基于时机理论的综合护理方案在全膝关节置换术患者中的应用

Application of comprehensive nursing plan based on timing theory in patients with total knee arthroplasty

目的以时机理论为指导,根据全膝关节置换术患者不同时期需求,制定综合护理干预方案,旨在优化护理质量,促进患者早日康复。方法选取2022年6月—2023年6月在湖州市第一人民医院拟进行全膝关节置换术治疗的患者共108例,采用随机数字表法将其分为对照组和试验组,每组均54例。对照组给予常规护理和随访,试验组开展基于时机理论的综合护理干预,持续干预6个月,比较2组康复锻炼依从性、自我护理能力(ESCA)和膝关节功能量表(HSS)评分。结果试验组术后6个月康复锻炼依从性(主动学习依从、心理依从和身体依从)评分高于对照组(P<0.05);ESCA中的自我护理技能和健康知识水平维度评分及总分高于对照组(P<0.05);HSS评分中的功能、肌力、活动度、稳定性维度评分和总分分别为(18.98±3.70)分、(9.44±2.11)分、(17.45±3.09)分、(9.34±2.07)分、(85.78±5.67)分,均高于对照组[(14.23±2.45)分、(7.37±1.56)分、(15.23±3.44)分、(7.90±1.43)分、(74.29±5.62)分,t=17.866、19.091、16.789、23.451、19.231,P<0.05]。结论基于时机理论的综合护理对提高全膝关节置换患者术后康复锻炼依从性,增强自我护理能力,改善膝关节功能具有积极作用。

ObjectiveUnder the guidance of timing theory,according to the needs of total knee replacement patients in different periods,a comprehensive nursing intervention plan is developed to optimize the quality of nursing and promote the early recovery of patients.MethodsA total of 108 patients who were to undergo total knee arthroplasty in Huzhou First People's Hospital from June 2022 to June 2023 were selected and divided into control group and experimental group by random number table method,with 54 patients in each group.The control group was given routine nursing and follow-up,and the experimental group was given comprehensive nursing intervention based on timing theory for 6 months.The rehabilitation exercise compliance,exercise of self-care agency scale(ESCA)and hospital for special surgery(HSS)scores of the two groups were compared.ResultsThe scores of rehabilitation exercise compliance(active learning compliance,psychological compliance and physical compliance)of experimental group were higher than those of control group at 6 months after operation(P<0.05).The dimension scores and total scores of self-care skills and health knowledge level in ESCA were higher than those in control group(P<0.05).The scores of function,muscle strength,mobility and stability in HSS were(18.98±3.70)points,(9.44±2.11)points,(17.45±3.09)points,(9.34±2.07)points and(85.78±5.67)points,respectively,which were higher than those in the control group[(14.23±2.45)points,(7.37±1.56)points,(15.23±3.44)points,(7.90±1.43)points,(74.29±5.62)points,t=17.866,19.091,16.789, 23.451,19.231,P<0.05].ConclusionComprehensive nursing based on timing theory plays a positive role in improving postoperative rehabilitation exercise compliance,enhancing self-care ability and improving knee function of total knee replacement patients.