基于行为分阶段转变理论的干预方案在踝关节骨折术后患者中的应用

Application of Intervention Programs Based on the Theory of Behavior Change in Stages in Patients with Ankle Fracture After Operation

目的探讨基于行为分阶段转变理论的干预方案在踝关节骨折术后患者中的应用效果。方法采用前瞻性随机对照研究,选取濮阳市中医医院2020年8月至2022年8月收治需行手术治疗的踝关节骨折患者作为研究对象,采用随机数字表法将患者分为常规组与观察组。常规组接受常规护理,观察组在对照组基础上联合基于行为分阶段转变理论的干预方案。记录两组患者临床指标(住院时间、下床活动时间、骨折愈合时间),记录住院期间内并发症(感染、深静脉血栓等)发生率。出院时评估两组患者的治疗依从性、护理效果,于术后3个月时使用美国矫形足踝协会踝-后足评分系统评估踝关节功能。结果观察组住院时间、骨折愈合时间短于常规组,差异有统计学意义(P<0.05)。观察组治疗依从率高于常规组,观察组护理效果优于常规组,观察组并发症发生率低于常规组,差异有统计学意义(P<0.05)。术后3个月,观察组患者踝关节功能优于常规组,差异有统计学意义(P<0.05)。结论基于行为分阶段转变理论的干预方案可有效缩短住院、骨折愈合时间,延长下床活动时间,提高护理效果及患者治疗依从性,改善踝关节功能,降低术后并发症发生率。

Objective To explore the application effect of intervention programs based on the theory of behavior change in stages in patients with ankle fracture after operation.Methods A prospective randomized controlled study was used to select patients with ankle fracture who were admitted to Chinese Medicine Hospital of Puyang for surgical treatment from August 2020 to August 2022 as the study subjects.The patients were divided into the routine group and the observation group by random number table method.The routine group was treated with routine nursing.On this basis,the observation group combined with theory of behavior change in stages intervention.The clinical indicators(hospitalization time,time of getting out of bed,time of fracture healing)of the two groups of patients were recorded,and the incidence of complications(infection,deep vein thrombosis,etc.)during hospitalization was recorded.The treatment compliance and nursing effect of the two groups of patients were evaluated at the time of discharge,and the ankle joint function was evaluated using the American Orthopedic Foot and Ankle Association ankle-posterior foot scoring system at 3 months after operation.Results The time of hospitalization and fracture healing in the observation group was shorter than that in the routine group(P<0.05).The treatment compliance rate of the observation group was higher than that of the routine group,the nursing effect of the observation group was better than that of the routine group,and the complication rate of the observation group was lower than that of the routine group(P<0.05).Three months after operation,the ankle joint function of patients in the observation group was better than that in the routine group(P<0.05).Conclusion The intervention program based on the theory of behavior change in stages can effectively shorten the time of hospitalization and fracture healing,prolong the time of getting out of bed,improve the nursing effect and the patient’s treatment compliance,improve the ankle joint function,and reduce the rate of postoperative complications.