ABSTRACT
Objective:To explore the effect of Internet + technical liaison service mode on the postoperative continuing nursing of elderly patients with osteoporotic hip fractures.Methods:A total of 92 elderly patients with osteoporotic hip fractures who were admitted into in Orthopaedics Department of the First Affiliated Hospital of Soochow University from July 2018 to December 2019 were selected, and randomly divided into intervention group and control group by random number table method, with 46 cases in each group. The control group was given routine follow-up outside hospital, while the intervention group was given the continuing nursing led by the orthopedic specialist nurses based on the Internet + Technology home orthopedic care platform. All patients were followed up to 6 months after operation, and the differences of Harris Hip Score (Harris), Numeric Rating Scales (NRS), Barthel Index, Short Form 36-item Health Survey (SF-36) between the two groups were compared.Results:The Harris scores were 49.74 ± 4.28, 76.59 ± 4.33 and 90.78 ± 2.61 in the intervention group, and 46.17 ± 3.85, 74.26 ± 4.24 and 88.65 ± 2.17 in the control group in 1, 3 and 6 months after operation, respectively. The differences were statistically significant ( t=-4.20, -2.60, -4.26, all P<0.05). The NRS scores in the intervention group were 1.33 ± 0.47, 0.83 ± 0.38 and 0.76±0.43 in 1, 3 and 6 months after operation respectively, while the NRS scores in the control group were 1.61 ± 0.54, 0.96 ± 0.42 and 0.84 ± 0.38, respectively. The difference in pain scores between the two groups was statistically significant only at 1 month after operation ( t=2.68, P<0.05). The Barthel Index in the intervention group were 61.74 ± 8.90, 93.80 ± 5.29 and 98.26 ± 2.83 in 1, 3 and 6 months after operation respectively, while those of the control group were 60.33 ± 5.81, 91.09 ± 7.52 and 97.83 ± 3.10, respectively. The difference in Barthel Index between the two groups was statistically significant only in 3 months after operation ( t=-2.00, P<0.05). The scores of SF-36 in the intervention group were 93.73 ± 3.89, 100.26 ± 3.77 and 107.50 ± 3.56 at 1, 3 and 6 months after operation respectively, while those of the control group were 92.67±3.42, 97.71±2.67 and 103.68±2.83, respectively. The difference in SF-36 scores between the two groups was statistically significant only at 3 and 6 months after operation ( t=-3.74, -5.71, P<0.05). Conclusions:The continuing nursing based on multi-disciplinary team cooperation in hospital + Internet + Technology home orthopaedic nursing platform led by orthopaedic specialist nurses can improve joint function, relieve pain and improve quality of life of elderly patients with osteoporotic hip fractures after operation.
ABSTRACT
Objective To evaluate the effect of case management model on the stable patients with chronic obstructive pulmonary disease (COPD),containing health knowledge level,the number of acute exacerbation and the quality of life.Methods Fifty patients were divided into the experimental group and the control group with 25 cases each by random digits table method.The experimental group received the case management model for 3 months.The control group received routine care for 3 months.The COPD health Knowledge Questionnaire(CKQ) scores and St George's Respiratory Questionnaire(SGRQ) scores were measured for 4 times (the beginning of the intervention and 1 months,2 months,3 months later),and the numbers of acute exacerbation were measured at 3 months later.Results The CKQ scores at 1,2,3 months after intervention were (28.04±1.43),(28.20±1.00),(28.40±1.04) points in the experimental group,and (18.08±2.30),(18.50±1.87),(18.33±1.66) points in the control group,and there were significant differences (t=18.109,22.556,5.320,all P ＜ 0.01).The scores of SGRQ and symptom at 2 months and 3 months after intervention were (50.56±8.68),(49.40±8.05),(41.52±10.86),(37.16±8.90) points in the experimental group,and (57.42±10.22),(59.46±9.06),(54.50±8.67),(56.71 ±10.03) points in the control group,and there were significant differences (t=-7.222-2.536,P ＜ 0.05 or 0.01).The influence scores at 1,2,3 months after intervention were (46.28±8.74),(44.40±8.11),(42.04±8.22) points in the experimental group,and (51.50±7.77),(51.79±8.06),(54.08±6.96) points in the control group,and there were significant differences(t=-2.206,-3.197,-5.523,P ＜ 0.05 or 0.01).There was no statistically significant difference about activity scores between two groups before and after intervention (P ＞ 0.05).The numbers of acute exacerbation during 3 months with 3,22 cases in 1 and 0 time in the experimental group and 9,15 cases in the control group,and there was statistically difference between two groups(x2=4.306,P＜ 0.05).Conclusions The case management model can promote the stable COPD patients to know more disease-related health knowledge,and improve the health knowledge level.The case management model can reduce the symptoms of the stable COPD patients,reduce the frequency of acute exacerbation,reduce the influence of disease on daily life,prevent further decline in activity endurance,and improve the quality of life.