阶段性健康教育配合心理干预对髋关节置换术老年患者焦虑抑郁水平、相关知识掌握程度及生活质量的影响

Effect of staged health education combined with psychological intervention on anxiety and depression,mastery of related knowledge and quality of life in elderly patients with hip replacement

目的:探究阶段性健康教育配合心理干预对人工髋关节置换术老年患者焦虑抑郁水平、相关知识掌握程度及生活质量的影响。方法:按抽签法将2017年2月-2018年2月于我院择期行人工髋关节置换术的200例老年患者随机分为观察组与对照组各100例。对照组给予骨科常规护理及健康宣教。观察组给予阶段性健康教育配合心理干预。比较两组干预前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、疾病相关知识掌握程度及Harris评分、Barthel(BI)指数、世界卫生组织生活质量简表(WHOQOL-BREF)评分,并记录术后并发症情况。结果:观察组干预后SAS、SDS评分显著低于对照组,差异有统计学意义(t=-4.459,-2.749;P<0.05);观察组相关知识掌握程度显著高于对照组,差异有统计学意义(Z=2.613,P<0.05);观察组干预后Harris评分、BI指数显著高于对照组,差异有统计学意义(t=3.389,5.427;P<0.05);观察组干预后各项WHOQOL-BREF评分均显著高于对照组(t=3.184,2.320,2.769,2.386,3.183;P<0.05);观察组术后感染、关节脱位、压疮、静脉血栓、假肢松动并发症发生率均显著低于对照组,差异均有统计学意义(χ~2=5.674,4.188,6.737,2.296,3.255;P<0.05)。结论:人工髋关节置换术老年患者围手术期给予阶段性健康教育配合心理干预,可显著改善患者焦虑抑郁水平,提高疾病相关知识掌握程度,促进术后关节功能的恢复,并提高患者日常生活能力及生活质量水平,降低并发症风险。

Objective:To explore the effects of staged health education combined with psychological intervention on anxiety and depression,mastery of related knowledge and quality of life in elderly patients with artificial hip replacement.Methods:According to the lottery method,200 cases of elderly patients undergoing artificial hip replacement in our hospital from February 2017 to February 2018 were randomly divided into observation group and control group,with 100 cases in each group.Control group was given routine orthopaedic care and health education,and observation group was given staged health education combined with psychological intervention.The self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score,mastery of disease-related knowledge and Harris score,Barthel(BI)index,WHO quality of life-BREF(WHOQOL-BREF)score were compared between the two groups before and after intervention,and the postoperative complications were recorded.Results:The scores of SAS and SDS in observation group were significantly lower than those in control group(t=-4.459,-2.749;P<0.05).The mastery of related knowledge in observation group was significantly higher than that in control group(Z=2.613,P<0.05).The Harris score and BI index were significantly higher in observation group than those in control group after intervention(t=3.389,5.427;P<0.05).All item scores of WHO QOL-BREF scale after intervention in observation group were significantly higher than those in control group(t=3.184,2.320,2.769,2.386,3.183;P<0.05).The incidence rates of complications of infection,joint dislocation,pressure sore,venous thrombosis and prosthesis loosening were significantly lower in observation group than those in control group(χ~2=5.674,4.188,6.737,2.296,3.255;P<0.05).Conclusion:Staged health education combined with psychological intervention in the perioperative period of elderly patients with artificial hip replacement can significantly improve the level of anxiety and depression,increase the mastery of disease-related knowledge,promote the recovery of postoperative joint function,and improve the ability of daily living and quality of life,and reduce the risk of complications.