Influence of health education based on the transtheoretical model on kinesiophobia levels and rehabilitation outcomes in elderly patients undergoing total knee arthroplasty.

Objective: In this study, we evaluated the effectiveness of health education based on the transtheoretical model in reducing symptoms of kinesiophobia and enhancing rehabilitation outcomes among elderly patients post-total knee arthroplasty. Methods: Elderly patients post-knee replacement surgery were randomly divided into a control group, which received standard health education, and an experimental group, which received transtheoretical model-based health education. The intervention commenced on the day after surgery and continued for a duration of six months. Assessments of kinesiophobia scores, rehabilitation self-efficacy, and knee function were conducted before the intervention, and then at one, three, and six months postoperatively. Results: Between January 2022 and December 2022, 130 elderly patients who met the eligibility criteria were enrolled and subsequently randomly assigned into two groups of equal size. Comparable baseline characteristics were observed between the two groups The experimental group demonstrated lower kinesiophobia scores and higher scores in rehabilitation self-efficacy and knee function at one, three, and six months following surgery, compared to the control group. Conclusion: Health education based on a transtheoretical model reduces the symptoms of kinesiophobia and enhances rehabilitation self-efficacy and knee functions in elderly patients after knee replacement surgery.

Establishment and validation of the prediction model for postoperative delirium risk factors in older patients after total knee arthroplasty: A retrospective study.

This study aimed to establish an effective predictive model for postoperative delirium (POD) risk assessment after total knee arthroplasty (TKA) in older patients. The clinical data of 446 older patients undergoing TKA in the Orthopedics Department of our University from January to December 2022 were retrospectively analyzed, and the POD risk prediction model of older patients after TKA was established. Finally, 446 patients were included, which were divided into training group (n = 313) and verification group (n = 133). Logistic regression method was used to select meaningful predictors. The prediction model was constructed with nomographs, and the model was evaluated with correction curve and receiver operating characteristic curve. The logistic regression analysis showed that age, educational level, American Society of Anesthesiologists grade, accompaniment of chronic obstructive pulmonary disease, accompaniment of cerebral stroke, postoperative hypoxemia, long operation time, and postoperative pain were independent risk factors for POD after TKA (P < .05). The nomogram prediction model established. The area under receiver operating characteristic curve of the model group and the validation group were 0.954 and 0.931, respectively. The calibration curve of the prediction model has a high consistency between the 2 groups. The occurrence of POD was associated with age, educational level, American Society of Anesthesiologists grade, accompaniment of chronic obstructive pulmonary disease, accompaniment of cerebral stroke, postoperative hypoxemia, long operation time, and postoperative pain in TKA patients.

Application of national early warning score in assessing postoperative illness severity in elderly patients with gastrointestinal illnesses.

BACKGROUND: Population aging is a social problem that is being faced in most countries. OBJECTIVE: To apply the National Early Warning Score (NEWS) for an early warning on the vital signs and consciousness of elderly patients who are hospitalized in the gastrointestinal surgical department and to provide a reference for early detection of changes in illness severity in elderly patients by studying the correlation between NEWS value and changes in illness severity. METHODS: We enrolled 528 elderly patients who were hospitalized in the gastrointestinal surgical department of a tertiary grade A hospital in Guizhou Province between June 2020 and May 2021, to analyze how NEWS max value correlates with illness severity and obtain the optimal NEWS cutoff value for both potentially critically ill and critically ill elderly patients using the receiver operating characteristic (ROC) curve. RESULTS: There were statistically significant differences in NEWS values between elderly patients with various illness severities (P< 0.05). NEWS values correlated positively with illness severity (r= 0.605, P< 0.001). Based on the ROC curve, early warning trigger values for NEWS to identify potentially critically ill, critically ill and terminally ill elderly patients were 6, 7 and 8, respectively. The area under the curve (AUC) for potentially critically ill, critically ill and terminally ill elderly patients was 0.907, 0.921 and 0.939, respectively. NEWS performed better in detecting patient illness severity than Modified Early Warning Score (MEWS) in AUC, sensitivity, specificity, and Youden's index, with statistically significant differences (P< 0.05). CONCLUSION: An early warning on the vital signs and consciousness of hospitalized elderly patients using NEWS can facilitate advanced detection of changes in illness severity of elderly patients by medical staff and enable timely treatment, thus significantly lowering the risks of illness deterioration.