基于行为改变轮理论的膝关节置换术患者康复护理方案的构建

doi:10.3761/j.issn.0254-1769.2022.23.009

摘要/Abstract

摘要：

目的基于行为改变轮理论构建膝关节置换术患者康复护理方案，为临床膝关节置换术患者康复锻炼护理提供依据。方法在2022年3月—6月以行为改变轮理论为理论基础，通过文献回顾与头脑风暴构建康复护理方案初稿。采用德尔菲专家函询方法，对康复护理方案条目进行修改、增补或删减后再运用层次分析法确定各个条目的权重。结果 20名专家参加了2轮德尔菲专家函询，问卷的有效回收率均为100%。专家权威系数为0.925，2轮函询的肯德尔和谐系数分别为0.445、0.362（P<0.001），各级指标的重要性赋值均数为4.75~5.00分，最终形成的康复护理方案包含3个一级条目、7个二级条目、26个三级条目。结论该研究基于行为改变轮理论构建的膝关节置换术患者康复护理方案具有科学性和实用性，对借助移动健康技术指导膝关节置换术患者的康复护理具有指导意义。

关键词: 关节成形术, 置换, 膝, 行为改变轮理论, 移动健康技术, 康复护理, 德尔菲技术

Abstract:

Objective To construct a rehabilitation exercise nursing program for total knee arthroplasty （TKA） patients based on Behavioral Change Wheel （BCW） Theory and mobile health technology，and to provide a reference for the rehabilitation exercise nursing program for patients with TKA. Methods From March to June 2022，the first draft of evaluation indicators was constructed through literature review and brainstorming method with experts based on the BCW Theory. Delphi technique method was used to modify，add or delete items of the program，and then Analytic Hierarchy Process was used to determine the weight of each item. Results 2 rounds of Delphi consultations were conducted among 20 experts，and the effective recovery rate of the questionnaire was 100%. The expert authority coefficient was 0.925，and the Kendall harmony coefficients of the 2 rounds of consultations were 0.445 and 0.362，respectively （P<0.001）. The mean value of importance assignment of indicators at all levels was 4.75-5.00. The final program contained 3 first-level items，7 second-level items，and 26 third-level items. Conclusion The rehabilitation nursing program based on BCW Theory for TKA patients constructed in this study is scientific and applicable，with reference significance for guiding the rehabilitation nursing of TKA patients with the help of mobile health technology.

Key words: Arthroplasty, Replacement, Knee, Behavior Change Wheel Theory, Mobile Health Technology, Rehabilitation Nursing, Delphi Technique

孙湘雨, 徐园, 杨旭, 曹晶, 李加敏, 朱丽筠, 吴欣娟. 基于行为改变轮理论的膝关节置换术患者康复护理方案的构建[J]. 中华护理杂志, 2022, 57(23): 2877-2883.

SUN Xiangyu, XU Yuan, YANG Xu, CAO Jing, LI Jiamin, ZHU Liyun, WU Xinjuan. Construction of a rehabilitation nursing program for total knee arthroplasty patients based on Behavior Change Wheel Theory[J]. Chinese Journal of Nursing, 2022, 57(23): 2877-2883.

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