行为转变理论在全膝关节置换术康复中的应用

Initial outcomes of transtheoretical model used in rehabilitation of total knee arthroplasty

[目的]探讨行为转变理论(transtheoretical model,TTM)在全膝关节置换术康复中的应用初期效果.[方法]2021年1月-2021年6月拟行全膝置换的患者123例,采用抽签法随机分为两组.所有患者均行初次全膝置换手术,63例给予TTM干预,60例常规康复干预.比较两组的自我管理能力、膝关节功能、生活质量.[结果]自我管理能力方面,干预后两组患者的SMAS评分均较干预前显著增加(P<0.05),干预后TTM组SMAS评分各亚评分均明显高于常规组(P<0.05).在膝关节功能方面,随时间推移,两组患者的HSS评分均显著增加(P<0.05),术后1、3个月TTM组患者的HSS评分显著高于常规组(P<0.05).在生活质量方面,干预后两组患者的GQOLI-74评分均较干预前显著增加(P<0.05),干预后TTM组GQOLI-74评分各亚评分均明显高于常规组(P<0.05).[结论]应用行为转变理论的康复干预可有效提高患者术后的自我管理能力、促进膝关节功能恢复、改善生活质量.

[Objective]To explore the initial results of transtheoretical model(TTM)in the rehabilitation of primary unilateral total knee arthroplasty(TKA).[Methods]From January 2021 to June 2021,a total of 123 patients who were undergoing TKA were randomly divided into two groups by lotting.All patients received primary unilateral TKA,of them,63 patients were given perioperative TTM intervention,while the other 60 patients received conventional rehabilNation intervention.The self-management ability,knee function and quality of life were compared between the two groups.[Results]In terms of self-management ability,the SMAS scores in both groups increased sig・nificantly after intervention compared with those before intervention(P<0.05),and the TTM group proved significantly superior to the conventional group in all subscores of SMAS after intervention(P<0.05).In terms of knee function,HSS scores increased significantly over time in both groups(P<0.05),which in TTM group was significantly higher than that in conventional group at 1 and 3 months after operation(P<0.05).In terms of quality of life,the GQOLI-74 scores were significantly increased in both groups after intervention in comparison of those before intervention(P<0.05),and all subscores of GQOLI-74 in TTM group were significantly higher than those in conventional group after intervention(P<0.05).[Conclusion]The rehabilitation intervention enhanced by transtheoretical model does effectively improve patientsz self-management ability,promote the recovery of knee function and improve the quality of life.