基于认知-心理-疼痛维度的专项护理对老年股骨颈骨折患者疾病不确定感、康复训练依从性和关节功能的影响

Effects of special nursing based on cognition-psychology-pain dimensions on disease uncertainty,rehabilitation training compliance and joint function in elderly patients suffered from femoral neck fractures

目的探讨基于认知-心理-疼痛维度的专项护理对老年股骨颈骨折患者疾病不确定感、康复训练依从性和关节功能的影响。方法选择2019年1月—2021年12月本院收治的86例老年股骨颈骨折患者为研究对象,采用随机数表法分为对照组和观察组两组,每组各43例。对照组实施常规护理干预,观察组在其基础上实施基于认知-心理-疼痛维度的专项护理干预。比较术后2 h时、术后12 h时、术后1 d时,两组患者疼痛状况[数字疼痛评分法(NRS)]。记录干预前及干预3个月后,两组患者疾病不确定感[疾病不确定感成人量表(MUIS量表)]、训练依从性(康复训练依从性量表),比较干预3个月后,两组患者关节功能[Harris髋关节功能评分量表(Harris量表)]。结果术后12 h时、术后1 d时较术后2 h时,两组患者NRS量表评分均有上升,且观察组低于同时间段对照组,差异有统计学意义(P<0.05)。干预3个月后较干预前,两组患者MUIS量表评分均有下降,且观察组低于对照组,差异有统计学意义(P<0.05)。干预3个月后较干预前,两组患者康复训练依从性量表均有上升,且观察组高于对照组,差异有统计学意义(P<0.05)。干预3个月后,观察组患者各项Harris量表评分均高于对照组,差异有统计学意义(P<0.05)。结论基于认知-心理-疼痛维度的专项护理可帮助老年股骨颈骨折患者缓解术后疼痛,减少疾病不确定感,提高训练依从性,加快关节功能恢复,具有临床价值。

Objective To explore the effects of special nursing based on cognition-psychology-pain dimensions on disease uncertainty,rehabilitation training compliance and joint function in elderly patients with femoral neck fractures.Methods 86 elderly patients suffered from femoral neck fractures who were treated in the hospital from January 2019 to December 2021 were selected as the research subjects,and they were divided into control group and observation group with 43 cases in each group by the completely randomized grouping method of the random number table method.The control group carried out routine nursing intervention,while the observation group was given special nursing intervention based on cognition-psychology-pain dimensions.The pain status[Numerical Rating Scale(NRS)]was compared between the two groups at 2 hours,12 hours and 1 day after surgery.The disease uncertainty[Mishel Uncertainty in Illness Scale for Adults(MUIS scale)and training compliance(Rehabilitation Training Compliance Scale)of patients in the two groups were recorded before intervention and after 3 months of intervention,and the joint function[Harris Hip Function Scale(Harris scale)]of patients in the two groups was compared after 3 months of intervention.Results The NRS score of the two groups were increased at 12 hours and 1 day after surgery compared with that at 2 hours after surgery,and the NRS score in observation group was lower than that in control group at the same time point(P<0.05).After 3 months of intervention,the scores of MUIS scale in the two groups were decreased compared with those before intervention,and the scores in observation group were lower compared with those in control group(P<0.05).The scores of items of rehabilitation training compliance scale of patients in both groups were enhanced after 3 months of intervention compared to those before intervention,and the above scores were higher in observation group(P<0.05).After 3 months of intervention,the scores of aspects of Harris scale in observation group were higher than those in control group(P<0.05).Conclusions Special nursing based on cognition-psychology-pain dimensions can help to relieve the postoperative pain,reduce the disease uncertainty,improve the training compliance of elderly patients with femoral neck fractures and accelerate the joint function recovery,and it has clinical value.