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    請使用永久網址來引用或連結此文件: http://libir.tmu.edu.tw/handle/987654321/63504


    題名: 持續性追蹤指導對接受膝關節置換術病患術後膝 關節功能之成效:隨機對照試驗
    The effects of nurse-led follow-up on postoperative knee joint function in patients receiving total knee arthroplasty: A randomized controlled trial
    作者: 季若妤
    JI, RUO-YU
    貢獻者: 護理學系碩士在職專班
    蔡佩珊
    關鍵詞: 人工膝關節置換術;膝關節功能;持續性追蹤指導
    Total knee arthroplasty;Knee joint function;Nurse-led follow-up program
    日期: 2023-07-07
    上傳時間: 2024-01-30 14:29:31 (UTC+8)
    摘要: 背景：護理人員在病患術前提供護理指導可緩解病患對手術的焦慮，但對於術後恢復之成效有限，且病患常因術後不適症狀忽略復健運動之重要性，過渡期護理對於退化性關節炎患者術後恢復扮演著重要角色，然而術後電訪追蹤等持續性護理追蹤指導對接受膝關節置換術病患術後膝關節功能之成效仍待評估。
    研究目的：探討膝關節置換術後病患接受出院後持續性追蹤指導對於膝關節功能之成效。
    方法：本研究採隨機對照試驗，以北部某醫學中心骨科病房之膝關節置換術後病患為收案對象，控制組採常規照護，實驗組除常規照護外另由護理人員提供出院前探視與自我照顧手冊導讀，及於手術後每週一次、每次15分鐘，為期四週的持續性追蹤指導。兩組病患於手術前進行前測、術後兩週、術後一個月以膝關節功能評估量表（Knee injury and Osteoarthritis Outcome Score; KOOS）及結構式問卷收集手術後三十天內門急診利用情形與人口學變項。資料分析採用廣義估計方程式（Generalized Estimating Equations; GEE）檢定兩組在不同時間點之膝關節功能之差異。
    結果：本研究共納入132人，共117人完成試驗。GEE檢定顯示無論於手術後兩週或手術後一個月，實驗組膝關節功能總分改善幅度皆顯著高於控制組（p=.001及 <.001）。而兩組手術後三十天內門急診利用情形則無顯著差異（p=.093）。
    結論：膝關節置換術後病患可透過持續性追蹤指導提供過渡期照護，加強病患自我照護的動機與能力，進而改善術後膝關節功能。
    Background: Preoperative patient education can alleviate patient’s anxiety about the surgery, but its effectiveness on postoperative recovery is limited. Moreover, patients’ adherence to rehabilitation exercises is often low due to postoperative discomfort. Transitional care is crucial for the postoperative recovery of patients with degenerative knee osteoarthritis. There is a lack of experimental research assessing the effects of nurse-led postoperative follow-up on postoperative knee joint function in patients receiving total knee arthroplasty, making it difficult to determine its effectiveness.
    Objective: This study aimed to examine the effects of nurse-led follow-up on postoperative knee joint function in patients receiving total knee arthroplasty.
    Methods: A randomized controlled trial was conducted enrolling postoperative knee arthroplasty patients from the orthopedic ward of a medical center in Northern Taiwan. The control group received usual care. In addition to usal care, the experimental group received a nurse-led follow-up program. Briefly, a nurse visited the patient after the surgery and provided one-on-one instructions using the self-management handbook. After discharge, the experimental group also received weekly telephone support from the nurse; each lasted for 15-minute for four weeks. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used to assess knee joint function. Both groups underwent baseline measurements before surgery, and follow-up measurements at two weeks and one month after surgery. Data were analyzed using Generalized Estimating Equations (GEE) to determine the differences in the magnitude of changes in outcomes between groups.
    Results: A total of 132 patients were enrolled in this study, and 117 of them completed the trial. The GEE analysis revealed that the experimental group showed a significantly higher magnitude of improvements in the total KOOS score than the control group at two weeks and one month after surgery (p=.001 and p<.001). However, there was no significant difference in emergency department utilization between the two groups within 30 days after surgery (p=.093).
    Conclusion: Postoperative knee arthroplasty patients can benefit from nurse-led follow-up guidance, which provides transitional care, enhances patient’s motivation and ability for self-management, and consequently improves postoperative knee joint function.
    描述: 碩士
    指導教授:蔡佩珊
    委員:吳博貴
    委員:吳宥霖
    委員:蔡佩珊
    資料類型: thesis
    顯示於類別:[護理學系] 博碩士論文

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