自我效能与加速康复外科干预对老年全髋关节置换患者围术期的护理效果分析

Analysis of Perioperative Nursing Effect of Self-efficacy and Enhanced Recovery after Surgery Intervention on El⁃derly Patients with Total Hip Arthroplasty

目的:探讨自我效能与加速康复外科干预对老年全髋关节置换患者围术期的护理效果。方法:选取2020年3月—2021年4月郑州市骨科医院收治的82例老年全髋关节置换术患者作为研究对象,按照随机数表法分为对照组和观察组,每组各41例。对照组采用加速康复外科干预,观察组在对照组采用加速康复外科干预的基础上联合自我效能干预。两组患者均干预至出院。比较两组患者干预前后自我效能评分、Harris评分,干预后手术相关指标、血栓发生情况。结果:干预后,两组患者自我效能评分均升高,且观察组高于对照组,差异有统计学意义(t=7.659,P<0.05)。干预后,观察组下床活动时间、术后住院时间短于对照组,观察组护理满意度高于对照组,差异有统计学意义(t=7.257、2.131,P<0.05;χ^(2)=4.970,P<0.05)。干预后,两组患者疼痛评分、关节畸形评分均降低,且观察组低于对照组,两组患者关节活动评分、日常活动能力与步态评分均升高,且观察组高于对照组,差异有统计学意义(t=8.425、2.357、9.722、9.578,P<0.05)。两组患者血栓发生情况比较,观察组下肢深静脉血栓阳性率、肺栓塞阳性率低于对照组,差异有统计学意义(χ^(2)=4.479、4.205,P<0.05)。结论:自我效能联合加速康复外科干预可改善老年全髋关节置换患者的髋关节功能,降低下肢深静脉血栓发生率,提高自我效能,满意度较高。

Objective:To investigate the perioperative nursing effect of self-efficacy and enhanced recovery after surgery intervention on elderly patients with total hip arthroplasty.Methods:A total of 82 elderly patients with total hip arthroplasty who were admitted to the hospital from March 2020 to April 2021 were selected as the research objects,and divided into the control group and the observation group according to the random number table method,with 41 cases in each group.The control group was treated with accelerated rehabilitation surgery intervention,and the observation group was treated with accelerated rehabilitation surgery intervention combined with self-efficacy intervention.The patients in both groups were treated until discharge.The self-efficacy score,Harris score,surgery-related indicators and thrombosis after the intervention were compared between the two groups before and after the intervention.Results:After the intervention,the self-efficacy scores of the two groups were increased,and the observation group was higher than the control group,and the difference was statistically significant(t=7.659,P<0.05).After the intervention,the time of getting out of bed and postoperative hospital stay in the observation group were shorter than those in the control group,and the nursing satisfaction in the observation group was higher than that in the control group,with statistically significant differences(t=7.257,2.131,P<0.05,χ^(2)=4.970,P<0.05).After the intervention,the pain scores and joint deformity scores of the two groups were decreased,and the observation group was lower than the control group,with statistically significant differences(t=8.425,2.357,9.722,9.578,P<0.05).The positive rates of lower extremity deep vein thrombosis and pulmonary embolism in the observation group were lower than those in the control group,and the difference was statistically significant(χ^(2)=4.479,4.205,P<0.05).Conclusion:Self-efficacy combined with enhanced recovery after surgery intervention can improve the hip function of elderly patients with total hip arthroplasty,reduce the incidence of lower extremity deep vein thrombosis,improve self-efficacy,and have higher satisfaction.