聚焦解决模式对老年股骨隆间骨折患者术后康复的影响

目的 探讨基于聚焦解决模式的心理干预联合渐进式功能锻炼对老年股骨粗隆间骨折术后患者负性情绪及生活质量的影响。方法 采用随机数字表法将134例老年股骨粗隆间骨折患者分为对照组和观察组，各67例。对照组术后给予渐进式功能锻炼，观察组在对照组的基础上给予基于聚焦解决模式的心理干预联合渐进式功能锻炼。比较两组术后6个月内功能锻炼的依从性、术前（干预前）、术后6个月（干预后）Harris髋关节评分、术前、术后3 d、1个月、3个月、6个月抑郁自评量表（SDS）和焦虑自评量表（SAS）评分及术后6个月生活质量综合评定问卷（GQOLI-74）评分。结果 观察组功能锻炼的时间依从性、次数依从性均高于对照组（P＜0.05）；两组术后6个月Harris评分均较术前升高（P＜0.05），且观察组高于对照组（P＜0.05）；观察组术后3 d、1个月、3个月、6个月时SAS和SDS评分均低于对照组（P＜0.05）；观察组躯体职能、心理职能、情绪职能、认知职能和社会职能均高于对照组（P＜0.05）。结论 基于聚焦解决模式的心理干预联合渐进式功能锻炼可增加患者康复的信心，缓解患者的负性心理，提高患者康复锻炼依从性，加速术后康复，提高生活质量，值得临床借鉴应用。

Effect of Solution Focused Approach on Postoperative Rehabilitation of Elderly Patients with Intertrochanteric Fracture

Abstract:Objective To investigate the effects of psychological intervention based on focused solution mode and progressive functional exercise on negative emotion and quality of life in elderly patients with intertrochanteric fracture. Methods A total of 134 elderly patients with intertrochanteric fractures were divided into control group and observation group by random number table method, 67 cases each. In the control group, progressive functional exercise was given after operation, and the observation group was given psychological intervention based on the focus resolution mode combined with progressive functional exercise on the basis of the control group. Compliance with functional exercise within 6 months after surgery, preoperative (before intervention), postoperative 6 months (post-intervention) Harris hip score, preoperative, postoperative 3 d, 1 month, 3 months and 6 months depression self-rating scale (SDS) and anxiety self-rating scale (SAS) scores and the postoperative 6-month quality of life comprehensive assessment questionnaire (GQOLI-74) score. Results The time compliance and frequency compliance of the observation group were higher than that of the control group (P<0.05). The Harris score of the two groups was higher than that before the operation (P<0.05), and the observation group was higher than the control group. The SAS and SDS scores of the observation group were lower than those of the control group at 3 d, 1 month, 3 months and 6 months after operation (P<0.05). The physical function, psychological function and emotion of the observation group were observed. The functions, cognitive functions and social functions were higher than the control group (P<0.05).Conclusion Psychological intervention based on focused solution mode combined with progressive functional exercise can increase the confidence of patients' rehabilitation, relieve the negative psychology of patients, improve the compliance of rehabilitation exercises, accelerate postoperative rehabilitation and improve the quality of life. It is worthy of clinical application.