| Objective To investigate the early home rehabilitation experience of patients with total hip arthroplasty,the current status of rehabilitation of discharged patients,and the influencing factors.To evaluate the effect of home visiting on the joint function,self care agency,anxiety and depression of home rehabilitation patients undergoing hip arthroplasty.Methods This research consists of three stages.Stage one:A semi-structured interview was performed on 10 discharged patients from the first affiliated hospital of Anhui Medical University.The original data were analyzed to investigate the early home rehabilitation experience of patients with total hip arthroplasty.Stage two:Totally 407 discharged patients with total hip arthroplasty from the first affiliated hospital of Anhui Medical University were enrolled by convenience sampling method from January 2015 to October 2015.The self-designed general information questionnaire,Harris hip function score table,Exercise of self-care agency,Self-rating anxiety scale and Self-rating depression scale were used to investigate the current status of rehabilitation of discharged patients and the influencing factors.Stage three:Totally 113 discharged patients with total hip arthroplasty from the first affiliated hospital of Anhui Medical University were enrolled by convenience sampling method from October 2015 to July2016.They were randomly assigned to intervention or control group.The patients in the control group receiving continuity nursing including discharge guidance,outpatient referral and telephone follow-up while the patients in intervention group receiving home visiting.The baseline survey at discharge,Home visiting was at second week and eighth week after discharged,including rehabilitation intervention environment and lifestyle management,rehabilitation knowledge and technical guidance,nursing of pain and complications,psychological nursing,the intervention period is 6 months,and evaluate the effect of home visiting on the joint function,self care agency,anxiety and depression of home rehabilitation patients undergoing hip arthroplasty at 1,3,6 months.Results Stage one:The early rehabilitation experience of patients with hip arthroplasty including :(1)Deficiency of self-care ability;(2)Change of psychological experience;(3)Need of family rehabilitation knowledge and technical support;(4)Need of self-realization.Stage two:(1)Hip function scores of discharged patients in 2 months were(53.99 ± 5.06)and excellent rate was 5.3%.Hip function scores of discharged patients between 2 ~ 4 months were(68.62 ± 6.34)and excellent rate was 12.2%.Hip function scores of discharged patients between 4 ~ 6 months were(73.16 ± 7.65)and excellent rate was 21.5%.(2)The scores of self care ability of THA patients were(77.25± 6.32),(90.58 ± 6.46)and(104.32 ± 13.56),respectively.The highest level of health knowledge,followed by self-care responsibility,self-care skills and self-concept in the three times periods.There was a positive correlation between the total score of self-care ability and the dimensions of hip function and various dimensions(P<0.05)between 2 ~4 months and 4 ~ 6 months after discharged.(3)The scores of anxiety were(47.11 ±4.72),(41.91 ± 4.46)and(35.43 ± 4.52),respectively.The scores of depression were(44.84 ± 4.59),(38.32 ± 4.04)and(32.43 ± 3.86),respectively.There were positive correlations between anxiety and depression in the three periods(P<0.05).(4)Univariate analysis showed that there were differences in joint function between age,educational level,occupational and surgical methods(P<0.05).Multiple linear regression analysis showed that anxiety,depression,self-care ability,educational level and age had an effect on joint function.Stage three:(1)There were no significant differences in the general data,self-care ability,anxiety and depression level and hip function between intervention group and control group(P> 0.05).(2)The scores of joint function in intervention group were significantly higher than those in control group at 1,3 and 6 months after discharged(P <0.05).(3)The scores of self-care ability of intervention group were significantly higher than those of control group at 1,3 and 6months after discharged(P <0.05).(4)The scores of anxiety and depression in intervention group were lower than those in control group at 1,3 and 6 months after discharge,the difference was statistically significant(P <0.05).Conclution There are some defects in the rehabilitation of discharged patients with total hip arthroplasty.Anxiety,depression,self-care ability,educational level and age have an effect on joint function.Home visiting can effectively improve the joint function of patients,improve patient self-care,reduce anxiety and depression levels,improve home rehabilitation effect. |
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