全膝关节置换老年患者术后居家康复体验的现象学研究

Experience of Home-based Rehabilitation of Elderly Patients with Total Knee Arthroplasty:A Phenomenological Study

目的 深入了解全膝关节置换老年患者在居家康复阶段的体验,为制定居家情境下的延续护理策略提供依据。方法 采用现象学研究方法,选取2021年11月至2022年2月上海市某三级甲等医院骨科全膝关节置换术治疗出院的10例老年患者(≥60岁)进行半结构式访谈,采用Colaizzi七步分析法进行资料分析。结果 全膝关节置换患者术后居家康复体验可归纳为3个主题:满意功能改善与担忧不适症状并存,与康复训练的困难博弈,需要外界支持。结论 全膝关节置换老年患者在居家康复阶段存在症状管理、多学科制定动态康复训练方案以及医疗咨询的需求,应联合线上远程医疗技术、线下多级医疗机构的资源,为患者提供专业支持,鼓励照护者参与出院准备,提供环境设施建议,保障外界支持,促进居家快优康复。

Objective To explore the experience of elderly patients with total knee arthroplasty in the rehabilitation phase at home, and to provide a basis for formulating continuous nursing strategies at home.Methods The phenomenological research method was used to select 10 elderly patients(≥60) who were discharged from the Orthopedic Department of a tertiary A hospital in Shanghai from November 2021 to February 2022 after total knee arthroplasty for semi-structured interviews, and the Colaizzi 7-step analysis method was used to analyze the data.Results 3 themes were extracted, namely the coexistence of satisfactory function improvementand worrying discomfort symptoms, the struggle with difficulties in rehabilitation training, and the need of external support.Conclusions Elderly patients with total knee arthroplasty have the need for the symptom management, multidisciplinary development of dynamic rehabilitation training programs and medical consultation in the home-based rehabilitation.Online telemedicine technology and offline resources of multi-level medical institutions should be combined to provide professional support for patients.Caregivers should be encouraged to participate hospital discharge to preparation, provide advice on environment and facilities, guarantee the external support, and to promote rapid recovery at home.