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中华关节外科杂志(电子版)

中华关节外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (02) : 249 -253. doi: 10.3877/cma.j.issn.1674-134X.2020.02.022

所属专题： 文献；

临床经验

自理理论在关节炎出院患者中的应用评价
肖艳红1, 徐巧巧1,†()   
  1. 1. 441021　襄阳，湖北文理学院附属医院，襄阳市中心医院东津院区静配中心
  • 收稿日期:2018-12-14 出版日期:2020-04-01
  • 通信作者: 徐巧巧

Effects evaluation of theory of self-care in discharged elderly patients of knee osteoarthritis

Yanhong Xiao1, Qiaoqiao Xu1,†()   

  1. 1. Department of Pharmacy, The Affiliated Hospital of Xiangyang Central Hospital of Hubei University of Arts and Science, Xiangyang 441021, China
  • Received:2018-12-14 Published:2020-04-01
  • Corresponding author: Qiaoqiao Xu
  • About author:
    Corresponding author: Xu Qiaoqiao, Emial:
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肖艳红, 徐巧巧. 自理理论在关节炎出院患者中的应用评价[J]. 中华关节外科杂志(电子版), 2020, 14(02): 249-253.

Yanhong Xiao, Qiaoqiao Xu. Effects evaluation of theory of self-care in discharged elderly patients of knee osteoarthritis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(02): 249-253.

目的

探讨Orem自理理论在关节炎出院患者中的应用效果。

方法

选择2013年9月到2017年2月在襄阳市中心医院骨科行膝关节置换手术的老年膝骨关节炎出院患者72例为研究对象，其中骨科一病区的患者40例为观察组，骨科二病区的患者32例为对照组，排除智力障碍者。对照组给予常规出院护理，观察组给予Orem自理理论指导下的分级延伸护理，两组护理时间持续3个月，记录两组预后。采用t检验与χ2检验分析相关数据。

结果

观察组与对照组护理期间的功能锻炼依从性分别为100.0%和87.5%，观察组显著高于对照组(χ2＝5.294，P <0.05)；两组护理后美国特种外科医院(HSS)评分均显著高于护理前，护理后观察组的评分显著高于对照组(t＝7.444，P<0.05)。护理期间观察组的血栓栓塞、感染、尿潴留等并发症发生率为10.0%，对照组为40.6%，观察组显著低于对照组(χ2＝9.224，P<0.05)。观察组与对照组对护理服务满意度分别为97.5%和81.3%，观察组显著优于对照组(χ2＝5.349，P<0.05)。

结论

Orem自理理论指导下的分级延伸护理运用于老年膝骨关节炎出院患者，能提高患者功能锻炼的依从性、促进膝关节功能的改善，降低并发症发生率，提升患者满意度。

关键词: 骨关节炎, 膝, 自我护理, 模型, 护理学, 病人依从
Objective

To explore the effects of Orem theory of self-care in the discharged elderly patients of knee osteoarthritis.

Methods

From September 2013 to February 2017, 72 senile knee osteoarthritis patients in the department of orthopedics in Xiangyang Central Hospital who underwent hip replacement surgery were selected. Forty patients in the first orthopedics ward were the observation group, and 32 patients in the second orthopedics ward were the control group and were excluded people with intellectual disabilities. The control group were given routine discharge nursing, while the observation group were given graded extended care under the guidance of Orem theory of self-care. The nursing times in the two groups were lasted for three months, and the prognosis of two groups were recorded. The t test and chi-square test were used to analyze the relevant data.

Results

The compliance of the observation group and the control group were 100% and 87.5% respectively during the nursing period, and the observation group were significantly higher than the control group (χ2=5.294, P<0.05). The score of Hospital for Special Surgery(HSS) after nursing in the two groups were significantly higher than that before nursing, and the observation group after nursing weresignificantly higher than that of the control group(t=7.444, P<0.05). During the nursing period, the incidence of complications such as thromboembolism, infection and urinary retention was 10% in the observation group, while it was 40.6% in the control group. The observation group were significantly lower than the control group (χ2=9.224, P<0.05). The satisfaction of the observation group and the control group were 97.5% and 81.3% respectively, and the observation group was significantly higher than the control group (χ2=5.349, P<0.05).

Conclusion

The application of graded extended care under the guidance of Orem theory of self-care in the discharge patients of elderly knee osteoarthritis can improve the function of knee joint, improve the compliance of functional exercise, reduce the occurrence of complications, and improve patients' satisfaction with nursing work.

Key words: Osteoarthritis, knee, Self care, Models, nursing, Patient compliance
表1 两组患者一般资料对比
组别 例数 性别(男/女) 年龄[岁，(±s)] 手术患侧(左/右) 假体类型(生物型/水泥型) 住院时间[d，(±s)]
观察组 40 22/18 68±4 23/17 12/28 14±5
对照组 32 17/15 68±5 18/14 10/22 15±4
统计值   χ2＝0.025 t＝0.213 χ2＝0.011 χ2＝0.013 t＝0.533
P值   >0.05 >0.05 >0.05 >0.05 >0.05
表2 两组功能锻炼依从性对比
组别 例数 完全依从 部分依从 不依从 依从性(%)
观察组 40 36 4 0 100.0
对照组 32 22 6 4 87.5
χ2值   － － － 5.294
P值   － － － <0.05
表3 两组护理前后HSS评分对比[分，(±s)]
组别 例数(n) 护理前 护理后 t值 P值
观察组 40 50±9 91±5 33.195 <0.05
对照组 32 49±8 83±4 26.211 <0.05
t值   0.522 7.444    
P值   >0.05 <0.05    
表4 两组护理期间并发症情况对比
组别 例数 血栓栓塞 感染 尿潴留 合计
观察组 40 1 1 2 4(10.0%)
对照组 32 4 4 5 13(40.6%)
χ2值   － － － 9.244
P值   － － － <0.05
表5 两组护理服务满意度对比
组别 例数 非常满意 满意 不满意 满意度(%)
观察组 40 30 9 1 97.5
对照组 32 14 12 6 81.3
χ2值   － － － 5.349
P值   － － － <0.05
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