基于行动研究法的健康教育对全髋关节置换术患者术后康复的影响

Effects of health education based on action research method on the postoperative rehabilitation of patients with total hip replacement

目的探究基于行动研究法的健康教育对全髋关节置换术(THR)患者心理弹性、康复依从性、自护能力及术后髋关节功能康复的影响。方法采用随机数字表法将2019年1月—2022年1月河南省人民医院行THR的100例患者分为研究组(50例)与对照组(50例),分别接受基于行动研究法的健康教育与常规健康教育,干预至出院后3个月。干预前、干预后3个月分别通过心理弹性量表(CD-RISC)、Harris髋关节评分表对2组患者心理弹性、髋关节恢复情况进行评估,统计2组术后不同时间点康复依从情况、干预后1个月并发症发生情况,干预后3个月行自我护理能力测试量表(ESCA)测定。结果研究组干预后3个月CD-RISC与ESCA各项评分及干预后1个月、3个月Harris评分均明显高于对照组(均P<0.05);研究组术后1周、1个月、3个月完全依从率分别为88.00%、68.00%、54.00%,均明显高于对照组的50.00%、40.00%、28.00%(均P<0.05);研究组干预后1个月并发症总发生率(4.00%)明显低于对照组(22.00%,P<0.05)。结论基于行动研究法的健康教育能有效提高THR患者术后心理弹性与自护能力,增强其康复依从性,减少并发症,有利于髋关节恢复。

Objective To explore the effect of health education based on action research method on mental resilience,rehabilitation compliance,self-care ability and postoperative hip functional rehabilitation of patients with total hip replacement(THR).Methods A total of 100 patients who received THR in Henan Provincial People's Hospital from January 2019 to January 2022 were divided into study group(n=50)and control group(n=50)by the random number table method.They received action research method-based health education and routine health education respectively,and the intervention lasted for 3 months after discharge.Mental resilience and hip recovery of patients in the two groups were evaluated by using the Conner Davidson resilience scale(CD-RISC)and Harris hip rating scale before the intervention and after 3 months of intervention.The rehabilitation compliance of the two groups at different postoperative time points and complications after 1 month of intervention were analysed,and exercise self-care agency(ESCA)was performed after 3 months of intervention.Results The CD-RISC and ESCA scores of the study group were significantly higher than those of the control group after 3 months of intervention,as well as Harris scores after 1 and 3 months of intervention(all P<0.05).The complete compliance rates of the study group at 1 week,1 month and 3 months after surgery were 88.00%,68.00%and 54.00%,respectively,which were significantly higher than those of the control group at 50.00%,40.00%and 28.00%(all P<0.05).The total incidence of complications after 1 month of intervention in the study group was 4.00%,which was lower than that in the control group(22.00%,P<0.05).Conclusion Health education based on the action research method can improve the postoperative mental resilience and self-care ability of patients with THR,enhance their rehabilitation compliance,reduce complications and promote the recovery of hip joint.