Abstract:

Objective　To explore the application effect of intervention strategies of motivational behavior guidance model in patients after artificial knee joint replacement. Methods　In this prospective study, 100 patients who received artificial knee joint replacement in Zheng zhou Orthopaedic Hospital from January 2020 to December 2022 were selected as the research objects, and were divided into an intervention group and a control group by the random number table method, with 50 cases in each group. In the intervention group, there were 29 males and 21 females, aged (62.05±3.47) years. In the control group, there were 27 males and 23 females, aged (61.89±3.52) years. The patients in the control group received routine postoperative care, and on the basis the patients in the intervention group received postoperative intervention strategies of artificial knee joint replacement based on motivational behavior guidance. Both groups were intervened until discharge. The changes of Hospital for Special Surgery (HSS) score, range of knee joint motion, and self-efficacy assessed by General Self-Efficacy Scale (GSES) before intervention and 3 months after intervention were compared between the two groups, and the incidences of postoperative complications during intervention and follow-up and patients' satisfaction with nursing were compared between the two groups. t test, χ² test, and rank sum test were used. Results　After 3 months of intervention, the HSS scores, ranges of knee joint motion, and GSES scores in both groups were higher than those before intervention, and those in the intervention group were higher than those in the control group [(68.26±6.22) min vs. (64.32±5.98) min, (88.25±10.39)°vs. (83.31±11.66)°, (32.89±2.16) min vs. (31.54±2.35) min], with statistically significant differences (t=3.229, 2.237, and 2.991; all P<0.05). During follow-up, the incidence of postoperative complications in the intervention group was lower than that in the control group [4.0% (2/50) vs. 16.0% (8/50)], with a statistically significant difference (χ²=4.000, P=0.046). The nursing satisfaction of the intervention group was higher than that of the control group at discharge [94.0% (47/50) vs. 80.0% (40/50)], with a statistically significant difference (χ²=4.332, P=0.037). Conclusion　Postoperative intervention strategies of artificial knee joint replacement constructed under the guidance of motivational behavior can effectively promote the recovery of patients' knee joint function, improve the range of knee joint motion, reduce the incidence of postoperative complications, enhance the patients' self-efficacy, and improve the patients' satisfaction with nursing work.

Key words:

Artificial knee joint replacement, Motivational behavior, Knee joint function, Self-efficacy

摘要：

目的　探讨动机行为指导模式的干预策略在人工膝关节置换术后的应用效果。方法　采用前瞻性研究，选取2020年1月至2022年12月于郑州市骨科医院接受人工膝关节置换术的100例患者为研究对象，采用随机数字表法分为干预组与对照组，各50例。干预组男29例、女21例，年龄（62.05±3.47）岁；对照组男27例、女23例，年龄（61.89±3.52）岁。对照组患者实施术后常规护理，干预组患者在此基础上实施动机行为指导的人工膝关节置换术后干预策略，两组均干预至出院。比较两组干预前、干预后3个月美国特种外科医院（HSS）评分、膝关节活动度、自我效能感［采用一般自我效能感量表（GSES）评估］变化情况，对比两组患者干预过程中及随访期间术后并发症发生情况、患者对护理的满意度。采用t检验、χ²检验、秩和检验。结果　干预后3个月，干预组的HSS评分、膝关节活动度、GSES评分均高于对照组［（68.26±6.22）分比（64.32±5.98）分、（88.25±10.39）°比（83.31±11.66）°、（32.89±2.16）分比（31.54±2.35）分］，差异均有统计学意义（t=3.229、2.237、2.991，均P<0.05）。随访过程中干预组术后并发症发生率低于对照组［4.0%（2/50）比16.0%（8/50）］，差异有统计学意义（χ²=4.000，P=0.046）。干预组出院时护理满意度高于对照组［94.0%（47/50）比80.0%（40/50）］，差异有统计学意义（χ²=4.332，P=0.037）。结论　应用动机行为指导模式的人工膝关节置换术后干预策略可有效促进患者膝关节功能恢复，提高膝关节活动度，并能够降低术后并发症发生率，提升患者自我效能感，提高其对护理工作的满意度。

关键词:

膝关节置换术, 动机行为, 膝关节功能, 自我效能感