| Object(1) Draw total hip arthroplasty postoperative follow-up of the status quo phones and related documents, around total hip replacement patients individual needs, develop total hip arthroplasty procedures directory telephone follow-up inquiries.(2) Evaluation of total hip arthroplasty procedures follow-up inquiries telephone directory application results in clinical practice. Method(1) By the relevant literatures and classified, semi-structured interviews with patients, and clinical total hip replacement surgery related to the development of primary care norm dimensions and entry procedures directory inquiries telephone follow-up, using the Delphi method two rounds of expert advice, and the added dimension of entries, delete, or modify, eventually forming into the draft directory.(2) In our hospital in December 2013- August 2014 among patients meet the criteria of total hip arthroplasty in 228 cases were randomly divided into control and experimental groups for each 114 patients in the control group using conventional telephone follow-up mode follow-up mainly on the basis of "THR patient Care Handbook" relevant content. Followed up according to their own understanding, patient follow-up questions as well as previous cases to determine their own content. The experimental group of telephone follow-up program mode, Follow-up of this study developed by THR standard telephone follow-up inquiries directory. Six months after the two groups of samples into groups to answer the call frequency, quality of life, level of rehabilitation, self-care capacity and quality of patient satisfaction with telephone follow-up were compared. Results(1) The first round of grant letter asking Volume 25 were returned 20 positive coefficient of 80.00%; the second round of grant 20 questionnaires, 20, 100.00% positive coefficient. Where expert judgment coefficient of 0.86, familiarity factor of 0.92; expert authority coefficient of 0.89.(2) The importance of the first round of the assignment entry maximum 5.43 minimum 2.43; ≥50% selection rate of entry for 30, accounting for 96.77%; maximum variation coefficient of 0.31, the minimum is 0.09. The importance of the second round of the largest entry assignment 5.94 minimum 4.78; all indicators have reached the selection rate ≥50%; maximum variation coefficient of 0.21, the minimum is 0.08. The second round of the degree of variation is less than the first round. The second round of expert advice coordination degree higher than the first round, with a statistically significant difference comparing two(P <0.01).(3) In the control group receiving calls sample average 18.5 times / cases(77.08%); the experimental group to answer the phone 24 times / patients,(100%),(χ2 = 11.067, P <0.032). The control group, the average answer time 6.78 ± 0.45 min / times / patients in the experimental group receive time 13.25 ± 0.68 min / times / patients(t = 7.897, P <0.014). Answer the call of the experimental group than the control group positive(P <0.05)(4) The date of discharge two samples of quality of life assessment score is low, the experimental group of eight scores between 20.25- 62.35 points, score 370.38 ± 114.35 points; the control group between 21.97- 63.46, out of 372.56 ± 114.24 points. Two physical health scores were obtained at the lowest level in eight dimensions. Samples of the experimental group and the control group sample was not statistically significant(P> 0.05). Six months later, two samples of the eight dimensions of quality of life assessment score and score when compared with discharge significantly increased in the control group of eight scores between 65.78- 79.15 points, total score of 574.32 ± 110.78 points; the experimental group between 82.16- 97.44 points, total score of 721.88 ± 95.69 points. Physical health scores in the experimental group was at its highest level in eight dimensions, the control group in the first five. Samples of the experimental group and the control group was statistically significant sample appears(P <0.01) and total score in eight dimensions.(5) Two samples recovered at discharge level assessment score lower in the experimental group of seven scores between 1.49 to 28.95 points, a total score of 54.05 ± 6.78 points; the control group between 1.57 to 27.99, a total score of 55.56 ± 7.06 points. Samples of the experimental group and the control group sample scores in seven dimensions and no comparison was not statistically significant(P > 0.05). 6 months later, the two samples recovered seven dimensions to assess the level of scores and scores when compared with discharge significantly improved in the experimental group of seven scores between 3.52~42.08 points, total score of 93.74 ± 3.81 min; control group between 3.04~37.45, total score of 82.40 ± 6.81 points. Samples of the experimental group and the control group was statistically significant sample appears(P<0.01) and total score in seven dimensions.(6) Two samples at discharge in low self-care behavior score, the experimental group scored between 18.52- 32.95 points, total score of 110.01 ± 7.45 points; a low level of 29 cases(25.44%), the level of 76 cases( 66.67%), a high level of 9 cases(7.90%); the control group between 19.06- 33.24, total score of 109.56 ± 7.01 points; a low level of 30 cases(26.32%), the level of 77 cases(67.54%), high Level 7 cases(6.14%). The experimental group and the control group was not statistically significant(P> 0.05). Six months later, when two samples recovered significantly increased levels than discharged, the experimental group scored between 24.84- 52.78 points, total score of 153.42 ± 5.23 points; low for 8 cases(7.02%), the level of 80 cases(70.18%), a high level of 26 cases(22.81%); the control group between 21.37- 45.63, total score of 134.76 ± 8.84 points; a low level of 14 cases(12.28%), the level of 89 cases(78.07%), a high level of 11 cases(9.65%). Samples of the experimental group and the control group was statistically significant sample appears(P<0.01) in four dimensions, score and compare the level of classification.(7)In the experimental group six highest scores for inquiries etiquette for 19.04 ± 3.55 points, the lowest for troubleshooting, to 15.66 ± 3.47 points, total score of 88.89 ± 3.19 points; the highest scores in the control group was 15.31 ± 6.62 points etiquette Inquiries the lowest was 10.52 ± 7.64 Troubleshooting points, total score of 54.78 ± 6.28 points. Experimental group scored better than the control group, a statistically significant difference(P<0.05). Satisfaction with 69 cases in the experimental group(60.05%), not satisfied with only five cases(4.39%); control group, 17 cases of satisfaction(14.91%), not satisfied with 15 cases(13.16%), the two groups with statistically significant difference(P<0.01). Conclusions(1) Participate in the program directory of telephone follow-up inquiry letter Delphi expert consultation with higher professional and authoritative. Directory inquiry and revision after two letters, expert advice coordination degree rise, increased consistency, culminating with better reliability, authoritative directory inquiries telephone follow-up procedures, including four one dimension, 14 two entry-level, 42 three entries.(2) The application of telephone follow-up phone calls can effectively improve patient rate and reduce the rate of telephone follow-up release.(3) The application of telephone follow-up can effectively improve the quality of life of patients after THR home rehabilitation phase of rehabilitation and patient self-care ability levels.(4) The application of telephone follow-up after THR can improve patient satisfaction with telephone follow-up and strengthen the relationship between nurses and patients together to complete rehabilitation THR surgery. |
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