基于Snyder希望理论的护理干预对老年ERAS全髋关节置换术患者预后及认知功能的影响

Effects of nursing intervention based on Snyder's hope theory on prognosis and cognitive function in elderly patients undergoing total hip arthroplasty with ERAS

目的探讨基于Snyder希望理论的护理干预对老年加速康复外科(ERAS)全髋关节置换术患者预后及认知功能的影响。方法选择2020年1月至2023年1月收治的120例全髋关节置换术患者,按照随机数字表法将其分为对照组和观察组,各60例。对照组采用常规ERAS护理,观察组在对照组基础上给予基于Snyder希望理论的护理干预。比较两组患者护理前、后的心理弹性、应对方式、髋关节功能与认知功能、希望水平及自我效能感。结果护理前,两组的心理弹性量表(CD-RISC)、医学应对问卷(MCMQ)各维度评分比较,差异无统计学意义(P>0.05);护理后,观察组的CD-RISC各维度评分及面对评分高于对照组,屈服、回避评分低于对照组(P<0.05)。护理前,两组的Harris髋关节功能评分量表(HHS)、简易智能状态检查量表(MMSE)评分比较,差异无统计学意义(P>0.05);护理后,观察组的HHS、MMSE评分高于对照组(P<0.05)。护理前,两组的Herth希望量表(HHI)各维度评分及自我效能感量表(GSES)评分比较,差异无统计学意义(P>0.05);护理后,观察组的HHI各维度评分及GSES评分显著高于对照组(P<0.05)。结论基于Snyder希望理论的护理干预应用于老年ERAS全髋关节置换术患者中,能有效改善髋关节功能与认知功能,促进康复,提升预后。

Objective To explore the effects of nursing intervention based on Snyder's hope theory on prognosis and cognitive function in elderly patients undergoing total hip arthroplasty with enhanced recovery after surgery(ERAS).Methods A total of 120 patients undergoing total hip arthroplasty admitted from January 2020 to January 2023 were selected and divided into control group and observation group according to the random number table method,with 60 cases in each group.The control group was given routine ERAS nursing,and the observation group was given nursing intervention based on Snyder's hope theory on the basis of the control group.The psychological resilience,coping style,hip joint function and cognitive function,hope level and self-efficacy of the two groups before and after nursing were compared.Results Before nursing,there were no significant differences in the scores of each dimension of Connor-Davidson Resilience Scale(CD-RISC)and Medical Coping Modes Questionnaire(MCMQ)between the two groups(P>0.05);after nursing,the scores of each dimension of CD-RISC and confrontation score in the observation group were higher than those in the control group,and the scores of yield and avoidance were lower than those in the control group(P<0.05).Before nursing,there were no significant differences in the scores of each dimension of Harris Hip Score(HHS)and Mini-Mental State Examination(MMSE)between the two groups(P>0.05);after nursing,the HHS and MMSE scores of the observation group were higher than those of the control group(P<0.05).Before nursing,there were no significant differences in the scores of each dimension of Herth Hope Index(HHI)and General Self-Efficacy Scale(GSES)score between the two groups(P>0.05);after nursing,the scores of each dimension of HHI and GSES score in the observation group were significantly higher than those in the control group(P<0.05).Conclusion The nursing intervention based on Snyder's hope theory applied in elderly patients undergoing total hip arthroplasty with ERAS can effectively improve hip joint function and cognitive function,promote rehabilitation and improve prognosis.