早期康复训练结合Orem自理模式对交叉韧带损伤患者的影响研究
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摘要
目的探讨早期康复训练结合奥瑞姆(Orem)自理模式对交叉韧带损伤患者的影响。方法 2015年5月-2017年8月,82例韧带损伤患者行交叉韧带重建术,随机分为对照组和观察组,每组41例。对照组使用早期康复训练,观察组给予Orem自我护理模式。使用一般自我效能量表(GSES)、Barthel指数表(BI)来确定患者自我效能和日常生活能力的变化,对2组干预前后Lysholm评分(LKSS)和膝关节功能评分(HSS)的变化进行比较,并计算2组并发症的发生率。结果干预前,2组间HSS、LKSS、GSES和BI指数评分无显著差异(P> 0.05);干预6个月,2组HSS、LKSS、GSES、BI指数评分均上升(P <0.05),观察组改善率高于对照组,差异有统计学意义(P <0.05);观察组并发症的发生率略低于对照组,但差异无统计学意义(P> 0.05)。结论早期康复训练结合Orem自我护理模式可提高交叉韧带损伤患者的自我效能,改善关节功能和日常生活能力。
Objective To explore the application value of Orem self-care mode combined with early rehabilitation training in patients with cruciate ligament injuries. Methods Eighty-two patients with cruciate ligament injuries of knee joint who underwent arthroscopic knee cruciate ligament reconstruction in the hospital from May 2015 to August 2017 were randomly divided into control group and observation group, 41 cases in each group. Both groups were given routine early rehabilitation training intervention, and the observation group was additionally given Orem selfcare mode intervention. The improvement of self-efficacy and activities of daily living was evaluated with the general self-efficacy scale(GSES) and Barthel Index(BI). The incidence rates of postoperative complications in both groups were statistically analyzed. Changes in hospital special surgery(HSS) knee score and Lysholm knee score(LKSS) before and after the intervention were compared between the two groups. Results There was no significant difference in the score of HSS, LKSS, GSES or BI between the two groups before intervention(P > 0.05). The above scores were increased after 6 months of intervention(P < 0.05), and the increase in the observation group was greater than that in the control group(P < 0.05). The incidence of complications in the observation group was slightly lower than that in the control group(P > 0.05). Conclusion Orem self-care mode combined with early rehabilitation training can improve the self-efficacy of patients with cruciate ligament injuries, and improve their knee function and activities of daily living.
Objective To explore the application value of Orem self-care mode combined with early rehabilitation training in patients with cruciate ligament injuries. Methods Eighty-two patients with cruciate ligament injuries of knee joint who underwent arthroscopic knee cruciate ligament reconstruction in the hospital from May 2015 to August 2017 were randomly divided into control group and observation group, 41 cases in each group. Both groups were given routine early rehabilitation training intervention, and the observation group was additionally given Orem selfcare mode intervention. The improvement of self-efficacy and activities of daily living was evaluated with the general self-efficacy scale(GSES) and Barthel Index(BI). The incidence rates of postoperative complications in both groups were statistically analyzed. Changes in hospital special surgery(HSS) knee score and Lysholm knee score(LKSS) before and after the intervention were compared between the two groups. Results There was no significant difference in the score of HSS, LKSS, GSES or BI between the two groups before intervention(P > 0.05). The above scores were increased after 6 months of intervention(P < 0.05), and the increase in the observation group was greater than that in the control group(P < 0.05). The incidence of complications in the observation group was slightly lower than that in the control group(P > 0.05). Conclusion Orem self-care mode combined with early rehabilitation training can improve the self-efficacy of patients with cruciate ligament injuries, and improve their knee function and activities of daily living.
引文
[1]董晓艳,刘静,张建平,等.膝关节前交叉韧带损伤患者术后膝关节功能的恢复及影响因素[J].中华现代护理杂志,2015,21(4):452-454.
[2]SONESSON S,KVIST J.Dynamic and static tibial translation in patients with anterior cruciate ligament defi ciency initially treated with a structured rehabilitation protocol[J].Knee Surgery Sports Traumatology Arthroscopy,2015,25(8):1-10.
[3]陈柯,张杰敏,张馨梅,等.阶段性系统康复锻炼在膝关节前交叉韧带损伤重建术后的应用效果[J].西部医学,2016,28(4):560-563.
[4]李英英.早期康复干预对关节镜下前交叉韧带重建术后膝关节功能恢复的影响[J].山东医药,2014,54(18):105.
[5]NARIN S,UNVER B,BAKIRHAN S,et al.Cross-cultural adaptation,reliability and validity of the Turkish version of the Hospital for Special Surgery(HSS)Knee Score[J].Acta Orthopaedica Et Traumatologica Turcica,2014,48(3):241-248.
[6]鲍瑞林.膝关节交叉韧带重建手术前后lysholm膝关节活动评分比较[J].宁夏医科大学学报,2013,35(12):1410-1413.
[7]王才康,胡中锋,刘勇.一般自我效能感量表的信度和效度研究[J].应用心理学,2001,7(1):37-40.
[8]李奎成,唐丹,刘晓艳,等.国内Barthel指数和改良Barthel指数应用的回顾性研究[J].中国康复医学杂志,2009,24(8):737-740.
