Application Research Of Transitional Care Intervention Based On "Timing It Right" In Patients With Total Hip Replacement And Their Caregivers

Objective To investigate the actual experience of caretakers in patients undergoing total hip replacement during the entire care period,analyze the characteristics and content of their needs,and discuss the impact of continuity care based on timing theory on caregiving ability of caregivers,burden of carers,and rehabilitation effect of patients.Method Using combination of qualitative and quantitative research methods.Qualitative research: Under the guidance of timing theory,descriptive phenomenological methods were used to collect real experience data of caregivers in patients undergoing total hip replacement at five different stages.The data were analyzed using the Colaizzi 7-step method to understand that Demand content and characteristics of different periods,formulate a continuous nursing intervention program based on timing theory.Quantitative research(intervention study):Randomized grouping was used to randomly classify 2 orthopaedic subjects with no statistically significant differences in the number of beds,disease types,medical titles,and academic qualifications into the intervention group and the control group.The subjects of the control group and the intervention group were selected by the random number table method.The control group was treated with routine nursing and follow-up.The intervention group was combined with the health education manual on the basis of routine nursing,under the guidance of timing theory,according to the characteristics of different stages of demand.And tools such as public platforms to provide continuity of care to patients and caregivers.Before the intervention,one month after discharge,and three months of discharge,Harris Harris score,activities of daily living ability scores,caregiving ability and burden scores were analyzed to evaluate the effect of intervention.Select SPSS18.0 software for data entry and analysis.Results Qualitative research phase: The five phases of care needs extracted under the guidance of timing theory are:(1)the diagnostic period: the need for emotional support;the need for disease and disease knowledge;the need to care for capacity;and the need for psychological adjustment.(2)Perioperative period: demand for information related to surgery;demand for economic assistance;need for pain control;need for sharingcare work;demand for rehabilitation exercise guidance;(3)Preparation period: Demand for discharge of hospital procedures;Demand for rehabilitative exercise guidance;Demand for psychological adjustment;Demand for guiding patient role change.(4)Implementation period: assisting home debugging needs;spiritual support needs;guidance requirements for preventing falls again;correct interpretation of data needs;group mutual assistance needs;home extended nursing needs(5)adaptation period: improving quality of life needs;return to social contact needs Community medical needs.Nursing Intervention Stage: Before the intervention,caregiving ability and care burden were taken by the two groups of caregivers.There was no significant difference in Harris score and scores of activities of daily living activities between the two groups(P>0.05).At the time of discharge from hospital for one month,the total score of care ability(14.63�1.395)and each dimension of the control group were higher than the total score of care ability of the intervention group(10.82�1.380)and each dimension score,and the differences were statistically significant(P<0.05);The control group's total care score(42.31�3.123)and each dimension score were higher than the intervention group's total care score(33.97�5.529)and each dimension score,the difference was statistically significant(P< 0.05)The total Harris score in the control group(60.97�10.506)was lower than the Harris score in the intervention group(73.91�11.156),and the difference was statistically significant(P<0.05);the total score of the activities of daily living in the control group was(39.00�3.985).Lower than the total score of the intervention group(55.61�4.636),the difference was statistically significant(P<0.05).When discharged for 3 months,the total score of care ability(11.43�1.352)and each dimension of the control group were higher than that of the intervention group(5.48�1.253)and the scores of all dimensions,and the differences were statistically significant(P<0.05);The total care score(30.11�3.188)and the scores of each dimension in the control group were higher than the total score(14.03�2.778)and the dimension scores of the care burden in the intervention group(P<0.05).The total Harris score in the control group(60.97�10.506)was lower than the Harris score in the intervention group(73.91�11.156),and the difference was statistically significant(P<0.05).The total activity of daily living activities in the control group was(73.94�9.387.)Less than the total score of the intervention group(85.00�1.246),the difference was statistically significant(P< 0.05).Conclusion The needs of caregivers of THR patients during the entire care period are multi-faceted,covering physical,psychological,social,cognitive,and so on.And the main content of demand has been continuously adjusted over time.Continuance nursing under the guidanceof timing theory can enhance the caregiving ability of the caregiver;reduce the care burden;improve the rehabilitation effect and quality of life of the patient.