Department of Orthopaedic Surgery, The Fourth Hospital of Wuhan, Wuhan, 430030 Hubei Province, China.
Department of Rehabilitation, The Fourth Hospital of Wuhan, Wuhan, 430030 Hubei Province, China.
Comput Math Methods Med. 2022 Apr 12;2022:1247002. doi: 10.1155/2022/1247002. eCollection 2022.
To explore the influence of rehabilitation nursing under the guidance of Health Action Process Approach (HAPA) model on the perioperative nursing effect of artificial hip replacement and to analyze the effect of this nursing model on the quality of life and postoperative rehabilitation of patients undergoing artificial hip replacement.
A total of 200 patients with hip arthroplasty treated in our hospital from January 2019 to July 2021 were enrolled. The patients were randomly assigned into the control group and study group. The former received routine nursing, and the latter received rehabilitation nursing under the guidance of the HAPA model. Nursing satisfaction, pain score, Harris hip function score, timed stand-up-walk test, MBI score, and quality of life score were compared.
First of all, we compared the nursing satisfaction. In the study group, 86 cases were very satisfied, 8 cases were satisfied, and 6 cases were general; the satisfaction rate was 100%. In the control group, 48 cases were very satisfied, 22 cases were satisfied, 12 cases were general, and 18 cases were dissatisfied; the satisfaction rate was 82.0%. The nursing satisfaction in the study group was higher compared to that in the control group ( < 0.05). Secondly, we compared the pain scores. Before nursing, there exhibited no significant difference ( > 0.05). After nursing, the pain score of the two groups increased. Moreover, the pain score of the study group at discharge and 1 month, 3 months, and 6 months after operation was lower compared to that of the control group ( < 0.05). Before nursing, there exhibited no significant difference in the Harris hip joint function score ( > 0.05). After nursing, the Harris hip function score increased. Furthermore, the Harris hip function score of the study group at discharge and 1 month, 3 months, and 6 months after operation was higher compared to that of the control group ( < 0.05). In terms of the timed stand-up-walking test, there exhibited no significant difference before nursing ( > 0.05). After nursing, the time of the timed stand-up-walk test in both groups decreased. And the timed stand-up-walk test at discharge and 1 month, 3 months, and 6 months after operation in the study group was lower compared to that in the control group ( < 0.05). Compared with the MBI scores, there exhibited no significant difference before nursing ( > 0.05). After nursing, the MBI scores increased. Of note, the MBI scores of the study group at discharge and 1 month, 3 months, and 6 months after operation were higher compared to those of the control group ( < 0.05). Finally, we compared the scores of life quality. Before nursing, there exhibited no significant difference ( > 0.05). After nursing, the scores of life quality decreased. The scores of physiological function, psychological function, social function, and health self-cognition in the study group were lower compared to those in the control group ( < 0.05).
The perioperative rehabilitation nursing program of artificial hip replacement for the elderly based on the HAPA model is feasible, which can effectively enhance the functional recovery of hip joint, promote the ability of self-care of daily life, relieve pain and anxiety, and help to achieve dynamic balance and gait stability in the early stage. The rehabilitation program is better than routine nursing. As a new social cognitive model, the HAPA model is applied to the rehabilitation nursing environment of hip replacement from the aspect of social cognitive behavior, which can help to enhance the rehabilitation behavior of elderly patients, playing an important role in the rehabilitation effect of perioperative nursing.
探讨健康行动过程方法（HAPA）模型指导下的康复护理对人工髋关节置换术围手术期护理效果的影响，并分析该护理模式对人工髋关节置换术后患者生活质量和康复的影响。
选取 2019 年 1 月至 2021 年 7 月在我院接受髋关节置换术的 200 例患者为研究对象。将患者随机分为对照组和研究组，前者接受常规护理，后者接受 HAPA 模型指导下的康复护理。比较护理满意度、疼痛评分、Harris 髋关节功能评分、定时站立行走试验、MBI 评分和生活质量评分。
首先，我们比较了护理满意度。在研究组中，86 例非常满意，8 例满意，6 例一般；满意度为 100%。在对照组中，48 例非常满意，22 例满意，12 例一般，18 例不满意；满意度为 82.0%。研究组的护理满意度高于对照组（<0.05）。其次，我们比较了疼痛评分。护理前，两组无显著差异（>0.05）。护理后，两组疼痛评分均升高。此外，研究组在出院时以及术后 1 个月、3 个月和 6 个月的疼痛评分均低于对照组（<0.05）。护理前，两组 Harris 髋关节功能评分无显著差异（>0.05）。护理后，Harris 髋关节功能评分均升高。此外，研究组在出院时以及术后 1 个月、3 个月和 6 个月的 Harris 髋关节功能评分均高于对照组（<0.05）。在定时站立行走试验方面，护理前无显著差异（>0.05）。护理后，两组的定时站立行走试验时间均缩短。且研究组在出院时以及术后 1 个月、3 个月和 6 个月的定时站立行走试验时间均低于对照组（<0.05）。与 MBI 评分相比，护理前无显著差异（>0.05）。护理后，MBI 评分均升高。值得注意的是，研究组在出院时以及术后 1 个月、3 个月和 6 个月的 MBI 评分均高于对照组（<0.05）。最后，我们比较了生活质量评分。护理前，两组无显著差异（>0.05）。护理后，生活质量评分均降低。研究组在生理功能、心理功能、社会功能和健康自我认知方面的评分均低于对照组（<0.05）。
基于 HAPA 模型的老年人工髋关节置换术围手术期康复护理方案可行，能有效促进髋关节功能的恢复，提高日常生活自理能力，减轻疼痛和焦虑，有助于在早期实现动态平衡和步态稳定。康复方案优于常规护理。作为一种新的社会认知模型，HAPA 模型从社会认知行为的角度应用于髋关节置换的康复护理环境中，可以帮助增强老年患者的康复行为，对围手术期护理效果起到重要作用。
