發展全膝關節置換術後居家復健衛教手冊

Development the Home-Based Postoperative Rehabilitation Manual in Patients After Total Knee Replacement

背景/目的：全膝關節置換術（total knee replacement, TKR）是骨膝關節炎後期的常見治療方式，術後復健能加強患者身體活動功能及避免術後合併症。本研究旨在發展「全膝關節置換術後居家復健衛教手冊」以提升膝關節置換術患者術後對復健運動上的執行率及成效。 研究方法：本研究參考學者建議建構衛教手冊共六程序，包括確認衛教對象及手冊施作目的、TKR術後之相關資料收集、衛教手冊內容制定、具體編寫衛教手冊內容、專家評審初稿及衛教手冊測試，並以李克特5分量表進行衛教手冊「內容適用性」、「內容正確性」與「文字易讀性」檢測專家內容效度。 研究結果：本衛教手冊內容含TKR術後運動的重要性、骨膝關節炎診斷方式及危險因子、術後的活動及姿勢、居家日常生活注意事項、飲食指導、復健運動的注意事項、術後3個月內可執行的復健運動等七項。手冊整體平均值為4.46±0.54分，手冊內容的適用性、正確性及易讀性之內容效度指數分別為.88、1及.88，整體內容效度指數為.92。 結論：除了應考量居家復健運動的劑量及強度外，定期追蹤患者後續復健狀況是有其必要性。期望本衛教手冊之發展可促使TKR患者在居家復健的意願及成效，進而改善生活品質並達到健康促進。

Background / Purpose : Home-based rehabilitation is essential issue after total knee replacement (TKR), that could be significantly improve physical function, and avoid fall accident. The purpose of the study was to develop the home-based rehabilitation manual for patient after TKR, and to improve the implementation rate and effectiveness of rehabilitation exercises for TKR patients after surgery. Methods: This study used six steps referred to the scholars’ methods to construction of the home-based rehabilitation manual, including confirm the health education target and the purpose of the manual, collect relevant data after total knee arthroplasty, formulate the content of the health education manual, specifically compile the content of the health education manual, the first draft of the expert review and the first draft of the expert review, and based on 5-point Likert scale to calculate the mean ± SD and content validity index (CVI). Result: This manual content included: the importance of exercise after TKR, diagnosis and risk factors of osteoarthritis, post-operative activities and posture, precautions for daily life at home, dietary guidance, precautions for home rehabilitation exercise after TKR surgery, homebased rehabilitation performed within three months after surgery for TKR. This manual total mean score was 4.46±0.54. The CVI of the applicability, correctness and legibility of the manual content were .88, 1, and .88 respectively, and total CVI was .92. Conclusions: The dosage and intensity of home-based rehabilitation exercises should be considered, and regularly track is needed. We expect that home-based rehabilitation manual will enhance the willingness and effectiveness of TKR patients to rehabilitate at home, thereby improve the quality of life, and achieve a health promotion.