基于健康信念的阶梯式护理干预策略在儿童肱骨髁上骨折术后康复中的应用

Application of stepwise nursing intervention strategy based on health beliefs in the postoperative rehabilitation of children with humerus supracondylar fracture

目的 探讨基于健康信念的阶梯式护理干预策略在儿童肱骨髁上骨折术后康复中的应用效果。方法 纳入安徽省阜阳市人民医院2022年5月至2023年3月拟行手术治疗的100例肱骨髁上骨折患儿,按照随机数字表法将其分为观察组和对照组,各50例。两组均进行常规健康宣教,对照组在此基础上实施阶梯式护理干预,观察组在对照组基础上加健康信念干预,两组均干预12周。干预后,评估两组锻炼依从性,比较干预前后两组肘关节活动度、肘关节功能评分,出院前评估家属满意度[纽卡斯尔护理满意度量表(NSNS)]。结果 观察组整体锻炼依从性高于对照组(P<0.05)。干预后,两组屈曲、旋前、旋后活动度均较干预前升高,且观察组高于对照组,两组伸直活动度较干预前降低,且观察组低于对照组(P<0.05)。干预后,两组疼痛、运动、稳定性、日常生活功能均较干预前提高,且观察组高于对照组(P<0.05)。观察组家属NSNS评分高于对照组(P<0.05)。结论 基于健康信念的阶梯式护理干预策略可提高儿童肱骨髁上骨折术后康复锻炼依从性,促进肘关节功能恢复,且患儿家属满意度高。

Objective To explore the application effect of stepwise nursing intervention strategy based on health beliefs in the postoperative rehabilitation of children with humeral supracondylar fractures.Methods A total of 100 children with humerus supracondylar fracture who were scheduled for surgical treatment in Fuyang People's Hospital,Anhui Province from May 2022 to March 2023,and they were divided into the observation group and the control group by random number table method,with 50 cases in each group.Both groups received routine health education,while the control group received stepwise nursing intervention on this basis.The observation group received health belief intervention on the basis of the control group.Both groups received 12 weeks of intervention.After intervention,the exercise compliance of the two groups was evaluated.The elbow joint activity and elbow joint function score were compared between the two groups before and after intervention.The family satisfaction(Newcastle nursing satisfaction scale [NSNS]) was evaluated before discharge.Results The overall exercise compliance of the observation group was better than that of the control group(P<0.05).After intervention,the flexion,pronation,and supination activity of both groups increased compared with those before intervention,and the observation group was higher than the control group.The extension activity of both groups decreased compared with those before intervention,and the observation group was lower than the control group(P<0.05).After intervention,the pain,movement,stability,and daily living function of both groups improved compared with those before intervention,and the observation group was higher than the control group(P<0.05).The NSNS scores of family members in the observation group were higher than those in the control group(P<0.05).Conclusion The stepwise nursing intervention strategy based on health beliefs can improve the compliance of postoperative rehabilitation exercises for children with humerus supracondylar fractures and promote the recovery of elbow joint function,and have high satisfaction from the families of the children.