回授法健康教育模式在胫骨平台骨折患者术后康复训练中的应用

Effects of teach-back health education of rehabilitation exercise in patients after tibial plateau fracture surgery

目的探讨回授法健康教育模式在胫骨平台骨折患者术后康复训练中的应用效果。方法采用便利抽样法,选取2019年1月—2020年1月南京医科大学淮安第一医院收治的100例胫骨平台骨折术后患者为研究对象,按照随机数字表法随机分为对照组(n=50)和观察组(n=50)。对照组给予发放手册、集中讲座、康复训练专项指导、心理干预、饮食管理等常规护理干预,观察组联合应用回授法健康教育模式。随访6个月,比较两组患者的康复训练自我效能、康复训练依从行为、膝关节功能等指标。结果干预后,观察组胫骨平台骨折术后患者的应对自我效能、任务自我效能、康复自我效能总分高于对照组(P<0.05),且观察组胫骨平台骨折术后患者的身体锻炼依从、主动寻求建议依从、锻炼监督依从、康复训练依从性总分高于对照组(P<0.05)。观察组胫骨平台骨折术后患者的美国纽约康奈尔大学特种外科(HSS)医院膝关节功能评分、胫骨平台后倾角(PA)高于对照组,胫骨平台内翻角(TPA)低于对照组(P<0.05)。结论回授法健康教育模式有助于促进胫骨平台骨折术后患者康复自我效能的养成,增强康复训练依从行为,改善关节功能。

Objective To explore the effect of teach-back health education in postoperative rehabilitation exercise of patients after tibial plateau fractures surgery.Methods From January 2019 to January 2020,100 postoperative patients with tibial plateau fractures admitted to the Affiliated Huaian First Hospital of Nanjing Medical University were selected by convenience sampling as the research object.According to the random number table method,the patients were randomly divided into the control group(n=50)and the observation group(n=50).The control group was given routine nursing such as handbook distribution,intensive lectures,special guidance on rehabilitation exercise,psychological intervention,and diet management,while the observation group was given the teach-back health education.During the 6-month follow-up,the rehabilitation exercise self-efficacy,rehabilitation exercise compliance,and knee joint function were compared between the two groups.Results After intervention,the total scores of coping self-efficacy,task self-efficacy and rehabilitation self-efficacy of patients after tibial plateau fracture in the observation group were higher than those in the control group(P<0.05).The total scores of physical exercise compliance,active seeking advice compliance,exercise supervision compliance,and rehabilitation exercise compliance of patients in the observation group after tibial plateau fracture were higher than those in the control group(P<0.05).The knee joint function score of New York Cornell University Hospital for Special Surgery(HSS)and tibial plateau posterior slope angle of patients in the observation group after tibial plateau fracture surgery were higher than those in the control group,and the tibial plateau varus angle was lower than that of the control group,and the differences were statistically significant(P<0.05).Conclusions The teach-back health education is helpful to promote the development of rehabilitation self-efficacy in patients after tibial plateau fracture surgery,enhance rehabilitation exercise compliance,and improve joint function.