混合式衛教對全膝關節置換術老年病人疼痛及關節角度之成效

Hsueh-Ling CHANG; Hsiao-Ling HUANG; Yu-Chu CHUNG

doi:10.6224/JN.202304_70(2).07

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P45 - 55

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

DOI： 10.6224/JN

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混合式卫教对全膝关节置换术老年病人疼痛及关节角度之成效

Effects of a Hybrid Health Education Program on Pain and Knee Angle in Elderly Patients After Total Knee Replacement Surgery

张雪玲(Hsueh-Ling CHANG) ；黄晓令(Hsiao-Ling HUANG) ；锺玉珠(Yu-Chu CHUNG)

护理杂志； 70 卷 2 期 (2023 / 04 / 01) ， P45 - 55

繁体中文;英文 DOI： 10.6224/JN.202304_70(2).07

混合式卫教；全膝关节置换术；疼痛；膝关节角度； hybrid health education ； total knee replacement ； pain ； knee angle

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摘要 │ 参考文献 (28) │ 国际计量

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Background: Patients experience pain and limited knee angle after total knee replacement (TKR) surgery. The effectiveness of routine discharge health education remains limited. Purpose: This study was designed to assess the effect of hybrid health education on postoperative pain and knee angle in patients with TKR.  Methods: A single blind and randomized controlled trial study was used. Fifty-two patients with TKR were randomly assigned to either the experimental group (n = 26), which received standard care with hybrid health education and performed the multimedia-guided intervention for 30 min per day for 16 weeks, or the control group (n = 26), which received routine care only. The data collection times were at pretest (preoperative) and at the 1st week, 6th week, 12th week, 16th week after surgery. Results: A total of 22 patients in the experimental group and 26 patients in the control group completed this study. After the 16-week hybrid health education intervention, the results of generalized estimating equations analysis showed that pain in the experimental and control groups differed significantly at week 12 (β= -1.43, p = .025) and week 16 (β= -1.52, p = .014); worst pain in the past week had significantly improved at week 12 (β= -1.40, p = .041) and week 16 (β= -1.55, p = .024); average pain over the past 1 week had significantly improved at week 16 (β = -1.24, p = .035); and knee extension angle had significantly improved at week 16 (β= -5.52, p = .033). Conclusion/ Implications for Practice: The results of this study showed that elderly patients who received hybrid health education after TKR had significantly improved postoperative pain and knee angle and that degree of improvement in the experimental group was better than in the control group. It is recommended that the content and methods of hybrid health education developed in this study be incorporated into discharge interventions and that long-term outcomes be tracked for reference.

参考文献 ( 28 ) 〈TOP〉

吴依苹, Y.-P.,唐国民, K.-M.,洪丽珍, L.-C.(2016)。人工膝关节及髋关节置换术病患术後疼痛之分析。领导护理，17(2)，80-93。
连结：
Allsop, S.,Fairhall, R.,Morphet, J.(2019).The impact of pre-operative telephone support and education on symptoms of anxiety, depression, pain and quality of life post total knee replacement: An exploratory case study.International Journal of Orthopaedic and Trauma Nursing,34,21-27.
Bade, M. J.,Kittelson, J. M.,Kohrt, W. M.,Stevens-Lapsley, J. E.(2014).Predicting functional performance and range of motion outcomes after total knee arthroplasty.American Journal of Physical Medicine & Rehabilitation,93(7),579-585.
Bourne, R. B.,Chesworth, B. M.,Davis, A. M.,Mahomed, N. N.,Charron, K. D. J.(2010).Patient satisfaction after total knee arthroplasty: Who is satisfied and who is not?.Clinical Orthopaedics and Related Research,468(1),57-63.
Boyce, L.,Prasad, A.,Barrett, M.,Dawson-Bowling, S.,Millington, S.,Hanna, S. A.,Achan, P.(2019).The outcomes of total knee arthroplasty in morbidly obese patients: A systematic review of the literature.Archives of Orthopaedic and Trauma Surgery,139(4),553-560.

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