Application Of Home Care Program Based On Empowerment Model In Postoperative Rehabilitation Of Children With Developmental Dislocation Of The Hip

ObjectivesThis study takes family empowerment as the theoretical basis to clarify the existing problems of caregivers,explore the application effect of family empowerment care program in postoperative rehabilitation nursing of children with developmental hip dislocation,and provide clinical basis for future studies on caregivers of children with DDH.MethodsA total of 108 children diagnosed with DDH and their caregivers admitted to the pediatric orthopedics Department of a Grade-III hospital in Anhui Province from July2021 to June 2022 were selected as the study objects.According to the order of diagnosis time,the children were divided into control group and intervention group,with 54 cases in each group.Control group received routine nursing program;The intervention group implemented the family care program based on the empowerment model,which was carried out by clarifying the caregiver’s problems,guiding the caregivers to express their emotions,setting goals,making program plans and evaluating the effects.General data questionnaire,hip function evaluation questionnaire,postoperative complication questionnaire,Family Care-Giver Task Inventory and Caregiver Burden Interviewwere used to collect data before and after intervention.Independent sample T test,paired sample T test,Chi-square test,Mauchly spherical test and Greenhouse Geisser correction were used to analyze the effects of family empowerment care program on the recovery of hip joint function,the incidence of postoperative complications,caregiver’s ability and caregiver’s burden.Results1.Comparison of characteristics of general demographic data between the two groups,There was no significant difference in the general demographic characteristics of the children and their caregivers between the two groups(P>0.05),and the baseline was comparable.2.Hip function evaluation of the two groupsBefore intervention,there was no significant difference in the excellent and good rate of Mckay evaluation grade between the two groups(22.0% vs 20.0%)(P>0.05).There were statistically significant differences in the excellent and good rates of Mc Kay evaluation grade(64.0% vs 80.0%,78.0% vs 90.0%)between the two groups 6 to 8weeks after intervention and three months after intervention(P<0.05).There was no significant difference in the excellent and good rate of Severin evaluation grade between the two groups(34.0% vs 32.0%)before intervention,but there were statistically differences in the excellent and good rates of Severin evaluation grade(60.0% vs82.0%、76.0% vs 92.0%)between the two groups 6 to 8 weeks after intervention and three months after intervention(P<0.05).3.Incidence of complications in the two groupsThe complication rates of the two groups were statistically significant at 1 week after intervention,6 to 8 weeks after intervention and 3 months after intervention(20.0% vs6.0%,18.0% vs 4.0%,16.0% vs 2.0%)(P<0.05).3.Caregiving ability scores of the two groups of caregivers(1)The F-time main effect was statistically significant(P<0.001),indicating that there were differences in the scores of caregivers with DDH at different time points without considering intervention factors;(2)Comparison between groups: Before intervention,there was no statistical significance in caregiving ability scores(28.74±3.92 vs 27.56±3.41)between the two groups(P> 0.05).One week after intervention and 6 to 8 weeks after intervention,there were statistically significant differences in caregiving ability scores between the two groups(25.84±2.17 vs 24.16±2.81,19.52±2.97 vs 13.48±4.90)(P <0.05).(3)The F interaction effect was statistically significant(P<0.001),indicating that the effect of the time factor on the caregiving ability score of the caregivers of children with DDH was different with different intervention methods,and the change trend of the caregiving ability score of the caregivers of children with DDH was different in the two groups at the three time points(T1,T2,T3).4.Caregiving burden scores of the two groups of caregivers(1)The F-time main effect was statistically significant(P< 0.001),indicating that there were differences in the scores of caregivers with DDH at different time points without considering intervention factors;(2)Comparison between groups: Before intervention,there was no statistical significance in caregivers’ burden score(51.28±5.22 vs 51.06±5.61)between the two groups(P>0.05).One week after intervention and 6 to 8 weeks after intervention,there were statistically significant differences in caregivers’ burden scores(42.42±5.44 vs37.84±4.18,33.84±6.71 vs 19.90±4.65)between the two groups(P<0.05).(3)The F interaction effect was statistically significant(P<0.001),indicating that the effect of time factor on the caregiver burden score of children with DDH was different with different intervention methods,and the change trend of caregiver burden score of children with DDH was different in the two groups at three time points(T1,T2,T3).ConclusionFamily care program based on empowerment model can effectively promote the recovery of postoperative joint function in children with DDH,reduce the incidence of postoperative complications in children with DDH,improve the caring ability of family caregivers of children with DDH,and reduce the caring burden of family caregivers.