肝硬化老年衰弱患者综合运动康复护理方案的构建及应用

doi:10.3761/j.issn.0254-1769.2023.20.001

摘要/Abstract

摘要：

目的构建肝硬化老年衰弱患者综合运动康复护理方案并探讨其应用效果。方法采用文献回顾、半结构式访谈法构建综合运动康复护理方案初稿，于2021年11月—12月对16名专家进行2轮函询，并结合预试验结果确定方案内容。采用便利抽样法，选取2022年1月—6月在郑州市某三级甲等医院感染科住院的肝硬化老年衰弱患者作为研究对象。按照病区进行分组，试验组在常规护理的基础上应用综合运动康复护理方案进行干预，对照组接受常规护理。比较两组干预后1、3个月的肝衰弱指数、生活质量及不良事件发生情况。结果 2轮专家函询的有效问卷回收率分别为85.00%、94.12%，专家的权威系数分别为0.823、0.833，肯德尔和谐系数分别为0.175、0.196（P<0.001）。最终构建的综合运动康复护理方案包含2个一级条目、8个二级条目和24个三级条目。在该方案的应用过程中，共脱落10例，最终试验组和对照组各纳入58例。干预后1个月，两组肝衰弱指数比较，差异具有统计学意义（P=0.036）。干预后3个月，两组肝衰弱指数和生活质量比较，差异均具有统计学意义（P<0.05）。两组均未发生跌倒、骨折等不良事件。结论该研究构建的肝硬化老年衰弱患者综合运动康复护理方案具有科学性、可行性及安全性，能改善患者的衰弱状况和生活质量。

关键词: 肝硬化, 老年人, 衰弱, 康复, 运动, 护理

Abstract:

Objective This study aims to construct a comprehensive exercise rehabilitation program for elderly patients with cirrhosis and frailty，and to explore its application effect. Methods Through literature research and qualitative research，a comprehensive exercise rehabilitation program was drafted. From November to December 2021，16 experts were consulted，and a comprehensive exercise rehabilitation program for elderly patients with cirrhosis and frailty was formed. From January to June 2022，the convenience sampling was used to select the elderly patients with cirrhosis and frailty in the infection department of a tertiary A hospital in Zhengzhou City as the research subjects. The experimental group was given the comprehensive exercise rehabilitation program on the basis of routine care，while the control group was only given routine care. Liver weakness index，quality of life and adverse events were compared between the 2 groups at 1 and 3 months after the intervention. Results The effective questionnaire recovery rates of the 2 rounds of expert consultations were 85.00% and 94.12%；the expert authority coefficients were 0.823 and 0.833；Kendall harmony coefficients were 0.175 and 0.196（P<0.001）. Finally，the comprehensive exercise rehabilitation program included 2 first-level items and 8 second-level items and 24 third-level items. During the application of this program，10 cases dropped，and 58 cases were finally included in the experimental group and the control group respectively. At 1 month after the intervention，the Liver Frailty Index between the 2 groups were statistically significant（P=0.036）. At 3 months after intervention，there were significant differences in the Liver Frailty Index and Quality of Life between the 2 groups（P<0.05）. No adverse events such as falls and fractures occurred in the 2 groups. Conclusion The comprehensive exercise rehabilitation program constructed in this study is safe and effective for elderly patients with frailty cirrhosis，and it can improve the frailty status and quality of life of elderly patients with cirrhosis.

Key words: Liver Cirrhosis, Aged, Frailty, Rehabilitation, Exercise, Nursing Care

李思雨, 袁媛, 安然, 姬永辉, 张凤. 肝硬化老年衰弱患者综合运动康复护理方案的构建及应用[J]. 中华护理杂志, 2023, 58(20): 2437-2445.

LI Siyu, YUAN Yuan, AN Ran, JI Yonghui, ZHANG Feng. Construction and application of a comprehensive exercise rehabilitation program in elderly patients with cirrhosis and frailty[J]. Chinese Journal of Nursing, 2023, 58(20): 2437-2445.

图/表 3

表1 肝硬化老年衰弱患者综合运动康复护理方案

Table 1 Comprehensive exercise rehabilitation program in elderly patients with cirrhosis and frailty

表2 两组一般资料比较

Table 2 Baseline characteristics of 2 groups of patients

表3 两组不同时间点肝衰弱指数和生活质量比较（$\bar{x}±s$)

Table 3 Comparison of Liver Frailty Index and quality of life of 2 groups of patients at different time points（$\bar{x}±s$)

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