基于健康行为改变整合理论的老年髋部骨折病人术后居家运动方案的构建及应用OA

Objective:To develop a postoperative home exercise program for elderly patients with hip fracture,and to evaluate its effectiveness.Methods:Through literature review and Delphi expert consultation,a postoperative home exercise program for elderly patients with hip fracture based on integrated theory of health behavior change(ITHBC)was formed.The elderly patients with hip fracture surgery from a tertiary grade A hospital in Shenzhen city were selected as the research subjects.Among them,35 patients from March to June 2024 were assigned to the control group,and 33 patients from July to September 2024 were assigned to the experimental group.The patients in control group received routine post-discharge care.The patients in experimental group received home exercise intervention in addition to the routine care.The scores of Harris Hip Scale(HHS),6-minute walking distance(6MWD),Activities of Daily Living(ADL),and Self-efficacy for Rehabilitation Outcome Scale(SER)scores of the two groups were compared at the time of discharge,the end of 1st month after discharge,and the end of the third month after discharge.Results:At the end of 1st month and the end of the third month after discharge,the HHS score,6MWD,ADL score,and SER score of the experimental group were all better than those of the control group(all P<0.05).The exercise compliance of the experimental group showed an overall upward trend.Although there was brief fluctuation in the 5th and 6th weeks,and then followed by recovery and maintenance at a high level.Conclusions:The postoperative home exercise program for elderly patients with hip fracture based on integrated theory of health behavior change is scientifically and practically feasible.It could effectively improve the exercise function,daily living activity ability,and rehabilitation belief of elderly hip fracture patients,and improve their exercise compliance.