基于BCW理论的护理干预在改善膝关节置换术后恐动症的应用

目的 探讨基于行为改变轮(BCW)理论的护理干预在改善膝关节置换术后恐动症中的应用。 方法 选取单侧全膝关节置换术病人60例，按入院顺序分为观察组和对照组，各30例。对照组采用膝关节术后常规护理方法，观察组在对照组基础上采用基于BCW理论的护理干预。比较2组病人恐动症评分和膝关节功能，分析观察组病人出院后恐动症评分与膝关节功能水平的相关性。 结果 2组病人干预前及出院后1、3、6个月恐动症评分逐渐降低(P < 0.01)；2组病人干预前恐动症评分差异无统计学意义(P>0.05)；观察组出院后1、3、6个月恐动症评分均明显低于对照组(P < 0.01)。2组病人干预前膝关节功能评分差异无统计学意义(P>0.05)；2组病人干预前及出院后1、3、6个月膝关节功能评分逐渐升高(P < 0.01)；观察组出院后1、3、6个月膝关节功能评分均明显高于对照组(P < 0.01)。观察组病人出院后1、3、6个月膝关节功能评分与恐动症评分均呈负相关关系(r=-0.202、-0.312、-0.365，P < 0.05~P < 0.01)。 结论 基于BCW理论的护理干预可以有效降低膝关节置换术后的恐动症水平，有利于病人膝关节功能恢复。

Application of nursing intervention based on BCW theory in reducing kinesiophobia after total knee arthroplasty

Objective To explore the application of nursing intervention based on behavior change wheel(BCW) theory in reducing kinesiophobia after total knee arthroplasty. Methods Sixty patients undergoing unilateral total knee arthroplasty were selected and divided into observation group and control group according to the order of admission, with 30 cases in each group.The control group was treated with routine nursing methods after knee surgery, and the observation group was treated with nursing intervention based on BCW theory on the basis of the control group.The kinesiophobia level and knee joint function level of patients in the two groups were compared, and the correlation between the kinesiophobia level and the knee joint function level in the observation group after discharge was analyzed. Results The kinesiophobia scores of patients in the two groups before intervention and at 1 month, 3 months, and 6 months after discharge gradually decreased(P < 0.01).There was no significant difference in kinesiophobia scores between the two groups before intervention(P>0.05), and the kinesiophobia scores in observation group were significantly lower than those in control group at 1 month, 3 months, and 6 months after discharge(P < 0.01).There was no significant difference in knee function scores of patients between the two groups before intervention(P>0.05);the knee function scores in the two groups before intervention and at 1 month, 3 months, 6 months after discharge gradually increased(P < 0.01);the knee function scores in observation group were significantly higher than those in control group at 1 month, 3 months, and 6 months after discharge(P < 0.01).The knee function scores of patients in observation group were negatively correlated with the kinesiophobia scores at 1 month, 3 months, and 6 months after discharge(r=-0.202, -0.312, -0.365, P < 0.05 to P < 0.01). Conclusions Nursing intervention based on the BCW theory can effectively reduce the level of kinesiophobia after total knee arthroplasty, which is beneficial to the recovery of knee function of patients.