摘要目的 探究健康赋权理论护理干预对全膝关节置换术后患者患者临床康复效果影响。方法 纳入2021年6月至2022年2月空军军医大学第二附属医院骨科行全膝关节置换的98例患者,按照入院顺序将患者分为对照组和试验组各49例。其中对照组男13例,女36例,平均年龄(67.12±7.84)岁;试验组男20例,女29例,平均年龄(66.59±5.57)岁。两组患者入院时年龄、性别、身体质量指数(body mass index,BMI)、教育程度比较差异无统计学意义。对照组采用全膝关节置换术后常规护理模式,试验组在对照组的基础上接受健康赋权理论护理干预。比较两组患者疼痛视觉模拟评分(visual analogue scale,VAS)、美国特种外科医院 (the hospital special surgery,HSS)膝关节功能评分、自我护理效能和术后并发症发生率。结果 术前两组VAS比较差异无统计学意义(P>0.05);术后7 d两组VAS较术前均降低(P<0.05),且试验组VAS低于对照组(P<0.05)。术前两组HSS评分比较差异无统计学意义(P>0.05);术后3个月、6个月两组HSS评分均较术前增加(P<0.05),且试验组HSS评分均高于对照组(P<0.05)。术后1个月试验组的健康知识水平、自我护理观念、自我护理责任感和自我护理能力的得分均高于对照组(P<0.05)。试验组术后并发症的发生率低于对照组(P<0.05)。结论 对于全膝关节置换术后患者,健康赋权理论护理干预可以提高患者对疾病的认知、减轻术后疼痛、恢复膝关节功能、提高自我护理效能、减少术后并发症的发生。
[1]Hawker GA.Osteoarthritis is a serious disease[J].Clin Exp Rheumatol,2019,120(5):3-6.
[2]Yamamoto K,Takagi M,Ito H.Emerging insights on surgical techniques and biomaterials for total hip and knee arthroplasty[J].Biomed Res Int,2016(2016):1496529.
[3]Kurtz S,Ong K,Lau E,et al.Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030[J].J Bone Joint Surg Am,2007,89(4):780-785.
[4]Berend ME,Lackey WG,Carter JL.Outpatient-focused joint arthroplasty is the future:The midwest center for joint replacement experience[J].J Arthroplasty,2018,33(6):1647-1648.
[5]Wadhera RK,Joynt Maddox KE,Yeh RW,et al.Public reporting of percutaneous coronary intervention outcomes:Moving beyond the status quo[J].JAMA Cardiol,2018,3(7):635-640.
[6]Shearer NB.Health empowerment theory as a guide for practice[J].Geriatr Nurs,2009,30(2 Suppl):4-10.
[7]Theodoulou A,Bramwell DC,Spiteri AC,et al.The use of scoring systems in knee arthroplasty:A systematic review of the literature[J].J Arthroplasty,2016,31(10):2364237;2368.
[8]Nahcivan NO.A turkish language equivalence of the exercise of selfcare agency scale[J].West J Nurs Res,2004,26(7):813-824.
[9]Tang X,Wang S,Zhan S,et al.The prevalence of symptomatic knee osteoarthritis in china:results from the china health and retirement longitudinal study[J].Arthritis Rheumatol,2016,68(3):648-653.
[10]Repicci JA,Eberle RW.Minimally invasive surgical technique for unicondylar knee arthroplasty[J].J South Orthop Assoc,1999,8(1):20-27.
[11]Shi Q,Diao Y,Qian J.Application of single-hole thoracoscopic surgery combined with eras concept for respiratory function exercise in perioperative period of lung cancer[J].Zhongguo Feiai Zazhi,2020,23(8):667-672.
[12]Kandarian BS,Elkassabany NM,Tamboli M,et al.Updates on multimodal analgesia and regional anesthesia for total knee arthroplasty patients[J].Best Pract Res Clin Anaesthesiol,2019,33(1):111-123.
[13]Gandhi R,Mahomed NN,Cram P,et al.Understanding the relationship between 3-month and 2-year pain and function scores after total knee arthroplasty for osteoarthritis[J].J Arthroplasty,2018,33(5):1368-1372.
[14]Wilson RA,WattWatson J,Hodnett E,et al.A randomized controlled trial of an individualized preoperative education intervention for symptom management after total knee arthroplasty[J].Orthop Nurs,2016,35(1):20-29.
[15]Hejblum G,Atsou K,Dautzenberg B,et al.Cost-benefit analysis of a simulated institution-based preoperative smoking cessation intervention in patients undergoing total hip and knee arthroplasties in france[J].Chest,2009,135(2):477-483.
[16]Paredes AZ,Hyer JM,Beal EW,et al.Impact of skilled nursing facility quality on postoperative outcomes after pancreatic surgery[J].Surgery,2019,166(1):1-7.
[17]Moyer R,Ikert K,Long K,et al.The value of preoperative exercise and education for patients undergoing total hip and knee arthroplasty:A systematic review and metaanalysis[J].JBJS Rev,2017,5(12):e2.
[18]Hoogeboom TJ,Oosting E,Vriezekolk JE,et al.Therapeutic validity and effectiveness of preoperative exercise on functional recovery after joint replacement:A systematic review and meta-analysis[J].PLoS One,2012,7(5):e38031.