[9]MYER G D,FORD K R,STASI S L D,et al.High knee abduction moments are common risk factors for patellofemoral pain(PFP)and anterior cruciate ligament(ACL)injury in girls:is PFP itself a predictor for subsequent ACL injury?[J].British Journal of Sports Medicine,2015,49(2):118-122.
[10]丁传红,田燕,彭瑾.系统康复护理在关节镜下前交叉韧带重建围术期的应用[J].中国中医骨伤科杂志,2015,23(2):63-64.
[11]朱宏彬,徐丽,窦玲云.综合护理干预在胫骨干骨折伴后交叉韧带损伤患者围术期中的应用[J].海南医学,2016,27(11):1885-1887.
[12]于淼,刘忆冰.人工韧带修复膝关节交叉韧带损伤[J].中国组织工程研究,2013,17(8):1441-1448.
[13]FAILLA M J,ARUNDALE A J,LOGERSTEDT D S,et al.Controversies in knee rehabilitation:anterior cruciate ligament injury[J].Clinics in Sports Medicine,2015,34(2):301-312.
[14]周秋英,陈翠萍,李丽娅.Orem护理在膝关节镜下前交叉韧带重建术中的应用[J].国际护理学杂志,2012,31(11):2179-2181.
[15]陈惠雅,陈小舒,胡克萍.Orem自理理论指导康复训练在ACL损伤重建术患者中的应用[J].齐鲁护理杂志,2017,23(18):35-37.
[16]MOKSNES H,GRINDEM H.Prevention and rehabilitation of paediatric anterior cruciate ligament injuries[J].Knee Surgery Sports Traumatology Arthroscopy,2015,24(3):1-7.
[17]刘丽梅.Orem自理模式在老年髋部骨折护理中的应用研究[J].现代中西医结合杂志,2015,24(19):2153-2154.
[18]汤舜銮,郑义君,肖智真.Orem自理模式对人工髋关节置换术老年患者髋关节功能恢复的影响[J].现代临床护理,2016,15(7):19-22.
[2]SONESSON S,KVIST J.Dynamic and static tibial translation in patients with anterior cruciate ligament defi ciency initially treated with a structured rehabilitation protocol[J].Knee Surgery Sports Traumatology Arthroscopy,2015,25(8):1-10.
[3]陈柯,张杰敏,张馨梅,等.阶段性系统康复锻炼在膝关节前交叉韧带损伤重建术后的应用效果[J].西部医学,2016,28(4):560-563.
[4]李英英.早期康复干预对关节镜下前交叉韧带重建术后膝关节功能恢复的影响[J].山东医药,2014,54(18):105.
[5]NARIN S,UNVER B,BAKIRHAN S,et al.Cross-cultural adaptation,reliability and validity of the Turkish version of the Hospital for Special Surgery(HSS)Knee Score[J].Acta Orthopaedica Et Traumatologica Turcica,2014,48(3):241-248.
[6]鲍瑞林.膝关节交叉韧带重建手术前后lysholm膝关节活动评分比较[J].宁夏医科大学学报,2013,35(12):1410-1413.
[7]王才康,胡中锋,刘勇.一般自我效能感量表的信度和效度研究[J].应用心理学,2001,7(1):37-40.
[8]李奎成,唐丹,刘晓艳,等.国内Barthel指数和改良Barthel指数应用的回顾性研究[J].中国康复医学杂志,2009,24(8):737-740.
[9]MYER G D,FORD K R,STASI S L D,et al.High knee abduction moments are common risk factors for patellofemoral pain(PFP)and anterior cruciate ligament(ACL)injury in girls:is PFP itself a predictor for subsequent ACL injury?[J].British Journal of Sports Medicine,2015,49(2):118-122.
[10]丁传红,田燕,彭瑾.系统康复护理在关节镜下前交叉韧带重建围术期的应用[J].中国中医骨伤科杂志,2015,23(2):63-64.
[11]朱宏彬,徐丽,窦玲云.综合护理干预在胫骨干骨折伴后交叉韧带损伤患者围术期中的应用[J].海南医学,2016,27(11):1885-1887.
[12]于淼,刘忆冰.人工韧带修复膝关节交叉韧带损伤[J].中国组织工程研究,2013,17(8):1441-1448.
[13]FAILLA M J,ARUNDALE A J,LOGERSTEDT D S,et al.Controversies in knee rehabilitation:anterior cruciate ligament injury[J].Clinics in Sports Medicine,2015,34(2):301-312.
[14]周秋英,陈翠萍,李丽娅.Orem护理在膝关节镜下前交叉韧带重建术中的应用[J].国际护理学杂志,2012,31(11):2179-2181.
[15]陈惠雅,陈小舒,胡克萍.Orem自理理论指导康复训练在ACL损伤重建术患者中的应用[J].齐鲁护理杂志,2017,23(18):35-37.
[16]MOKSNES H,GRINDEM H.Prevention and rehabilitation of paediatric anterior cruciate ligament injuries[J].Knee Surgery Sports Traumatology Arthroscopy,2015,24(3):1-7.
[17]刘丽梅.Orem自理模式在老年髋部骨折护理中的应用研究[J].现代中西医结合杂志,2015,24(19):2153-2154.
[18]汤舜銮,郑义君,肖智真.Orem自理模式对人工髋关节置换术老年患者髋关节功能恢复的影响[J].现代临床护理,2016,15(7):19-22.