行动研究法对椎体压缩性骨折患者术后康复进程、健康行为及再骨折风险的影响  

Impact of action research method on the rehabilitation process,health behavior,and risk of refracture in patients with vertebral compression fractures after surgery

作　　者：高越 刘阳 于丽娜 庞芳芳 GAO Yue;LIU Yang;YU Li-na;PANG Fang-fang(Outpatient Operating Room,the First People's Hospital of Pingdingshan,Pingdingshan 467000,Henan,CHINA;Health Management Center,the First People's Hospital of Pingdingshan,Pingdingshan 467000,Henan,CHINA;Outpatient Department,the First People's Hospital of Pingdingshan,Pingdingshan 467000,Henan,CHINA;the Second Department of Orthopedics,the First People's Hospital of Pingdingshan,Pingdingshan 467000,Henan,CHINA)

机构地区：[1]平顶山市第一人民医院门诊手术室,河南平顶山467000 [2]平顶山市第一人民医院健康管理中心,河南平顶山467000 [3]平顶山市第一人民医院门诊部,河南平顶山467000 [4]平顶山市第一人民医院骨外二科,河南平顶山467000

出　　处：《海南医学》2025年第4期580-585,共6页Hainan Medical Journal

基　　金：2022年河南省医学科技攻关联合共建项目(编号:LHGJ20220970)。

摘　　要：目的探究行动研究法对椎体压缩性骨折(VCF)术后患者康复进程、健康行为及再骨折风险的影响。方法选择2022年1~12月于平顶山市第一人民医院治疗的146例VCF患者作为研究对象,按随机数表法分为观察组和对照组各73例。对照组患者采取常规干预,观察组患者于对照组基础上采取以行动研究法为指导的护理对策,干预至出院3个月。比较两组患者术后1 d、出院时、出院后1个月的疼痛数字模拟法(NRS)评分及干预前、干预3个月后Oswestry功能障碍指数(ODI)、日本骨科协会评估治疗分数(JOA)、骨质疏松自我效能量表(OSES)评分、健康行为评分,干预结束后随访12个月统计再骨折发生率。结果出院时、出院后1个月,观察组患者的NRS评分分别为(3.86±0.42)分、(3.10±0.37)分,明显低于对照组的(4.74±0.48)分、(3.66±0.41)分,差异均有统计学意义(P<0.05);干预3个月后,观察组患者的ODI评分为(8.70±1.34)分,明显低于对照组的(10.62±2.08)分,JOA评分为(26.53±2.18)分,高于对照组的(23.12±3.37)分,差异均有统计学意义(P<0.05);干预3个月后,观察组患者的运动效能、摄钙效能和总分分别为(52.16±5.05)分、(55.13±4.24)分、(107.29±8.12)分,高于对照组的(43.09±4.54)分、(46.62±5.32)分、(89.71±7.18)分,差异均有统计学意义(P<0.05);干预3个月后,观察组患者的药物、运动、饮食、其他评分分别为(17.58±1.54)分、(15.36±1.74)分、(36.76±3.75)分、(11.24±1.75)分,明显高于对照组的(14.10±1.69)分、(11.18±1.96)分、(24.82±4.06)分、(9.10±1.24)分,差异均有统计学意义(P<0.05);随访12个月,观察组患者的再骨折发生率为1.37%,略低于对照组的6.85%,但差异无统计学意义(P>0.05)。结论行动研究法不仅能促进VCF患者术后康复,还有助于患者提升自我效能,强化健康行为能力,减少再骨折事件。Objective To explore the impact of action research on the rehabilitation process,health behavior,and risk of refracture in patients with vertebral compression fractures(VCF)after surgery.Methods A total of 146 VCF patients treated in the First People's Hospital of Pingdingshan City from January 2022 to December 2022 were selected as the research objects.They were randomly divided into an observation group and a control group according to a random number table method,with 73 patients in each group.The patients in the control group received routine intervention,and the patients in the observation group adopted nursing strategies guided by action research method on the basis of the control group.The intervention lasted for 3 months until discharge.The pain numerical simulation(NRS)scores of the two groups of patients 1 day after surgery,at discharge,and 1 month after discharge,as well as the Oswestry Disability Index(ODI)before intervention and 3 months after intervention,and the Japanese Orthopedic Association Assessment Treatment Score(JOA),Osteoporosis Self-efficacy Scale(OSES)score,health behavior score were compared between the two groups.The patients were followed up for 12 months after the intervention to calculate the incidence of re-fracture.Results At the time of discharge and one month after discharge,the NRS scores in the observation group were(3.86±0.42)points and(3.10±0.37)points,respectively,which were significantly lower than(4.74±0.48)points and(3.66±0.41)points in the control group(P<0.05).After 3 months of intervention,the ODI score in the observation group was(8.70±1.34)points,which was significantly lower than(10.62±2.08)points in the control group,and the JOA score was(26.53±2.18)points,significantly higher than(23.12±3.37)points in the control group(P<0.05).After 3 months of intervention,the exercise efficiency,calcium intake efficiency,and total score in the observation group were(52.16±5.05)points,(55.13±4.24)points,and(107.29±8.12)points,respectively,which were significantly high

关 键 词：椎体压缩性骨折 行动研究法 再骨折 健康行为 

分 类 号：R473.6[医药卫生—护理学]