Development And Experimental Study Of Rehabilitation Nursing Intervention Model For Patients With Hand Burns

Objective1. To construct the rehabilitation nursing intervention model for patients with handburns.2. To verify the effectiveness of the pattern through clinical control．MethodsThis research is divided into two parts:Part I, the construction of the rehabilitation nursing intervention model for patientswith hand burns1. Adopted documentary analysis to identify the factors affecting the recovery inpatients with hand burns under the findings and theories of related disciplines.2. This thesis attempts to use the International Classification of Functioning,Disability and Health (ICF) as a theoretical framework, consulting the health core setsfor hand conditions and the International Classification of Functioning, Disability andHealth (ICF) category in the adult patients and hospitalized patients, then confirmedthe rehabilitation demands of patients with hand burns from four aspects, and thenconfirmed the rehabilitation goals of patients with hand burns. From these we canconstruct the initial rehabilitation nursing pattern of intervention to patients with handburns.3. Adopted Delphi method to seek advice from experts in rotation, and constructedthe generally recognized pattern eventually.Part II, the clinical trials of the rehabilitation nursing intervention model forpatients with hand burnsThe semi-experimental study was used.60patients with hand burns were dividedtwo groups, i.e., the experimental group and the control group, by the hospitalizationtime. The hand-movement state, comprehensive health and related psychosocial indicators were measured before and after intervention. Repetitive measurementdeviation analysis, and simple effect analysis, such as Chi-square test, Rank sum test,One-Way ANOVA, were used to evaluate the effectiveness．Results1. The main factors affecting the rehabilitation level of patients with hand burns are:(1) biological factors: size of burns, depth of burns, loss of vital tissue and bloodvessels, need for donor sites, burn injuries on both hands or not, operation performedor not, hand positions,functional bracing,timing of intervention,as well as lack ofoptimal care and comprehensive rehabilitation treatment or not;(2) psychosocialfactor puts a lot more emphasis on psychological intervention and social support.2. Patients’ rehabilitation objectives, which represented in the classified category ofICF, comprise the followings. Firstly, the rehabilitation of body structures andfunctions, such as emotional stability, cognitive consonance, having a sound sleep,alleviation of pruritus and pains, reestablishment of self-consciousness and recoveryin hand joint, wound, muscle strength, skin reaction which including sense of heat andtouch etc. Secondly, participation in activities, such as writing, carrying, grasping,washing hands, eating, dressing and having a bathe, keeping fundamentalinterpersonal relationships, returning to post and taking part in recreational activitiesand so on. Thirdly, the improvement of environment, it means that appropriatetemperature and humidity, as well as daily necessities and rehabilitation equipment,which contributes to the recovery in the burnt hands, are accessible to patients, andthey’ll have the strong support of relatives, friends, medical personnel, society andpolicy.3. The quantitative rehabilitation nursing intervention model for patients with handburns was established.4. While two groups of patients with hand burns were hospitalized, their Barthelindex scores had no statistical significance (P>0.05). While discharged from hospital,Barthel index scores of the experimental group was remarkably higher than the control. The differences between Barthel index scores of two groups had statisticalsignificance (P<0.05).5. While in hospital, the general score of BSHS-A and the scores of physicalfunction, psychological function, social relationships and general health had nostatistical significance (P>0.05). As time goes by, the experimental group becamesuperior to the control. The BSHS-A scores of the former was remarkably higher thelatter. The differences between index scores of two groups had statistical significance(P<0.05).6. When wound almost healed, the differences between finger joint TAM and grippower of two groups had no statistical significance (P>0.05). During the middle andlater periods, the TAM and grip power of the experimental group, which had trainingin the recovery room, were better than the control. The former was superior to thelatter. The differences between TAM and grip power of them had statisticalsignificance (P<0.05)7. The follow-up results showed that the hand deformity rate of experimental groupwas lower than that of the control group,. The condition of resuming work of theformer was superior to the latter. The differences between hand deformity rate andconditions of resuming work of two groups had statistical significance (P<0.05).8. It was three months after being discharged from hospital, the general score ofMHQ and the scores of hand function, daily activities, work performance, the outwardappearance of hands, and degree of satisfaction of the experimental group were higherthan the control. The differences between the scores of two groups had statisticalsignificance. The differences between the scores of pains of two groups had nostatistical significance (P>0.05).Conclusion1. The rehabilitation nursing intervention model for patients with hand burnscontributes to improve the ability of activities of daily living of patients with handburns.2. The rehabilitation pattern of intervention to nurse patients with hand burns contributes to improving psychological and social functions of patients and quality oflife.3. The rehabilitation pattern of intervention to nurse patients with hand burns coulddecrease the frequency of hand deformity, help patients with hand burns resume workearly and derive great satisfaction from knowing that their hands restored to health.