Application of Caregiver Health Education Based on Timing Theory in the Postoperative Care of Elderly Industrial Hip Arthroplasties
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摘要:
目的 探索照顾者基于时机理论指导下的健康教育应用在老年髋关节置换术后护理中的效果。 方法 采用方便取样法将行髋关节置换术的80例老年患者分为对照组和观察组,每组40例,对照组给予骨科常规护理,观察组在骨科常规护理的基础上基于时机理论(total hip replacement,TIR)指导下的健康管理。采用髋关节功能评分量表、日常生活活动能力评定量表(Barthel指数)、照顾者负担问卷、家属照顾者照顾能力测量进行比较并评价2组照顾者的健康教育在老年髋关节置换术后护理中的应用效果。 结果 分别观察出院后1个月和3个月患者髋关节功能评分和日常生活活动能力评定指数,观察组显著高于对照组(P < 0.01);出院时,出院后1个月和3个月观察组家属照顾者照顾能力测量评分(P < 0.01)和照顾者负担问卷评分(P < 0.01)显著低于对照组。 结论 基于时机理论指导下的健康教育能够有效减轻照顾者的照顾负担,增强照顾者的照顾能力,提高患者的康复效果,改善患者的生活质量。 Abstract:0bjective To explore the effectiveness of caregivers based on health education under the guidance of timing theory in the nursing of elderly patients after hip replacement. Methods By convenient sampling method, eighty elderly patients undergoing hip replacement were divided into control group and observation group, 40 cases in each group. The control group was given routine orthopedic care, and the observation group was based on health management under the guidance of the timing theory (total hip replacement, TIR) based on routine orthopedic care. The Harris Hip Score, Activities of Daily Living Scale (Barthel index), Caregiver Burden Inventory and Family Caregiver Task Inventory were used to compare and evaluate the application effect of health education of two groups of caregivers in the nursing of elderly patients after hip replacement. Results The patients were observed one month and three months after discharge, the Harris score and Barthel index of the observation group were significantly higher than those of the control group (P < 0.01). At discharge, 1 month after discharge and 3 months after discharge, the FCTI score (P < 0.01) and CBI score (P < 0.01) of family caregivers in the observation group were significantly lower than those in the control group. Conclusion Caregivers based on health education under the guidance of timing theory can effectively reduce the care burden of caregivers, enhance the care ability of caregivers, improve the rehabilitation effect of patients, and ameliorative the quality of life of patients. -
Key words:
- Caregiver /
- Health education /
- After hip replacement in the elderly /
- Timing theory
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表 1 2组患者一般资料比较 [n(%)/($ \bar x \pm s $),n=40]
Table 1. Comparison of general information between two groups of patients [n(%)/($ \bar x \pm s $),n=40]
特征 观察组 对照组 χ2/Z P 年龄(岁) 64.5±6.00 63±5.75 −1.113 0.266 性别 0.833 0.361 男 26(65.0) 22(55.0) 女 14(35.0) 18(45.0) 文化程度 5.002 0.287 文盲 1(2.5) 4(10.0) 小学 20(50.0) 14(35.0) 初中 11(27.5) 12(30.0) 高中 3(7.5) 7(17.5) 大专及以上 5(12.5) 3(7.5) 手术原因 2.116 0.549 股骨头缺血性坏死 32(80.0) 27(67.5) 先天性髋关节发育不良 1(2.5) 3(7.5) 髋关节退行性关节炎 2(5.0) 2(5.0) 股骨颈骨折/
