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Objective To use the cognitive reinforcement comprehensive intervention program constructed by our team to intervene in patients with spinal cord injury and evaluate its clinical application effect.Methods A non-randomized trial design was adopted to select 97 patients with spinal cord injury from November 2021 to September 2022.Forty-four patients from March to September 2022 in a Grade A hospital in Hefei City were included in the experimental group,and 53 patients from November 2021 to February 2022 were included in the control group.The cognitive reinforcement comprehensive intervention program was used to intervene in the experimental group,and the conventional rehabilitation nursing was used to intervene in the control group.The intervention lasted for 12 weeks in both groups.The Changsha Montreal Scale,Social Support Rating Scale,Rehabilitation Exercise Self-efficacy Scale,Spinal Cord Injury Independence Rating Scale and Hamilton Anxiety Scale were used to measure the two groups before intervention,1 month after intervention and 3 months after intervention.Results 40 cases in the experimental group and 48 cases in the control group completed the study.Repeated measurement ANOVA showed that the temporal,interactive and intergroup effects of cognitive function scores and anxiety scores were statistically significant(P＜0.05).The time effect and interaction effect of the subjective support dimension score,coping self-efficacy dimension score of the two groups were statistically significant(P＜0.05).One month after the intervention,the cognitive function scores of test group were higher than before intervention and control group,and the anxiety scores were lower than before intervention and control group(P＜0.05).Three months after the intervention,the scores of cognitive function,subjective support dimension and coping self-efficacy dimension of experimental group were higher than those before intervention and control group,and the scores of anxiety level were lower than those before intervention and control group(P＜0.05).Conclusion Comprehensive intervention of cognitive reinforcement can improve the cognitive function of patients with spinal cord injury,delay the process of cognitive impairment,enhance self-confidence,relieve anxiety,and promote physical and mental rehabilitation of patients.
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Objective:To explore the mediating effect of self-efficacy and fatigue between depression and cognitive function in patients with spinal cord injury.Methods:General information questionnaire, Hamilton Depression Scale, Montreal Cognitive Scale, Rehabilitation Exercise Self-Efficacy Scale, Fatigue Revised Scale were used to investigate 256 cases of spinal cord injury patients from December 2018 to August 2020. The deviation-corrected percentile Bootstrap method was used to test the chain mediating effect of rehabilitation exercise self-efficacy and fatigue on depression and cognitive function.Results:Correlation analysis showed that depression was negatively correlated with cognitive function ( r=-0.146, P<0.01), self-efficacy of rehabilitation exercise ( r=-0.115, P<0.01), and positively correlated with fatigue ( r=0.317, P<0.01), self-efficacy of rehabilitation exercise was positively correlated with cognitive function ( r=0.903, P<0.01), and negatively correlated with fatigue ( r=-0.889, P<0.01), and fatigue was negatively correlated with cognitive function ( r=-0.217, P<0.01). The mediation model test showed that depression had a significant direct effect on cognitive function, with an effect value of -0.141 and an effect size of 50.20%. Self-efficacy of rehabilitation exercise and fatigue had a significant mediating effect between depression and cognitive function. The effect value was -0.096, -0.026, the effect size was 34.1%, 9.3%, and the chain mediation effect of rehabilitation exercise self-efficacy-fatigue was also significant, the effect value was -0.018, and the effect size was 6.4%. Conclusions:Depression in patients with spinal cord injury not only directly affects cognitive function, but also indirectly affects cognitive function through the mediating effects of self-efficacy of rehabilitation exercise and fatigue, and the chain-type mediating effect of rehabilitation exercise self-efficacy and fatigue.
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Objective:To summarize the perioperative nursing points of percutaneous kyphoplasty (PKP) in elderly patients with osteoporotic vertebral compression fractures assisted by robots, so as to provide reference for orthopedic nursing.Methods:From July 2019 to February 2021, the data of 72 patients undergoing robot-assisted PKP in the spinal surgery of the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed. The perioperative nursing points were summarized, and the nursing experience was summarized. The nursing under the new measures of precise minimally invasive treatment was analyzed and discussed. The length of hospital stay, postoperative ambulation time, complications and satisfaction survey results of patients were collected and recorded. The Numerical Rating Scale(NRS) score, Self-rating Anxiety Scale(SAS) score and Oswestry Disability Index (ODI) score before and after surgery were compared. The correlation analysis of the scores of various factors was combined to comprehensively evaluate the surgical and nursing effects.Results:All patients had no complications related to machine use during and after operation, and their symptoms were improved to varying degrees. Fifty-seven cases of indwelling catheter, catheter time (19.00±14.24) h. The preoperative hospitalization time was (6.16±2.22) d, and the postoperative hospitalization time was (1.94±0.99) d. Postoperative bed time was (16.34±6.81) h. Postoperative nursing satisfaction was (98.55±2.44)%.The postoperative NRS and SAS scores were (1.00±0.55) and (32.06±5.33) points, respectively, which were lower than those before operation (3.51 ± 0.71) and (39.08±8.86) points, and the differences were statistically significant ( t values were 33.976, 8.184, P<0.01). There were statistically significant differences in six indicators of ODI scores before and after surgery, including low back pain, walking, standing, sitting, sleep and self-care ( P<0.01). Correlation analysis showed that there was a strong correlation between the six ODI score factors and the NRS score. The four factors of sitting, walking, low back pain and standing were highly correlated with SAS. Conclusions:The implementation of good perioperative nursing management for patients with PKP assisted by robot can effectively promote the rehabilitation of patients, reduce the incidence of complications and improve patient satisfaction.