健康信念对膝关节置换术后患者膝关节功能恢复及功能锻炼依从性的影响

目的探讨健康信念对膝关节置换术后患者膝关节功能恢复、功能锻炼依从性的影响。方法采用便利抽样法,选取2019年1—12月北京积水潭医院收治的205例膝关节置换术患者作为研究对象。由于研究中失访、脱落7例,最终完成研究的患者例数为198例。采用随机数字表法进行分组,观察组与对照组各99例。于出院前给予对照组常规康复指导,观察组在常规康复指导的基础上给予健康信念培训。于出院时,出院后1、3、6个月比较两组患者的膝关节功能、功能锻炼依从性及健康信念,并分析相关性。结果患者的院外功能康复锻炼依从性问卷得分、纽约特种外科医院(HSS)膝关节功能评分及健康信念量表得分均存在时间效应、组间效应以及交互效应(P<0.05)。出院后1、3、6个月观察组患者的院外功能康复锻炼依从性问卷得分、HSS膝关节功能评分及健康信念量表得分均高于对照组,差异均有统计学意义(P<0.05)。患者出院后1个月HSS膝关节功能评分与健康信念量表的5个维度呈正相关(P<0.05);患者出院后3、6个月HSS膝关节功能评分与个人健康信念呈正相关(P<0.05)。患者出院后1个月功能锻炼依从性与健康信念量表的5个维度呈正相关(P<0.05);患者出院后3个月功能锻炼依从性与个人健康信念、实施能力、控制力呈正相关(P<0.05);患者出院后6个月功能锻炼依从性与个人健康信念呈正相关(P<0.05)。结论膝关节置换术后患者健康信念水平越高,功能锻炼依从性越高,膝关节功能恢复越好,因此临床医护人员需对该类患者进行必要的健康信念干预。

Effects of health belief on knee joint function recovery and functional exercise compliance in patients after knee arthroplasty

Objective To explore the effects of health belief on knee joint function recovery and functional exercise compliance in patients after knee arthroplasty.Methods Totally 205 patients undergoing knee arthroplasty who were hospitalized in Beijing Jishuitan Hospital from January to December 2019 were selected by convenient sampling.Since 7 cases were lost to follow-up or dropped out during the study,the number of patients who finally completed the study was 198.The random number table was used for grouping,with 99 cases in each group.Before leaving the hospital,patients in the control group received routine rehabilitation guidance,while patients in the observation group received health belief training on the basis of routine rehabilitation guidance.The knee joint function,functional exercise compliance and health belief were compared between the two groups at the time of discharge,1,3,and 6 months after discharge,and the correlation between them was analyzed.Results The Patients'Out-of-Hospital Functional Rehabilitation Exercise Compliance Questionnaire Scores,the Hospital for Special Surgery(HSS)Knee Joint Function Scores and the Health Belief Scale Scores showed time effects,inter-group effects and interaction effects(P<0.05).The scores of the Out-of-Hospital Functional Rehabilitation Exercise Compliance Questionnaire,the HSS Knee Function Score and the Health Belief Scale of the observation group at 1,3,and 6 months after discharge were higher than those of the control group,and the differences were statistically significant(P<0.05).The HSS Knee Function Score of the patients at 1 month after discharge was positively correlated with the 5 dimensions of the Health Belief Scale(P<0.05);the HSS Knee Function Score of the patients was positively correlated with personal health beliefs at 3 and 6 months after discharge(P<0.05).The patients'functional exercise compliance at 1 month after discharge was positively correlated with the 5 dimensions of the Health Belief Scale(P<0.05);the patients'functional exercise compliance at 3 months after discharge was positively correlated with personal health beliefs,implementation ability,and control(P<0.05);the patients'functional exercise compliance at 6 months after discharge was positively correlated with personal health beliefs(P<0.05).Conclusions The higher the health belief level of patients after knee arthroplasty,the higher the functional exercise compliance,and the better the recovery of knee joint function.Therefore,it is necessary for clinical medical staff to provide health belief intervention for these patients.