全膝关节置换术恐动症患者术后早期功能锻炼体验的质性研究

doi:10.3761/j.issn.0254-1769.2019.11.013

摘要/Abstract

摘要：

目的了解全膝关节置换术恐动症患者术后早期功能锻炼的真实体验。方法采用目的抽样法,对14例全膝关节置换术恐动症患者进行半结构式访谈,并采用Braun主题分析法对访谈资料进行分析、归纳及提炼主题。结果全膝关节置换术恐动症患者术后早期功能锻炼的体验可归纳为4个主题：疼痛恐惧（疼痛敏感度增强,将疼痛视作威胁）;对早期功能锻炼效果的不确定感（担心关节假体脱落,质疑早期功能锻炼效果,低效型运动状态）;压力较大（经济压力、心理压力）以及支持系统薄弱（缺少家庭支持,缺乏专业技术支持,渴望社会支持）。结论全膝关节置换术恐动症患者疼痛较为明显,对术后早期功能锻炼的积极性不高,且承受较大的心理压力,临床医护人员应重视其运动体验,给予必要的社会支持。

关键词: 关节成形术,置换,膝, 早期活动, 恐动症, 康复护理, 质性研究

Abstract:

Objective To explore the real experience of total knee arthroplasty（TKA） patients with kinesiophobia towards early rehabilitation exercise.Methods A semi-structured interview was conducted with 14 TKA patients with kinesiophobia recruited by purposive sampling method,then the Braun’s analysis method was applied to analyze,induce,and refine themes of interview data.Results Four themes regarding early rehabilitation exercise were extracted,including fear of pain（increased sensitivity of pain,pain as a threat）,uncertainty about the effects of early rehabilitation exercise（fear of joint prosthesis falling off,unsure about the effect of early rehabilitation exercise,and inefficient exercise status）,high pressure（economic pressure and psychological pressure）,and lack of social support（lack of family support,deficient inprofessional technical support,and desire for social support）.Conclusion The TKA patients with kinesiophobia have obvious pain,low enthusiasm for early rehabilitation exercise,suffering great psychological pressure. Clinicians and nurses should pay attention to their exercise experience and provide necessary social support.

Key words: Arthroplasty,Replacement,Knee, Early Mobilization, Kinesiophobia, Rehabilitation Nursing, Qualitative Research

蔡立柏, 刘延锦, 崔妙然, 郭玉茹, 郑爽爽, 王彦艳. 全膝关节置换术恐动症患者术后早期功能锻炼体验的质性研究[J]. 中华护理杂志, 2019, 54(11): 1663-1667.

CAI Libai, LIU Yanjin, CUI Miaoran, GUO Yuru, ZHENG Shuangshuang, WANG Yanyan. Early rehabilitation exercise in total knee arthroplasty patients with kinesiophobia：a qualitative study[J]. Chinese Journal of Nursing, 2019, 54(11): 1663-1667.

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