教学反馈法在人工髋关节置换术围手术期康复锻炼中的应用

目的探讨教学反馈法应用于人工髋关节置换术围手术期康复锻炼中的效果。 方法选择2017年1月至2018年4月广州医科大学附属第一医院骨科行初始人工髋关节置换术患者100例。纳入标准为首次髋关节置换术,无精神障碍和认知障碍;排除偏瘫、下肢肌力低于Ⅳ级、心肝肾功能严重不全。按随机数字表法分为护理对照组和观察组,每组各50例,对照组给予常规康复锻炼指导,观察组采用教学反馈法进行康复锻炼指导。两组患者于术后1周、1个月采用Harris评分进行髋关节功能评分;于术后1周发放广州医科大学附属第一医院骨科自行设计的髋关节置换术知识知晓调查表进行健康知识知晓评分;于出院前1 d发放广州医科大学附属第一医院病房护理服务满意度征询表进行患者服务满意度评分。计量资料采用独立样本t检验分析;分类变量采用卡方检验分析。 结果术后1周、1个月Harris评分观察组(70±10)、(77±7)高于对照组(62±8)、(68±7),组间差异有统计学意义(t＝－4.72、－6.63,P<0.05);健康知识知晓评分观察组(97±5)高于对照组(94±7),组间差异有统计学意义(t ＝－3.09,P<0.05);服务满意度评分观察组(98±4)高于对照组(93±7),组间差异有统计学意义(t ＝－4.88,P<0.05)。 结论教学反馈法可以提高初始人工髋关节置换术健康教育的效果,促进术后康复锻炼有效进行,提高治疗效果及护理服务满意度。

Application of teach-back method in perioperative rehabilitation exercise of patients undergoing artificial hip replacement

ObjectiveTo discuss the effect of teach-back method in perioperative rehabilitation exercise of patients undergoing artificial hip replacement. MethodsFrom January 2017 to April 2018, 100 patients with primary artificial hip replacement from the department of orthopedics of the First Affiliated Hospital of Guangzhou Medical University were selected to participate in this project. The inclusion criteria were primary hip replacement, and no mental illness; the exclusion criteria were hemiplegia, lower limb paralysis and severe organ failures. All the participants were equally divided to the experimental group and the control group by random number table method, the control group (50 cases) received routine rehabilitation exercise guidance; the experimental group (50 cases) received rehabilitation exercise guidance with nurse-patient interaction method. The joint function of two groups was evaluated by Harris grade on one week and one month after the operation; all the participants were asked to complete the questionnaire designed by orthopedics department of the First Affiliated Hospital of Guangzhou Medical University regarding "the awareness rate of hip replacement knowledge" one week after the operation; the inpatients’ satisfaction were evaluated by the "satisfaction questionnaire of ward nursing care" provided by our department of orthopedics on the day before discharging. The data were analysed by t test and chi-square test. ResultsThe Harris scores in the experimental group (70±10)、(77±7) were significantly higher than those in the control group (62±8)、(68±7) on one week and one month after the operation (t=-4.72、-6.63, P<0.05). And the scores of health and disease knowledge were respectively (97±5)and (94±7)in the experimental group and the control group on one week after the operation (t=-3.09, P<0.05); the satisfaction score was obviously higher in the experimental group (98±4) than in the control group (93±7); the statistical data of this project showed significant difference between the control group and the experimental group (t=-4.88, P<0.05). ConclusionThe application of teach-back method could improve the effect of related health education, promote postoperative rehabilitation and increase treatment efficacy and patients’ satisfaction on nursing service.