Construction And Application Of Follow-Up Care Program Based On "Internet+" For Patients With Total Knee Arthroplasty

ObjectiveTo construct follow-up care program based on “Internet+” for patients with total knee arthroplasty,according to the follow-up care needs of total knee arthroplasty patients,and explore effect of the follow-up care program,in order to provide reference for clinical nurses to use Internet technology for follow-up care.Methods1.A total of 268 total knee arthroplasty patients admitted to the Department of Joint Surgery in a tertiary Class A hospital in Qingdao from April to July 2019 were selected as the research subjects.Questionnaires were used to investigate the total knee arthroplasty patients’ general information,follow-up care status,follow-up care needs,knee function and self-efficacy.To analyze the follow-up care needs of patients with total knee arthroplasty and its influencing factors.2.Literature review was conducted,combined with the relevant guidelines for follow-up care of total knee arthroplasty patients and the results of the current survey,and the framework of the follow-up care program was initially formed.And then the Delphi method was used to conducted two rounds of expert consultation,modified the program content,and finally formed the follow-up care program based on “Internet+” for total knee arthroplasty patients.3.The convenience sampling method was used,a total of 80 total knee arthroplasty patients admitted to the Department of Joint Surgery in a tertiary Class A hospital in Qingdao from September to November 2019 were selected.80 patients were randomly divided into intervention group and control group by using random number table method,with 40 patients in each group.The control group was followed up by telephone,and the intervention group was followed up by “Internet+” follow-up care program.The knee function,self-efficacy and quality of life of the two groups were compared before surgery,1 month and 3 months after surgery.SPSS 24.0 software was used for statistical analysis.Results1.Follow-up care need score of total knee arthroplasty patients was(56.18±8.35),and functional exercise need score was the highest,which was(3.85±0.75).The most desired form of follow-up care for total knee arthroplasty patients was Internet follow-up(52.61%).The results of multiple linear regression analysis showed that education level,living situation,rehabilitation knowledge mastery,knee function and self-efficacy were the influencing factors of follow-up care needs of total knee arthroplasty patients.2.The results of Delphi expert consultation show that the positive coefficient of the two rounds of expert consultation were both 100%.The expert authority coefficients of the two rounds of expert consultation were 0.80 and 0.84,respectively.Expert coordination coefficients of the two rounds of expert consultation were 0.246 and 0.308(P<0.05),respectively.Then the follow-up care program based on “Internet+” for total knee arthroplasty patients was finally determined.3.(1)Repeated measurement variance results showed that the time effect,inter-group effect and interaction effect of knee function scores and range of knee motion at different time points in 2 groups were statistically significant(P<0.05).Further pair comparison showed that the knee function score and range of motion of the intervention group were higher than those of the control group at 1 month and 3 months after surgery(P<0.05).(2)Repeated measurement variance results showed that the time effect,inter-group effect and interaction effect of self-efficacy score at different time points in 2 groups were statistically significant(P<0.05).Further pair comparison showed that the self-efficacy score of the intervention group were higher than those of the control group at 1 month and3 months after surgery(P<0.05).(3)At 1 month and 3 months after surgery,the total scores of quality of life in the intervention group were(58.14±4.81)and(78.81±5.27),respectively.The total scores of quality of life in the control group were(56.00±4.12)and(72.03±4.18),respectively.The total scores of quality of life in the intervention group were higher than that in the control group(P<0.05).Conclusions1.Total knee arthroplasty patients have relatively high level of follow-up care needs.Education level,living situation,rehabilitation knowledge mastery,knee function and self-efficacy are influencing factors for follow-up care needs of patients with total knee arthroplasty.2.The follow-up care program based on “Internet+” for total knee arthroplasty patients has a high level of enthusiasm and authority among experts.The evaluation of the intervention program by correspondence experts is consistent,and the opinions of experts tend to be the same.Thus this program is scientific to a certain extent.3.The follow-up care program based on “Internet+” for total knee arthroplasty patients is beneficial to improve the knee function,the self-efficacy and the quality of life of total knee arthroplasty patients,and enhance their confidence to return to their families and society.