健康赋权理论在老年脆性骨折病人中的护理干预

目的探讨基于健康赋权理论的护理干预在老年脆性骨折病人中的临床疗效。方法104例脆性骨折病人采用随机数字表法分为观察组与对照组，各52例。对照组采取骨科常规护理，观察组采用基于健康赋权理论的护理，评估观察组病人健康赋权和自我效能水平，评估2组病人术后下肢静脉血栓、关节僵硬、切口感染等并发症及出院后3、6、9个月骨折愈合率。结果观察组病人健康赋权总均分（3.01±0.87）分。各维度得分分别最高为支持维度总均分（3.17±0.66）分，最低为重建自我维度，总均分（2.92±0.45）分。自我效能水平总分为（53.23±11.67）分，锻炼维度为（19.78±8.12）分，食钙维度为（33.45±5.72）分。观察组干预后3个月和6个月健康赋权总均分和各维度得分均较干预前有所提升（P < 0.05~P < 0.01），干预后3个月和6个月自我效能总分、锻炼维度和食钙维度均高于干预前（P < 0.05~P < 0.01），自我效能总分和锻炼维度干预后6个月显著高于干预后3个月（P < 0.01）。2组病人术后下肢静脉血栓、关节僵硬、切口感染发生率差异均无统计学意义（P>0.05）。观察组在出院3个月和6个月时骨折愈合率均高于对照组（P < 0.05）。结论基于健康赋权理论的护理干预能够增强老年脆性骨折病人自我效能和健康赋权水平，有利于病人术后骨折的提早愈合。

Application value of health empowerment theory in nursing elderly patients with brittle fracture

ObjectiveTo explore the clinical curative effects of the nursing intervention based on health empowerment theory in elderly patients with brittle fracture.MethodsOne hundred and four patients with brittle fracture were divided into the observation group and control group according to the random number table method(52 cases each group).The control group were nursed with routine orthopedic nursing care, while the observation group was nursed with the mothod based on the health empowerment theory.The levels of health empowerment and self-efficacy in the observation group were evaluated.The postoperative lower limb venous thrombosis, joint stiffness, incision infection and fracture healing rates at 3, 6 and 9 months after discharge were assessed in two groups.ResultsThe total score of health empowerment in the observation group was (3.01±0.87)points.The highest score of each dimension was the total mean score of the support dimension(3.17±0.66)points, while the lowest score was the reconstruction of the self-dimension(2.92±0.45)points.The total score of self-efficacy was (53.23±11.67)points, the exercise dimension was (19.78±8.12)points, and the calcium intake dimension was (33.45±5.72)points.After 3 and 6 months of nursing intervention, the total score of health empowerment and each dimension score in the observation group increased compared with those before intervention(P < 0.05 to P < 0.01), and the total score of self-efficacy, exercise dimension and feed calcium dimension were higher than those before intervention(P < 0.05 to P < 0.01).The total score of self-efficacy and exercise dimension in the observation group after 6 months of intervention were significantly higher than those after 3 months of intervention(P < 0.01).There was no statistical significance in the incidence of lower limb venous thrombosis, joint stiffness and incision infection between two groups(P>0.05).The fracture healing rate in observation group was significantly higher than that in control group after 3 and 6 months of discharge(P < 0.05).ConclusionsThe nursing intervention based on health empowerment theory can enhance the self-efficacy and health empowerment levels of elderly patients with brittle fracture, which is beneficial to the early healing of postoperative fracture.