基于跨理论模型的延续性护理对老年膝关节炎患者的干预效果

摘要

目的 探讨基于跨理论模型(TTM)的延续性护理对老年膝关节炎(KOA)患者的干预效果.方法 选取2015年1月至2016年12月收治的老年KOA患者120例,采用随机数字表法将其分为观察组和对照组,每组60例.观察组实施基于TTM的延续性护理干预措施,对照组实施延续性护理干预措施.实施6个月后应用Lysholm膝关节评分量表(LKSS)及膝关节疼痛指数(LI)评分表评价并对比2组患者膝关节功能及症状,对比实施6个月后2组患者康复训练依从性、不同行为阶段分布情况及生命质量.结果 观察组LKSS总分为(78.04 ± 8.55)分,对照组为(69.22 ± 7.90)分,2组比较差异有统计学意义(t=6.780,P<0.05),观察组LI评分为(5.37 ± 1.05)分,对照组为(6.09 ± 1.60)分,2组比较差异有统计学意义(t=3.356,P<0.05);2组康复训练依从性等级分布、不同行为阶段等级分布比较差异有统计学意义(Z=5.814、6.910,均P<0.05),且观察组完全依从率、行动及维持阶段百分比分别为85.00%(51/60)、53.33%(32/60),均高于对照组的55.00%(33/60)、28.33%(17/60),差异有统计学意义(χ2=12.857、7.761,均P<0.05);观察组患者生命质量评分中身体、症状、情绪、社交、工作评分及总分分别为(26.37 ± 3.08)、(11.80 ± 2.15)、(18.66 ± 2.27)、(14.98 ± 2.52)、(6.93 ± 0.94)、(78.69 ± 10.36)分,均高于对照组的(24.22 ± 3.32)、(9.44 ± 1.29)、(17.24 ± 3.07)、(14.06 ± 2.07)、(6.56 ± 1.05)、(71.62 ± 12.15)分,差异有统计学意义(t=2.034~7.291,均P<0.05).结论 对老年KOA患者实施基于TTM的延续性护理可显著改变患者健康行为阶段,且能提高患者康复训练依从性及生命质量,有助于改善患者膝关节功能状态及症状.%Objective To investigate the effect of continuous nursing based on transtheoretical model (TTM) on elderly patients with knee osteoarthitis (KOA). Methods A total of 120 elderly patients with KOA from January 2015 to December 2016 were selected and divided into observation group and control group by the random digits table method , with 60 cases in each. The observation group was given continuous nursing based on TTM, while the control group was given continuous nursing. The functions and symptoms of knee joint of the 2 groups were evaluated by Lysholm Knee Scale Scores (LKSS) and Lequesne's Indexes (LI) after 6 months of implementation and compared. The compliance of rehabilitation training, the distribution of different behavior stages and the quality of life were compared after 6 months of implementation. Results The score of LKSS of the observation group was (78.04±8.55) points, and that of the control group was (69.22 ± 7.90) points, and there was significant difference between the 2 groups (t=6.780, P<0.05). The LI of the observation group was (5.37±1.05) points, and the control group was (6.09 ± 1.60) points, and there was significant difference between the 2 groups (t =3.356, P<0.05). There were significant differences in the distributions of the compliance of rehabilitation training and different behavior stages between the 2 groups (Z=5.814, 6.910, P<0.05). The rate of completely compliance, the percentage of action and maintenance stages of the observation group was 85.00%(51/60), 53.33% (32/60), and the control group was 55.00% (33/60), 28.33% (17/60) , and there was a significant difference between the 2 groups (χ2=12.857, 7.761, P<0.05). The physical condition, symptom and other 5 life quality scores and the total score of the observation group was (26.37±3.08), (11.80±2.15), (18.66± 2.27), (14.98±2.52), (6.93±0.94), (78.69±10.36) points, and the control group was (24.22±3.32), (9.44± 1.29), (17.24±3.07), (14.06±2.07), (6.56±1.05), (71.62±12.15) points, and there was significant difference between the 2 groups (t =2.034-7.291, all P<0.05). Conclusions The application of continuous nursing based on TTM on elderly patients with KOA can significantly change the stages of healthy behavior, improve the patients' compliance of rehabilitation training and quality of life, improve the function and symptom of knee joint.