院外医疗干预对门诊膝关节疼痛患者康复锻炼依从性及效果的影响  

Effect of medical intervention outside hospital on exercise compliance in patients with knee joint pain

作　　者：李乐翔[1] 袁伟[1] 刘宁[1] 周嵘[1] 韩武翔 付奇伟[1] 吴海山[1] 钱齐荣[1] 

机构地区：[1]第二军医大学附属上海长征医院关节外科,上海200003

出　　处：《中国骨与关节损伤杂志》2017年第6期561-564,共4页Chinese Journal of Bone and Joint Injury

基　　金：国家自然科学基金(8171727)

摘　　要：目的探讨院外医疗干预行为对门诊膝关节疼痛患者康复锻炼依从性及效果的影响。方法选择自2015-12—2016-06因"膝关节疼痛"需在家进行膝关节功能康复功能锻炼的骨科门诊患者230例,按照随机数字法将患者分为试验组和对照组。试验组与医师互留联系方式,患者可主动联系医师,医师每周通过微信及电话对患者进行随访指导,督促锻炼。对照组在家自行康复锻炼,无医师督促。首诊1个月后安排门诊复诊了解患者康复锻炼执行情况,观察对比2组依从性及锻炼效果并进行统计分析。结果 217例获得随访,试验组114例,对照组103例。试验组康复锻炼依从性总分(8.32±2.00)分,高于对照组(7.11±1.56)分,差异有统计学意义(t=4.987,P=0.002)。试验组康复锻炼后KSS评分(79.83±3.90)分,高于对照组(65.01±3.80)分,2组术后KSS评分比较差异有统计学意义(t=28.332,P<0.001)。每日锻炼记录、锻炼项目完成度较高的患者具有更好的依从性,且依从性越高的患者康复锻炼效果更好。结论医师与门诊患者建立有效的院外沟通,给予指导、督促,能提高患者的自我效能,增强康复锻炼的依从性及效果。Objective To investiagte the effect of medical intervention outside hospital on exercise compliance in the patients with knee joint pain. Methods Two hundred and thirty cases in orthopedic outpatient department were selected from December 2015 to June 2016 who had pain and needed to be at home for knee functional rehabilitation exercise, and divided into test group and control group according to the random number method. The test group and the physician could contact each other. The patient could take the initiative to contact the physician and the doctor could guide patients and urge them to do exercise every week through the WeChat and telephone follow-up. The control group did self-rehabilitation exercise at home, without physician supervision. One month after the first visit, outpatients re-visited and the physician could understand the implementation of rehabilitation exercise in patients with observation and compared compliance and exercise effects of 2 group and performed statistical analysis. Results Two hundred and seventeen cases were followed up, 114 cases in the test group and 103 cases in the control group of. The rehabilitation exercise compliance score in the test group （8.32＋2.00） was higher than that of the control group （7.11＋1.56）, the difference was statistically significant （t =4.987, P =0.002）. KSS score of test group after exercise （59.83~3.90） was higher than that of the control group （65.01＋3.80）. There was significant difference between the two groups （t =28.332, P 〈0.001）. Patients with daily exercise record and a higher degree of exercise project completion had better compliance. The higher the compliance of patients, the better the rehabilitation exercise effect. Conclusion Effective communication between physicians and patients outside the hospital, and the guidance and supervision of the exercise can improve the patient＇s self-efficacy, enhance the compliance and the effect of rehabilitation exercise.

关 键 词：康复训练 功能锻炼 依从性 医疗干预 膝关节 关节疼痛 

分 类 号：R684[医药卫生—骨科学]