基于放松训练的心理模式结合5E康复模式对骨肉瘤保肢治疗患者围手术期康复效果的影响  

Effects of mental model based on relaxation training and 5E rehabilitation model on the perioperative rehabilitation of patients with osteosarcoma

作　　者：李娟[1] 周文娟 代艺[2] 王田 阮婷玉 Li Juan;Zhou Wenjuan;Dai Yi;Wang Tian;Ruan Tingyu(Department of Orthopedics,Union Medical College Affiliated to Huazhong University of Science and Technology,Wuhan 430022,China;Administrative Management of Union Medical College Affiliated to Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022 [2]华中科技大学同济医学院附属协和医院行政管理,武汉430022

出　　处：《中国实用护理杂志》2021年第31期2438-2443,共6页Chinese Journal of Practical Nursing

摘　　要：目的探讨基于放松训练的心理模式结合5E康复模式对骨肉瘤保肢治疗患者围手术期康复效果的影响,为围手术期康复提供参考。方法选择2018年1月至2019年12月华中科技大学同济医学院附属协和医院收治的142例骨肉瘤患者。按照随机数字表法将患者分为观察组及对照组,每组71例。对照组采取常规围手术期护理,观察组采取基于放松训练的心理模式结合5E康复模式。分别采用Karnofsky功能状态评分量表、广泛性焦虑量表(GAD-7)、健康问卷抑郁症状群量表(PHQ-9)评估2组患者护理前后的生命质量、焦虑、抑郁水平,采用国际骨与软组织肿瘤协会(MSTS)评分评估2组患者护理后患肢恢复情况,观察2组患者的不良反应发生情况。结果护理前2组患者的生命质量评分差异无统计学意义(P>0.05),护理后观察组生命质量评分为(91.10±12.38)分,高于对照组的(82.20±12.51)分,差异有统计学意义(t值为10.441,P<0.001);护理前2组患者GAD-7和PHQ-9评分差异无统计学意义(P>0.05),护理后观察组GAD-7和PHQ-9评分分别为(5.21±3.12)、(4.41±3.43)分,低于对照组的(6.82±3.34)、(6.43±3.13)分,差异有统计学意义(t值为9.531、10.592,P<0.001);观察组护理后的患肢恢复优良率为71.9%(51/71),高于对照组的54.9%(39/71),差异有统计学意义(χ^(2)值为10.468,P<0.001);观察组不良反应发生率为5.6%(4/71),对照组为12.7%(9/71),差异有统计学意义(χ^(2)值为12.543,P<0.001)。结论基于放松训练的心理模式结合5E康复模式可以提高骨肉瘤保肢治疗患者术后康复效果,使患者树立信心,能主动积极配合治疗和参与术后康复训练,通过干预,使患者积极调整心态,为后期进一步辅助治疗奠定基础,更有利于提高患者生命质量,改善预后。Objective To explore the effect of mental model based on relaxation training and 5E rehabilitation model on the perioperative rehabilitation of patients with osteosarcoma,in order to provide the reference for rehabilitation nursing of patients with osteosarcoma.Methods A total of 142 osteosarcoma patients were selected from January 2018 to December 2019 in the Affiliated Union Hospital of Tongji Medical College of Huazhong University of Science and Technology.According to the random method of digital table,the patients were divided into observation group and control group,71 cases respectively.The control group took routine nursing,and the observation group patients took the mental model based on relaxation training and 5E rehabilitation mode.The quality of life,the levels of depression and anxiety before and after intervention were evaluated by Karuafsky Functional State Score,Generalized Anxiety Scale(GAD-7)and Health Questionnaire Depression Symptom Group Scale(PHQ-9).The recovery of the affected limb was evaluated by the Musculoskeletal Tumor Society(MSTS).The adverse reactions were observed.Results There was no significant difference in the quality of life between the two groups before nursing(P>0.05).After nursing,the quality of life score was(91.10±12.38)points in the observation group and(82.20±12.51)points in the control group.The difference was statistically significant(t value was 10.441,P<0.001).There was no significant difference in GAD-7 and PHQ-9 scores between the two groups before nursing(P>0.05).After nursing,the GAD-7 and QPH-9 score were(5.21±3.12),(4.41±3.43)points in the observation group and(6.82±3.34),(6.43±3.13)points in the control group.The differences were statistically significant(t values were 9.531,10.592,P<0.001).The excellent and good recovery rate of the affected limb in the observation group was 71.9%(51/71)in the observation group and 54.9%(39/71)in the control group,the difference was statistically significant(χ^(2) value was 10.468,P<0.001).The incidence of adverse rea

关 键 词：骨肉瘤 康复 预后 放松训练 5E康复模式 

分 类 号：R473.78[医药卫生—护理学]