首页|全膝关节置换术后患者居家康复锻炼方案的构建

全膝关节置换术后患者居家康复锻炼方案的构建

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目的 构建全膝关节置换术后患者居家康复锻炼方案,促进患者术后居家管理.方法 以知识行动框架指导方案构建,系统检索全膝关节置换术后居家康复锻炼的相关文献并评价质量,提取及汇总最佳证据形成锻炼意见;采用德尔菲法进行2轮咨询,确定居家康复锻炼内容;通过患者、实践者、管理者访谈,分析实施证据的促进因素和阻碍因素;采用专家小组会议制定居家康复锻炼内容实施的行动策略.结果 共纳入23篇文献,筛选24条锻炼意见并细化为术后2～26周的居家康复锻炼内容;确定3个促进因素与4个阻碍因素;最终形成全膝关节置换术后患者居家康复锻炼方案,并制定康复锻炼评估与实践流程图.结论 全膝关节置换术后患者居家康复锻炼方案的制定遵循实施科学的知识行动框架,纳入最佳证据,结合专业人员判断、患者意愿及可用资源,可为患者进行居家康复锻炼提供规范系统的干预指引.
Development of a home-based rehabilitation program for patients receiving total knee arthroplasty
Objective To develop a home-based rehabilitation program for patients receiving total knee arthroplasty(TKA)and to promote home management.Methods Guided by the Knowledge-to-Action framework,the development of home-based rehabilita-tion protocol involved such steps:first step,systematic literature review and quality assessment of relevant studies on home-based rehabilitation after TKA were performed;second step,the best evidence was extracted and summarized to generate rehabilitation contents;third step,two rounds of expert consultation were conducted using the Delphi method to determine the most appropriate rehabilitation contents;fourth step,qualitative interviews with patients,practitioners,and managers,were conducted to better understand facilitators and barriers of evidence implementation;and the last step,action strategies were formulated by an expert panel.Results A total of 23 articles were included,Twenty four items of rehabilitation contents were selected for home-based reha-bilitation and a detailed protocol across postoperative weeks 2-26 was formulated.Three facilitators and four bar-riers were identi-fied.A home-based rehabilitation program and a flowchart for the assessment and implementation of the program were developed.Conclusion Following the Knowledge-to-Action framework,the home-based rehabilitation program,which incorporates the best ev-idence and considers professional judgments,patient preferences,and available resources,can offer standardized and systematic in-tervention guidelines for patients engaging in home-based rehabilitation exercises.

total knee arthroplastyhome exerciserehabilitation exerciseevidence-based nursingknowledge-to-action frameworkimplementation scienceevidence implementation

陈茹、施春香、单亚维、沈中鸣、陈维佳、谢彤

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上海中医药大学光华临床医学院(上海,200052)

上海市光华中西医结合医院

上海中医药大学护理学院

全膝关节置换术 居家锻炼 康复锻炼 循证护理 知识行动框架 实施科学 证据转化

国家自然科学基金青年基金上海中医药大学"杏林学者-护理青年"人才计划上海市长宁区卫生健康委科研项目

722041652022HLXL0520214Y019

2024

10.3870/j.issn.1001-4152.2024.01.088

护理学杂志
华中科技大学同济医学院

护理学杂志

CSTPCD北大核心
影响因子：2.062
ISSN：1001-4152
年,卷(期)：2024.39(1)
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