),尹朱丹,李莹,包倪荣,刘云()
),YIN Zhu-dan,LI Ying,BAO Ni-rong,LIU Yun()
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目的 探讨基于遗忘曲线规律的阶段性考核在肩袖修复术患者健康教育中的应用效果。方法 采用便利抽样,选取2019年6月—2020年7月在南京市某三级甲等医院行关节镜下肩袖修复术的120例患者,随机分为试验组和对照组,每组60例。对照组实施常规护理,试验组在常规护理的基础上实施基于遗忘曲线规律的阶段性考核,根据考核结果进行再教育。比较两组术前1天、术后第2周、术后第3个月肩关节活动度、Constant-Murley评分;比较试验组在健康教育后20 min、手术当日、术后第1天、第5天、第2周、第1个月、第3个月阶段性考核分数。结果 肩关节活动度组间与时间存在交互效应：前屈上举角度（F交互=18.044,P<0.001）,外展上举角度（F交互=14.855,P<0.001）,中立位外旋角度（F交互=45.280,P<0.001）。简单效应分析显示,术后第2周、第3个月,试验组肩关节活动度大于对照组：前屈上举角度（t=2.232、31.950,P<0.05）,外展上举角度（t=32.950、31.260,P<0.05）,中立位外旋角度（t=8.387、12.488,P<0.05）。Constant-Murley评分组间与时间存在交互效应（F交互=117.000,P<0.001）,简单效应分析显示,术后第2周、第3个月,试验组评分高于对照组（t=11.547、11.123,P<0.001）。试验组各阶段考核分数存在差异（F=100.043,P<0.05）,分数总体呈上升趋势。结论 应用基于遗忘曲线理论的阶段性考核方法科学可行,有助于加强患者康复知识记忆,提高健康教育效果,从而改善患者术后康复效果,可为临床健康教育提供了新方法。
Objective To explore the effects of periodic assessment based on the forgetting curve in health education of patients undergoing rotator cuff repair. Methods One hundred and twenty patients who underwent arthroscopic rotator cuff repair in a tertiary hospital in Nanjing from June 2019 to July 2020 were randomly divided into the experimental group and the control group,with 60 cases in each group. The patients in the control group received routine care. Patients in the experimental group received a periodic assessment based on the forgetting curve besides routine care and re-education based on assessment results. The shoulder joint range of motion and Constant-Murley score were compared between the two groups 1 day before surgery,2 weeks and 3 months after surgery. The test score of patients in the experimental group was compared at 20 min,the day of surgery and 1 d,5 d,2 weeks,1 month and 3 months after surgery. Results There was an interaction effect of the shoulder range of motion between groups and time：the forward bending angle（Finteraction=18.044,P<0.001）,the abduction angle（Finteraction=14.855,P<0.001）,and the neutral position of external rotation angle（Finteraction=45.280,P<0.001）. The simple effect analysis showed that after 2 weeks and 3 months of the surgery,the shoulder range of motion in the experimental group was greater than that in the control group,so was the forward bending angle（t=2.232,31.950,P<0.05）,the abduction angle（t=32.950,31.260,P<0.05）,the neutral position of external rotation angle（t=8.387,12.488,P<0.05）. The Constant-Murley score had an interaction effect between groups and time（Finteraction=117.000,P<0.001）. A simple effect analysis showed that after 2 weeks and 3 months of surgery,the score of the experimental group was higher than that of the control group（t=11.547,11.123,P<0.001）. There are significant differences in the assessment scores of the experimental group at each stage（F=100.043,P<0.05）,and the overall scores show an upward trend. Conclusion The health education method based on the forgetting curve theory is feasible. It helps to strengthen patient’s rehabilitation knowledge,improve the effects of health education,thereby improving health outcomes of patients after operation. The study provides a new way for clinical health education.