响因素,为同行在相应领域中制定针对性策略提供依据。方法通过对2016年10月—2020年10月在医院行全髋关节置换术的乡镇中老年患者居家康复效果,进行单因素及Logistic回归分析,找出影响其康复的危险因素。结果共有138例患者纳入研究,男73例(占52.90%),女65例(占47.10%),年龄45~86(58.36±10.66)岁。因康复不良或关节移位,术后3个月再次入院手术患者10例(占7.25%)。其中年龄、接受教育程度、照顾者角色、信息获取途径纳入回归方程。在多因素分析结果显示:年龄、主要照顾者、康复信息主要来源是患者Harris髋关节功能康复效果的影响因素。年龄越大Harris髋关节功能康复效果越差;在学历方面,本科及以上学历患者Harris髋关节功能康复效果优于低学历患者,并比高中及专科学历的患者Harris髋关节功能康复效果好;在照顾者因素中,夫妻照顾的患者Harris髋关节功能康复效果不如子女照顾的患者,父母照顾的患者康复效果比子女照顾的患者较差,保姆照顾者康复效果最差;在信息来源中,医院出院指导及电话随访指导的患者Harris髋关节功能康复效果优于单纯出院指导的患者,个人经验为指导信息的患者康复效果最差。差异有统计学意义(P<0.05)。结论对于乡镇居民在接受全髋关节置换术后长时间的居家康复过程,做好高龄老人、低教育程度患者的术前评估,重视照顾者的教育,拓宽服务渠道有利于患者康复。

Objective To explore the home rehabilitation effect of middle-aged and elderly patients in townships after total hip arthroplasty and its influencing factors,so as to provide some recommendations to formulate targeted strategies in corresponding fields.Methods Based on the home rehabilitation effect of middle-aged and elderly township patients who underwent total hip arthroplasty in hospital from October 2016 to October 2020,univariate and Logistic regression analysis were conducted to find out the risk factors affecting their rehabilitation.Results A total of 138 patients were included in the study:73 males(52.90%)and 65 females(47.10%),aged 45-86(58.36±10.66).Due to poor rehabilitation or joint displacement,10 patients(7.25%)were readmitted to the hospital three months after operation.Age,education background,caregiver role and access to information were included in the regression equation.The results of multivariate analysis showed that age,main caregivers and main sources of rehabilitation information were the influencing factors for the rehabilitation effect of patients’Harris hip function.The older Harris was,the worse the hip recovery effect was.In terms of educational background,the rehabilitation effect of Harris hip function in patients with high educational background was better than that in patients with low educational background.In terms of the caregiver factor,the rehabilitation effect of Harris hip function of patients taken care of by husband and wife was worse than that of patients attended by children,and the rehabilitation effect of nurse caregivers was the worst.Among the information sources,the rehabilitation effect of Harris hip function in patients with hospital discharge guidance and telephone follow-up guidance was better than that of patients with discharge guidance alone,and the rehabilitation effect of patients with personal experience as guidance information was the worst.(P<0.05).Conclusion For township residents in the long rehabilitation at home after total hip arthroplasty,preoperative evaluation of the elderly and patients with low education level,the education of caregivers,and broadened educational channels are conducive to patients’rehabilitation.