基于信息-动机-行为技巧的延续护理在膝关节置换术后患者中的应用

Information-motivation-behavioral skill based continuity nursing in postoperative knee arthroplasty patients

目的探讨基于信息-动机-行为技巧模型(IMB)下的延续护理在膝关节置换术(TKA)后患者中的应用价值,为临床提高康复自我效能及功能锻炼依从性提供新思路。方法选取医院骨一科2021年1月—2023年6月择期实施TKA的患者80例为研究对象,按照组间基线资料具有可比性原则将患者分为对照组和观察组,各40例。两组患者住院时间行常规围术期护理,出院后对照组行常规延续护理,观察组则基于IMB模型下实施延续护理,评估并比较两组患者护理前、护理1个月后、护理3个月后康复自我效能、功能锻炼依从性以及膝关节功能变化情况。结果两组患者三个时点(护理前、护理1个月后、护理3个月后),康复自我效能评分随康复时间的延长呈增加的趋势,时间之间差异有统计学意义(P_(时间)<0.05);护理后各时点均以观察组高于对照组,差异有统计学意义(P_(组间)<0.05),并且随观察时间延长,组间差异逐渐增大,差异有统计学意义(P_(交互)<0.05)。两组患者三个时点(护理前、护理1个月后、护理3个月后),功能锻炼依从性评分呈增加的趋势,时间之间差异有统计学意义(P_(时间)<0.05);护理后各时点均以观察组高于对照组,差异有统计学意义(P_(组间)<0.05),并且随观察时间延长,组间差异逐渐增大,差异有统计学意义(P_(交互)<0.05)。两组患者三个时点(护理前、护理1个月后、护理3个月后),膝关节功能评分呈增加的趋势,时间之间差异有统计学意义(P_(时间)<0.05);护理后各时点均以观察组高于对照组,差异有统计学意义(P_(组间)<0.05),并且随观察时间延长,组间差异逐渐增大,差异有统计学意义(P_(交互)<0.05)。结论基于IMB模型下对TKA患者开展延续护理,可通过增强患者康复自我效能与提升其功能锻炼依从性,继而进一步改善患者预后。

Objective To explore the application value of continuity of care based on the information-motivationbehavioral skill model(IMB)in patients total knee arthroplasty(TKA),to provide new ideas for clinical improvement of selfefficacy in rehabilitation and adherence to functional exercises.Methods 80 patients who underwent TKA in the Department of Orthopaedics from January 2021 to June 2023 were selected for the study,they were divided into a control group and an observation group of 40 cases each according to the principle of comparability of baseline data between groups.The patients in both groups underwent conventional perioperative care during hospitalization,and after discharge,the control group underwent conventional continuing care,while the observation group underwent continuing care based on the IMB model,and the changes in rehabilitation self-efficacy,compliance with functional exercises and knee function were evaluated and compared between the two groups before care,after 1 month of care and after 3 months of care.Results The results showed that the rehabilitation self-efficacy scores of the patients in the two groups at the three time points(before care,after 1 month of care,and after 3 months of care)tended to increase with the extend of recovery time,with statistically signifi cant differences between the time points(P<0.05);the observation group was higher than the control group at all time points after nursing,with statistically signifi cant differences(P<0.05),the difference between the two groups increased with the extension of the observation time after nursing,with statistically signifi cant differences(P<0.05).At three time points(before care,after 1 month of care,after 3 months of care),the functional exercise compliance scores of patients in the two groups showed an increasing trend,and the difference between the time points was statistically signifi cant(P<0.05);the observation group was higher than the control group at all time points,with statistically signifi cant differences(P<0.05),and the differences between the groups gradually increased with the extension of observation time,with statistical signifi cance(P<0.05).The knee function scores of the two groups at the three time points(before care,after 1 month of care,after 3 months of care)showed an increasing trend,and the difference between the time points was statistically signifi cant(P<0.05);the observation group was higher than the control group at all time points after nursing,and the difference was statistically significant(P<0.05),and the difference between the groups gradually increased with the extension of the observation time,and the difference was statistically signifi cant(P<0.05).Conclusion Continuing care for TKA patients based on the IMB model could further improve the prognosis of patients by enhancing their rehabilitation self-efficacy and improving their compliance with functional exercises.