基于CICARE沟通模式的赋能护理模式对老年髋骨骨折患者术后恐动症及跌倒恐惧心理的影响

Effects of empowerment nursing based on CICARE communication mode on postoperative kinesiophobia and fear of falling in elderly patients with hip fractures

目的探究基于CICARE沟通模式的赋能护理模式对老年髋骨骨折患者术后恐动症及跌倒恐惧心理的影响。方法选择2019年1月至2022年1月在西安国际医学中心医院就诊的84例老年髋骨骨折患者为研究对象,按随机数表法分为观察组和对照组各42例。对照组患者采用常规护理方式,观察组患者采用基于CICARE沟通模式的赋能护理模式,两组均进行3个月护理。比较两组患者护理前后的术后患者恐动症评分量表(TSK)评分、国际跌倒效能感量表(FES-I)评分、Berg平衡量表(BBS)评分、汉密尔顿焦虑评分表(HAMA)评分、一般自我效能感量表(GSES)评分、改良Barthel指数评定量表(MBI)评分及护理满意度,记录患者术后并发症发生情况。结果护理后,观察组患者的FES-I、TSK及HAMA评分分别为(10.04±3.18)分、(29.49±4.38)分、(8.72±1.45)分,明显低于对照组的(12.73±3.01)分、(34.15±5.27)分、(10.58±2.01)分,差异均有统计学意义(P<0.05);护理后,观察组患者BBS、GSES及MBI评分分别为(49.33±7.15)分、(35.42±3.37)分、(78.06±8.65)分,明显高于对照组的(42.84±6.56)分、(28.16±4.51)分、(71.22±8.14)分,差异均有统计学意义(P<0.05);护理后,观察组患者护理满意度中的情志护理、护理技术、护理态度、健康教育评分分别为(23.06±1.24)分、(22.43±1.08)分、(21.72±0.94)分、(23.21±0.87)分,明显高于对照组的(20.18±1.52)分、(19.59±1.26)分、(18.91±1.52)分、(22.06±1.13)分,差异均有统计学意义(P<0.05);观察组和对照组患者术后并发症总发生率分别为7.14%、14.29%,差异无统计学意义(P>0.05)。结论基于CICARE沟通模式的赋能护理模式能够降低老年髋骨骨折患者跌倒恐惧程度、提高其平衡能力,改善术后恐动症情况,并能提高其自我效能,改善其不良情绪,提高术后生活能力,护理满意度更高。

Objective To explore the effect of empowerment nursing based on Connect,Introduce,Communi-cate,ask,respond,exit(CICARE)communication mode on postoperative kinesiophobia and fear of falling in elderly pa-tients with hip fractures.Methods A total of 84 elderly patients with hip fractures treated in Xi'an International Medi-cal Center Hospital between January 2019 and January 2022 were enrolled as the research subjects.According to random number table method,they were divided into an observation group(n=42)and a control group(n=42).The control group was given routine nursing,while the observation group was given empowerment nursing based on CICARE communica-tion mode for 3 months.The scores of Tampa Scale for Kinesiophobia(TSK),Short Falls Efficacy Scale International(FES-I),Berg Balance Scale(BBS),Hamilton Anxiety Scale(HAMA),General Self-efficacy Scale(GSES),modified Barthel index(MBI),and nursing satisfaction were compared between the two groups before and after nursing.The oc-currence of postoperative complications was recorded.Results After nursing,scores of FES-I,TSK,and HAMA in the observation group were(10.04±3.18)points,(29.49±4.38)points,and(8.72±1.45)points,significantly lower than(12.73±3.01)points,(34.15±5.27)points,(10.58±2.01)points in the control group(P<0.05).After nursing,scores of BBS,GSES,and MBI in the observation group were(49.33±7.15)points,(35.42±3.37)points,and(78.06±8.65)points,significantly higher than(42.84±6.56)points,(28.16±4.51)points,(71.22±8.14)points in the control group(P<0.05).Af-ter nursing,scores of nursing satisfaction with emotional nursing,nursing techniques,nursing attitudes,and health educa-tion in the observation group were(23.06±1.24)points,(22.43±1.08)points,(21.72±0.94)points,and(23.21±0.87)points,significantly higher than(20.18±1.52)points,(19.59±1.26)points,(18.91±1.52)points,(22.06±1.13)points in the con-trol group(P<0.05).The difference in total incidence of postoperative complications between the observation group and the control group was not statistically significant(7.14%vs 14.29%,P>0.05).Conclusion The empowerment nursing based on CICARE communication mode can reduce the fear of falling,improve balance ability,improve postoperative kinesiophobia and self-efficacy,relieve negative emotions and improve postoperative activities of daily living in elderly patients with hip fractures,with higher nursing satisfaction.