術前衛教對人工全膝關節置換術患者的活動功能及生活品質之探討

The exploration of preoperation education on functional activity and quality of life after total knee arthroplasty

本研究目的為探討手術前衛教對人工膝關節置換術患者之手術後活動功能恢復及其相關之影響因素。本研究為類實驗型研究設計。樣本來源為中部某家醫學中心接受人工膝關節置換術的患者，共六十位（控制組30位，實驗組30位）。資料收集流程為門診收案，並於手術前24-48小時先行訪談，說明研究目的與過程，取得同意後填寫受試者同意書、基本資料、活動功能評估表、SF-36健康調查量表，實驗組並同時接受衛教。實驗組及控制組填寫活動功能量表於手術後第七日及手術後第三十日。結果：術前衛教與第一次下床日、第七日及第三十日功能評估量表功能性量表總分平均及第七日及第三十日之膝關節活動度，兩組呈現顯著差異（t=.00、.0 22、.012、.042、.00, p<.05）。第一次下床日實驗組較控制組少1.17日，肢體功能性活動其實驗組都較控制組得分高。自我效能與三十日功能評估量表功能性量表總分平均、第七日及第三十日之膝關節活動度，呈現正相關（γ＝.635、.041、.0514, p<.05）。結論：本研究結果為手術前衛教在住院日數上無顯著差異，但實驗組較控制組少0.2日。而手術前衛教與術後活動功能呈現正相關，亦即是術前衛教有助於病患於手術後促進活動功能。自我效能和自覺健康狀況與活動功能呈現正相關，表示自我效能和自覺健康狀況越高者，其術後活動功能越佳。

Background : The purpose of this study for discussion about preoperative education on functional activity and its associated factors after total knee arthroplasty. Methods : Quasi­Experimental deign, the sample source from a medical center in the middle area of Taiwan was prepared to accept total knee arthroplasty (N=60) which divided into two groups : the control group (n=30) and experimental group (n=30) . The research data collection processes is that in the case of out-patient admission and 24-48 hours before surgery to an interview that to explain the purpose of study and research process and later to obtain the consent of the subjects filled out consent under the case agreed to join the study and at the same time, filled out the basic information on the activities of the functional assessment form, SF-36 health survey scale. The experimental group receive health education at the same time. Experimental group and control group complete the functional activities of scale on the seventh and the thirtieth day after the operation. Results : Pre-operative education associated with the case get out of bed on the first time, seventh and thirtieth day following the function of functional assessment scales which the average total score on the seventh day and the thirtieth day following knee activity, the experimental and control groups showed significant differences (t=.00, .022, .012, .042, .00, p <.05). Get out of bed on the first time was that experimental group was shorter than the control group is 1.17. The physical features of the activities of the experimental group than the control group scored was high. The total score of SF-36 and functional scale and self-efficacy was that seventh and thirtieth day following the activity of the knee, showing a positive correlation (y =.635, .041, .0514, p < .05). Conclusion : The results of this study for pre-operative education and the days in the hospital was no significant difference but the experimental group shorter than control group was 0.2 days. Pre-operative education and functional activity was a positive correlation, which is pre-operative education will help patients in the post-operative function of promotion activities. Self-efficacy and SF-36 showed a positive correlation function.