基于社会生态系统理论的全膝关节置换术后老年患者康复体验的质性研究

Qualitative research on rehabilitation experience of elderly patients after total knee arthroplasty based on social ecosystem theory

目的了解全膝关节置换术后老年患者康复的真实体验,为开展针对性康复干预提供参考。方法采用现象学研究方法,基于社会生态系统理论设置提纲,对11例全膝关节置换术后老年患者进行半结构式访谈,采用Colaizzi七步分析法分析资料。结果析出3个主题:微观系统层面为生理功能减退及心理素质下降;中观系统层面为缺少社交及家庭照护支持不足;宏观系统层面为康复照护需求多样及外部支持系统不完善。结论全膝关节置换术后老年患者的社会生态系统不容乐观,医护人员应关注患者康复过程中影响心身健康的各系统因素,并提供针对性康复护理服务,改善全膝关节置换老年患者的康复结局。

Objective To study the real rehabilitation experience of elderly patients after total knee arthroplasty(TKA)and provide reference for developing targeted rehabilitation intervention.Methods Eleven elderly patients after TKA received semi-structured interview by phenomenological approach based on the outlines of social ecosystem theory.The information was analyzed by Colaizzi 7-step analysis.Results Three themes were extracted,which were decline on physiological function and psychological quality in micro system level,deficiency on socialize and family care in medium system level,and various demand on rehabilitation care and insufficient on external support system in macro system level.Conclusion The social ecosystem is not optimistic for elderly patients after TKA.Medical staff should pay attention to factors of all systems which would effect patients’psychosomatic health during rehabilitation,provide targeted rehabilitation care and improve rehabilitation outcome for elderly patients after TKA.