股骨粗隆间骨折5(12.5) 8(20.0) 患侧 5.060 0.080 左侧 11(27.5) 17(42.5) 右侧 24(60.0) 14(35.0) 双侧 5(12.5) 9(22.5) 表 2 2组照顾者一般资料比较 [n(%)/($ \bar x \pm s $),n=40]
Table 2. Characteristics of general information between two groups of caregivers [n(%)/($ \bar x \pm s $),n=40]
特征 观察组 对照组 χ2/F P 年龄(岁) 45.65±12.17 47.38±13.61 1.541 0.218 性别 0.050 0.823 男 18(45.0) 19(47.5) 女 22(55.0) 21(52.5) 文化程度 6.626 0.157 文盲 0(0.0) 2(5.0) 小学 7(17.5) 6(15.0) 初中 15(37.5) 9(22.5) 高中 13(32.5) 11(27.5) 大专及以上 5(12.5) 12(30.0) 与患者关系 2.564 0.464 子女 16(40.0) 17(42.5) 配偶 17(42.5) 13(32.5) 父母 1(2.5) 0(0.0) 其他 6(15.0) 10(25.0) 表 3 入院时2组患者Harris评分、Barthel指数及2组照顾者FCTI评分、CBI评分 [($\bar x \pm s $),n=40]
Table 3. Harris score and Barthel index of patients in the two groups and FCTI score and CBI score of caregivers in the two groups on admission [($\bar x \pm s $),n=40]
项目 观察组 对照组 F/Z P 入院患者Harris评分 72.68±11.29 71.95±10.89 0.050 0.823 入院患者Barthel指数 85.00±10.00 85.00±15.00 0.235 0.814 入院照顾者FCTI评分 8.00±5.00 8.00±6.00 1.213 0.225 入院照顾者CBI评分 10.00±12.00 10.00±17.00 0.520 0.603 表 4 2组患者Harris评分比较 [($\bar x \pm s $),n=40]
Table 4. Comparison of Harris score between two groups of patients [($\bar x \pm s $),n=40]
组别 入院
Harris评分出院时
Harris评分出院后1个月
Harris评分出院后3个月
Harris评分时间简单效应 F P 偏η方 观察组 72.68±11.29 53.73±8.68 78.88±5.04 93.28±4.01 314.33 <0.001* 0.925 对照组 71.95±10.89 54.58±8.43 72.15±6.80 86.43±4.58 240.39 <0.001* 0.90 组别简单效应 F 0.085 0.197 25.256 50.561 P 0.771 0.658 <0.001* <0.001* 偏η方 0.001 0.003 0.245 0.393 *P < 0.01。 表 5 2组患者Barthel评分比较 [(m±q),n=40]
Table 5. Comparison of Barthel score between two groups of patients [(m±q),n=40]
观察指标 观察组 对照组 组别单独效应 Waldχ2 P 入院Barthel指数 85.00±10.00 85.00±15.00 0.125 0.724 出院时Barthel指数 65.00±15.00 65.00±20.00 0.299 0.585 出院后1个月Barthel指数 85.00±9.00 80.00±10.00 15.034 <0.001* 出院后3个月Barthel指数 100.00±5.00 90.00±10.00 44.169 <0.001* 时间单独效应 Waldχ2 874.61 257.69 P <0.001* <0.001* *P < 0.01。 表 6 2组照顾者FCTI评分比较 [(m±q),n=40]
Table 6. Comparison of FCTI scores between two groups of caregivers [(m±q),n=40]
观察指标 观察组 对照组 组别单独效应 Waldχ2 P 入院FCTI评分 8.00±5.00 8.00±6.00 0.401 0.526 出院时FCTI评分 5.00±4.00 7.00±10.00 6.886 0.009* 出院后1个月FCTI评分 4.50±6.00 6.00±14.00 15.120 <0.001* 出院后3个月FCTI评分 0.00±2.00 2.50±4.00 13.260 <0.001* 时间单独效应 Waldχ2 134.09 130.07 P <0.001* <0.001* *P < 0.01。 表 7 2组照顾者CBI评分比较 [(m±q),n=40]
Table 7. Comparison of CBI scores between two groups of caregivers [(m±q),n=40]
观察指标 观察组 对照组 组别单独效应 Waldχ2 P 入院CBI评分 10.00±12.00 10.00±17.00 0.326 0.568 出院时CBI评分 7.00±10.00 14.50±11.00 14.011 <0.001* 出院后1个月CBI评分 4.50±5.00 11.00±9.00 21.412 <0.001* 出院后3个月CBI评分 0.00±2.00 3.00±4.00 23.780 <0.001* 时间单独效应 Waldχ2 62.077 118.067 P <0.001* <0.001* *P < 0.01。 -
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