Application value of structured education in patients undergoing total knee arthroplasty
LIU Li1 SUN Jing2 YUAN Fujing1 SHAO Qian1 XIANG Fusheng1
1.Department of Orthopaedic, Ezhou Central Hospital, Hubei Province, Ezhou 436000, China;
2.Department of General Surgery, Ezhou Central Hospital, Hubei Province, Ezhou 436000, China
Abstract:Objective To evaluate application value of structured education on patients with total knee arthroplasty. Methods According to the single and double numbers of the hospitalization number,210 patients with total knee arthroplasty in Department of orthopedics of Ezhou Central Hospital from January 2014 to November 2017 were randomly divided into intervention group and control group, with 105 cases in each group. The control group adopted routine nursing measures, and the intervention group adopted structured education. Knee function improvement after operation 1 weeks, 2 weeks and March were assessed by range of motion (ROM). Visual rating scale (VAS) was used to assess pain. Self efficacy scale was used to evaluate postoperative recovery of self-confidence and nursing satisfaction. Results Compared with 1 week after operation, the ROM and self-efficacy scores of the two groups increased significantly with the prolongation of rehahilitation time, while VAS scones deereased significantly, and the differences were statistically significant (P < 0.01). In the intervention group, the scores of ROM, VAS and self-efficacy were significantly better than those in the control group after operation 1 weeks, 2 weeks and March (P < 0.01), and the satisfaction degree of nursing work was higher than that in the control group 2 weeks after operation (P < 0.01). Conclusion structured education can improve knee function, relieve pain and improve self-efficacy of TKA patients. It can improve the quality of life and nursing satisfaction to the greatest extent, and is worthy of promotion.
[1] Baker PN,van der Meulen JH,Lewsey J,et al. The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales [J]. J Bone Joint Surg Br,2007, 89(7):893-900.
[2] Beswick AD,Wylde V,Gooberman-Hill R,et al. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis?A systematic review of prospective studies in unselected patients [J]. BMJ Open,2012,2(1):e 000 435.
[3] 元蔚伟,焦同立.标准化健康教育在膝关节置换护理中的应用[J].中国社区医师:医学专业,2011,13(14):260.
[4] 张永芳,刘军.标准化健康教育在膝关节置换患者30例临床护理中的应用[J].中国继续医学教育,2015,7(15):198-199.
[5] 梅素萍,周斌,刘蕴萍.健康教育对膝关节置换术后康复的影响[J].实用临床医药杂志,2011,15(16):125-126.
[6] 赵先玲.健康宣教对关节置换术后康复的影响[J].河南中医,2006,26(3):87-88.
[7] 王莹,邵连芹,刘晓伟,等.量化健康教育对关节置换患者术后恢复的影响[J].齐鲁护理杂志,2007,13(8):104.
[8] Pua YH,Ong PH,Chong HC,et al. Knee extension range of motion and self-report physical function in total knee arthroplasty:mediating effects of knee extensor strength [J]. BMC Musculoskelet Disord,2013,14(1):33.
[9] 刘延锦,王敏,董小方.中文版运动锻炼自我效能感量表在脑卒中患者中的信效度研究[J].中国实用护理杂志,2016,32(13):974-977.
[10] 王桂兰,刘义兰,赵光红,等.住院患者对护理服务满意度评价的研究[J].中华护理杂志,2006,41(8):730-732.
[11] Leung Y,Salfinger S,Mercer A. The positive impact of structured teaching in the operating room [J]. Aust New Zeal J Obstet Gynaecol,2015,55(6):601-605.
[12] 谢庆云,符培亮,陈宜,等.晚期膝骨关节炎患者外周血中趋化因子表达谱的特征分析[J].成都医学院学报,2017, 12(4):429-433.
[13] Patil S,McCauley JC,Pulido P,et al. How do knee implants perform past the second decade?Nineteen-to 25-year followup of the Press-fit Condylar design TKA [J]. Clin Orthop Relat Res,2015,473(1):135-140.
[14] 朱新宇,徐昌霞.全程疼痛护理对膝关节置换术患者焦虑及睡眠质量的影响[J].中华现代护理杂志,2017(33):4274-4277.
[15] 张云慧,刘清仁,王淼,等.全膝关节置换术后疼痛管理新进展[J].国际麻醉学与复苏杂志,2018(1):74-78.
[16] 窦哲,杨云,黄健.全膝关节置换围手术期的镇痛:措施与对策[J].中国组织工程研究,2018(23):3716-3722.
[17] 王波,吴鹏,王铁军,等.混合药物关节腔周围注射对人工全膝关节置换术后镇痛疗效的前瞻性研究[J].临床和实验医学杂志,2018,17(13):1448-1452.
[18] 李薇.术后活动性疼痛护理评估在骨科膝关节置换患者中的应用[J].国际护理学杂志,2018(6):762-764.
[19] 张静萍,刘欣伟,王宇,等.快速康复干预在高龄全膝关节置换患者围手术期中的应用价值研究[J].中国医学装备,2017,14(3):90-93.
[20] 蔡宏澜,段宝霖,王雅,等.慢性疼痛病人伴发焦虑、抑郁和躯体化症状的现况分析[J].中国疼痛医学杂志,2017, 23(10):788-790.
[21] 张文祥,倪家骧.慢性疼痛患者发生抑郁和焦虑症状的研究[J].中国全科医学,2009,12(9):775-777.
[22] 陈国良,王梅,路桂军,等.慢性疼痛患者焦虑、抑郁状况调查及相关因素分析[J].中国疼痛医学杂志,2014, 20(4):226-230,235.
[23] 李乐之,姚树桥.慢性疼痛患者生活质量影响因素的路径分析[J].中华行为医学与脑科学杂志,2010,19(4):319-321.
[24] 闻洁曦,邢国刚.慢性疼痛与抑郁关系的研究进展[J].中国疼痛医学杂志,2012,18(7):436-440.
[25] 赵学军,傅志俭,宋文阁,等.躯体疾病所致慢性疼痛患者焦虑和抑郁状况及其相关因素的研究[J].山东大学学报:医学版,2005,43(4):350-352.
[26] 张秦娥,赖震.特色护理在膝骨性关节炎患者中的应用[J].中国现代医生,2017,55(27):155-158,162.