联络员主导的老年髋部骨折患者精准随访方案的构建与应用研究

Construction and application of accurate follow-up program for elderly patients with hip fracture led by liaison staff

目的 构建和应用以联络员为主导的老年髋部骨折患者精准随访方案,以规范此类患者的随访工作。方法 通过大量文献查阅、小组讨论和2轮Delphi专家咨询构建老年髋部骨折患者术后精准随访方案。以2020年8月-2021年1月骨科住院的110例老年髋部骨折患者作为研究对象,根据患者所在病区将其分为观察组和对照组,观察组实施基于联络员主导的精准随访方案,对照组采取常规随访和健康指导。随访6个月后,通过负性认知和健康赋权水平比较2组患者的随访效果。结果 本研究构建的老年髋部骨折患者精准随访方案包括联络员准入、随访频率、随访方式、随访评估和随访指导5个部分,涉及24项具体内容。随访6个月后,观察组患者的负性注意偏向、负性沉思偏向和负性认知总分低于对照组,患者获取支持、增长知识、参与治疗和健康赋权总分高于对照组,差异均有统计学意义(P<0.05)。结论 联络员主导的老年髋部骨折患者精准随访方案具有科学性和实用性,该方案的使用可降低患者的负性认知,提高其健康赋权水平。

Objective To construct and apply an accurate follow-up schemefor elderlypatients with hip fracture led by liaison staff, and to standardize the follow-up work of such patients. Methods Through a large number of literature review, group discussion, and 2 rounds of Delphi expert consultation, the postoperative accuratefollow-up schemefor elderly patients with hip fracturewas constructed.A total of 110 elderly patients with hip fracture who were hospitalized in orthopedics department from August 2020 to January 2021 were taken as the research object. Patients were divided into the experimental group and the control group according to their wards. The experimental group received the accurate follow-up scheme led by the liaisonstaff, and the control group was adopted routine follow-up and health guidance.After 6 months of follow-up, the outcomes of the two groups were compared by negative cognition and health empowerment. Results The accurate follow-up program for elderly patients with hip fracture constructed in this study included5 parts: contact access, follow-up frequency, follow-up method, follow-up evaluation and, follow-up guidance, involving 24 specific contents.After 6 months of follow-up, the total scores of negative attentional bias, negative meditation bias, and negative cognition in the experimental group were lower than those in the control group, while the total scores of patients’ access to support, knowledge growth, participation in treatment and health empowerment were higher than those in the control group, with statistical significance(P<0.05).Conclusions The accurate follow-up program for elderly patients withhip fracture led by liaison staffs is scientific and practical. The application of this program can reduce patients’ negative cognition and improve their health empowerment level.