PRECEDE-PROCEED模式对全髋关节置换患者生活行为的效果

doi:10.3969/j.issn.1006-9771.2020.10.016

摘要/Abstract

摘要：

目的探讨PRECEDE-PROCEED模式对全髋关节置换患者健康行为和生活质量的干预效果。
方法选择2018年2月至9月行初次人工全髋关节置换术的103例患者,分为对照组(n = 51)和干预组(n = 52)。对照组进行常规围手术期指导,干预组在此基础上实施PRECEDE-PROCEED模式,按照模式9个环节,以倾向因素、促成因素和强化因素为核心,围绕健康行为6个方面多维度制定干预措施。出院后随访6个月,分别在第1、3、6个月时采用健康促进生活方式量表Ⅱ(HPLP II)和健康调查简表(SF-36)进行评估。
结果两组出院时HPLP II和SF-36评分均无显著性差异(P > 0.05)。术后1、3和6个月,干预组HPLP II和SF-36评分均高于对照组( t > 2.307, P< 0.05)。
结论 PRECEDE-PROCEED模式可改变全髋关节置换患者术后不良的生活行为,提高健康行为水平和生活质量。

关键词: 全髋关节置换术, 髋, PRECEDE-PROCEED模式, 健康行为, 生活质量

Abstract:

Objective To explore the effect of PRECEDE-PROCEED model on health behavior and quality of life of patients after total hip arthroplasty.
Methods From February to December, 2018, 103 patients who underwent primary total hip arthroplasty were divided into control group (n = 51) and intervention group (n = 52). The control group received routine perioperative guidance, while the intervention group received PRECEDE-PROCEED model in addition, in accordance to the nine links of the model, multi-dimensional intervention measures should be formulated with tendency factors, contributing factors and strengthening factors as the core. They were followed up for six months after discharge, and were assessed with Health Promoting Life style Profile II (HPLP II) and the MOS Item Short From Health Survey (SF-36) one, three and six months after discharge, respectively.
Results There was no significant difference in the scores of HPLP II and SF-36 between two groups at discharge (P > 0.05). The scores of HPLP II and SF-36 were higher than in the intervention group than in the control group one, three and six months after discharge ( t > 2.307, P< 0.05).
Conclusion PRECEDE- PROCEED model could change the undesirable life behavior after operation, and improve the health behavior and quality of life of patients with total hip arthroplasty.

Key words: total hip arthroplasty, hip, PRECEDE-PROCEED model, healthy behavior, quality of life

中图分类号:

R687.4

刘静,李伦兰,廖晨霞,甘玉云,刘玲,代极静. PRECEDE-PROCEED模式对全髋关节置换患者生活行为的效果[J]. 《中国康复理论与实践》, 2020, 26(10): 1217-1222.

LIU Jing,LI Lun-lan,LIAO Chen-xia,GAN Yu-yun,LIU Ling,DAI Ji-jing. Effects of PRECEDE-PROCEED Model on Behavior of Patients after Total Hip Arthroplasty[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(10): 1217-1222.

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项目	对照组 (n = 51)	干预组 (n = 52)	χ²/t值	P值	项目	对照组 (n = 51)	干预组 (n = 52)	χ²/t值	P值
性别(n)			0.505	0.615	入院诊断(n)			5.761	0.124
男	21	24			髋部骨折	21	12
女	30	28			股骨头坏死	18	20
年龄(岁)	62.10±11.10	61.87±13.24	0.300	0.764	骨关节炎	10	19
职业(n)			2.143	0.543	先天性髋关节脱位	2	1
农民	27	28			并发症(n)			2.622	0.623
工人	9	13			无	10	8
退休	13	8			内分泌疾病	14	16
其他	2	3			心血管疾病	21	25
婚姻(n)			2.601	0.457	呼吸疾病	4	1
已婚	43	47			其他	2	2
未婚	1	2			吸烟(n)			0.393	0.695
离婚	1	1			是	12	14
丧偶	6	2			否	39	38
文化水平(n)			4.579	0.205	饮酒(n)			1.235	0.220
小学及以下	25	27			是	12	18
初中	14	20			否	39	34
高中及中专	7	2			体质量指数(kg/m²)	22.76±3.68	23.71±4.06	1.313	0.192
大专及以上	5	3			居住环境(n)			0.349	0.728
居住成员(n)			1.422	0.491	平房	27	25
与配偶	39	43			电梯房	13	21
与子女	11	7			楼梯房	11	6
其他	1	2			术后禁忌姿势和不良行为知晓(n)			7.575	0.056
遵医嘱进行下肢功能锻炼(n)			6.355	0.096	不清楚	1	5
从不	0	1			清楚一点	38	32
有时	36	30			较清楚	12	12
经常	15	18			很清楚	0	3
总是	0	3

组别	n	出院时	术后1个月	术后3个月	术后6个月
对照组	51	112.75±12.76	123.90±9.72	131.27±12.14	138.67±12.60
干预组	52	110.3±12.67	127.88±7.71	140.08±15.55	154.75±20.31
t值		0.942	2.307	3.199	4.818
P值		0.349	0.023	0.002	< 0.001

组别	n	出院时	术后1个月	术后3个月	术后6个月
对照组	51	44.00±7.31	54.63±7.54	67.92±6.31	81.64±10.83
干预组	52	44.47±8.11	58.83±9.57	72.40±11.63	88.07±10.51
t值		0.313	2.471	2.435	3.508
P值		0.755	0.015	0.012	0.003