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| Effect of follow-up management based on 4R model on rehabilitation effect and quality of life of patients after total knee arthroplasty |
| ZHONG Wei SUN Wenlin▲ SHEN Xiaowen |
Rehabilitation Center, Huaian First People’s Hospital, Jiangsu Province, Huaian 223300, China
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Abstract Objective To explore the effect of follow-up management based on 4R model on the rehabilitation effect and quality of life of patients after total knee arthroplasty. Methods A total of 94 patients undergoing total knee arthroplasty were selected from the Rehabilitation Center, Huaian First People’s Hospital, Jiangsu Province from October 2018 to October 2021. According to random number table method, the patients were divided into control group and observation group, with 47 cases in each group. The control group was followed up by routine management, and the observation group was followed up by 4R model follow-up management. After discharge, the two groups were followed up by telephone once a week and outpatient once a month for a total of three months. Scores of visual analogue scale (VAS), hospital for special surgery (HSS), 36-item short form health surrey, short form 36, SF-36) quality of life score, and self-efficacy for rehabilition (SER) score were calculated before intervention, 1 and 3 months, respectively. Results There were significant differences in pain VAS between groups, time, and interaction between the two groups (P＜0.05). Further pound-for-pair comparison, intra-group comparison: VAS scores at 1 and 3 months of intervention in both groups were lower than before intervention, VAS scores at three months of intervention in both groups were lower than that at one month of intervention (P＜0.05). Comparison between groups: VAS scores of the observation group at 1 and 3 months of intervention were lower than those of the control group (P＜0.05). There were significant differences in HSS between groups, time, and interaction between the two groups (P＜0.05). Further pairwise comparison, intra-group comparison: HSS scores at 1 and 3 months of intervention in both groups were lower than those before intervention, and HSS scores at three months of intervention in both groups were lower than that at one month of intervention (P＜0.05). Inter-group comparison: the HSS scores of the observation group at 1 and 3 months of intervention were lower than those of the control group (P＜0.05). There were significant differences among groups, time, and interaction in SF-36 evaluation (P＜0.05). Further pairwise comparison, intra-group comparison: the scores of all dimensions in both groups at 1 and 3 months of intervention were higher than before intervention, and the scores of all dimensions in both groups at three months of intervention were higher than that at one month of intervention (P＜0.05). Inter-group comparison: the scores of all dimensions in the observation group were higher than those in the control group at 1 and 3 months after intervention (P＜0.05). There were significant differences in coping self-efficacy and task self-efficacy between groups, time, and interaction (P＜0.05). Further pairwise comparison, intra-group comparison: the scores of coping self- efficacy and task self-efficacy of both groups at 1 and 3 months of intervention were higher than those before intervention, and the scores of coping self-efficacy and task self-efficacy of both groups at three months of intervention were higher than those at one month of intervention (P＜0.05). Inter-group comparison: the coping self-efficacy and task self-efficacy scores of the observation group were higher than those of the control group after 1 and 3 months of intervention (P＜0.05). Conclusion 4R mode of follow-up management can effectively improve the rehabilitation effect of patients with total knee arthroplasty, reduce postoperative pain, and better improve the quality of life of patients, which can be popularized.
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