Intervention Study Of Frailty In The Collaborative Care Model On Elderly Patients After THR

Objective:To explore the intervention effect of the collaborative care model on postoperative frailty and survival quality of elderly patients with THR,and to improved frailty,and provide reference for the formulation of intervention measures on patients with frailty after THR.Methods:This study belonged to quasi-experimental study.Used the convenience sampling method,according to the inclusion criteria,60 hospitalized patients with total hip replacement(THR)were selected as the control group from January to March 2019,and 60 hospitalized patients with THR were selected as the intervention group from April to June 2019.The control group used the routine orthopedic nursing method,the intervention group used the collaborative care model to intervene the postoperative frailty patients on the basis of routine orthopedic nursing,and the observation time was all 3 months.The general data questionnaire,frailty phenotype scale,short form health survey questionnaire(SF-12)and other testing tools were used.The observation indexes of the two groups of patients were evaluated before intervention,at discharge,at 1 month and 3 months after intervention.With SPSS22.0 statistical software for data analysis.Mean±standard deviation was used for measurement data description,frequency and composition ratio were used for enumeration data description.The two independent sample t test was used for the measurement data conforming to the normal distribution,and the non-parametric test was used for the non-conforming normal distribution.T test was used to compare the indexes of the same time,repetitive measurement deviation analysis was used to compare the indexes of different time.The chi-square test or rank-sum test was used to compare baseline data between groups.Results:(1)Patients in the two groups before intervention:There was no statistically significant difference between the control group and the intervention group in the general demographic characteristics,hip joint Harris function score,mini nutritional assessment scale(MNA)score,living self-care ability assessment scale BI index score,frailty phenotype score and short form 12 health survey questionnaire(SF-12)score(P>0.05).The data of the two groups of patients were comparable.(2)The hip joint Harris function score in the two groups of patients:at discharge,the harris score in the control group,were not statistically significant compared with the intervention group(P>0.05);after 1 month and 3 months,the harris score in the control group was(79.53±4.70)(86.95 ± 6.37),and that of the intervention group was(82.02±5.38)(91.98±5.17),with statistically significant differences(P<0.01).(3)The MNA score in the two groups of patients:at discharge and after 1 month,the MNA score in the control group,were not statistically significant compared with the intervention group(P>0.05);After 3 months,MNA score of the control group was(19.60±1.46),and that of the intervention group was(21.58±1.57),with statistically significant differences(P<0.05).(4)The BI index score in the two groups of patients:at discharge,the BI index score in the control group was not statistically significant compared with those in the intervention group(P>0.05).After 1 month and 3 months,the BI index score of the control group was(73.92±3.70)(85.00±3.32),and that of the intervention group was(77.00±3.93)(89.92±3.30),with statistically significant differences(P<0.01).(5)The frailty score in the two groups of patients:at discharge,the frailty score in the control group was not statistically significant compared with those in the intervention group(P>0.05);After 1 month and 3 months,the frailty score of the control group were(3.28±0.46)(2.63±0.49),and that of the intervention group were(2.92±0.38)(2.18±0.47),with statistically significant differences(P<0.01).(6)The quality of life SF-12 score in the two groups of patients:at discharge and after 1 month,the physical component summary(PCS)score and The mental component summary(MCS)score of SF-12 in the control group was not statistically significant compared with those in the intervention group(P>0.05);After 3 months,The physical component summary(PCS)score of SF-12 in the control group was(36.13±1.90),and that of the intervention group was(37.13±2.10),with statistically significant differences(P<0.05);The mental component summary(MCS)score of SF-12 in the control group was(41.20±2.30),and that of the intervention group was(40.70±3.31),with no statistically significant difference(P>0.05).Conclusion:(1)The collaborative care model based on nutrition supplement and rehabilitation exercise was adopted to intervene the elderly patients after THR surgery,it can promote the recovery of hip joint function,and improved nutritional status.(2)The collaborative care model can improve self-care ability of elderly patients after THR surgery.(3)The collaborative care model can improve the frailty of elderly patients after THR surgery,and survival quality of elderly patients.