Application Of Symptom Management Theory Combined With Ternary Linkage Continuous Nursing Model In Elderly Patients After Hip Replacement

【Objective】Taking the symptom management theory as the framework,the qualitative research method is used to obtain the main continuing care needs of elderly patients after hip replacement,and the symptom experience in the symptom management theory is refined based on this,and the symptom experience is the main nursing problem to discuss The "hospital-community-family" ternary linkage continuing care model suitable for elderly patients after hip replacement surgery,and applied to elderly patients after hip replacement surgery on hip joint functional exercise,psychological care,pain care and medication guidance,for Later,It will provide clinical experience for other scholars to carry out continuous nursing research on elderly hip replacement patients in the future.【 Methods 】 This study first selected 12 elderly patients with hip replacement who were hospitalized in the Affiliated Hospital of Jiangsu University from October to December 2017.Based on one-on-one in-depth interviews and reading a large number of literatures,a qualitative study was conducted to understand the needs of elderly patients with hip replacement after discharge from the hospital for refining the main symptoms and experiences,and construct a discharge-continuation nursing plan based on the needs.Using the convenient sampling plus random number table grouping research method,the elderly patients who underwent hip replacement for the first time in the affiliated hospital of Jiangsu University from December2017 to June 2019 were selected as the research subjects.According to the order of discharge time,180 subjects who meet the criteria of discharge are randomly divided into a control group(n = 90)and an experimental group(n = 90)according to the random number table method.This study provides routine discharge guidance to the control group And health education.The experimental group adopts the ternary linkage continuing care model for health education.The ternary linkage group consists of orthopedic head nurses,specialist nurses,community nurses,community hospital doctors,tertiary hospital orthopedists,and nursing graduate students.The ternary linkage group conducts ternary linkage continuous nursing intervention on elderly patients with hip replacement,and the main content is hip joint functional exercise,pain,medication guidance,mental state and other conditions after discharge.Anxiety self-assessment score(SAS score),hip function(Harris score),and quality of life score(SF-36 score)at the time of discharge,1,3,and 6 months after discharge from the two groups of patients were measured by repeated measures analysis of variance Statistical analysis and comparison.Chi-square test was applied to the pain scores(VAS scores)and nursing service satisfaction scores of the two groups of patients at discharge,1,3,and 6 months after discharge.【Results】1.The qualitative research results show that the vast majority of elderly patients after hip surgery lack relevant knowledge of hip functional exercise after discharge and have a strong need for continuing care.The main symptom experience of this study is hip functional exercise and emotional state Nursing,pain care and medication guidance.2.Before nursing intervention,there was no significant difference in the general data,Harris score,SAS score,and SF-36 score between the two groups of study subjects and their main caregivers(P> 0.05),which was comparable.3.After nursing intervention,the main effects of Harris discharge,SAS score,and SF-36 score of elderly patients undergoing hip replacement surgery at different times of discharge and intervention nursing mode were significant(P <0.05),and all had interactive effects.Over time,the Harris,SAS,and SF-36 scores of the experimental group were better than those of the control group at 1,3,and 6 months after discharge(P <0.05).【 Conclusion 】 1.Pay attention to the continuing nursing needs of elderly patients after hip replacement,and adjust and improve the nursing intervention model in a targeted manner along with nursing problems.2.The continuation of care model using ternary linkage can improve the anxiety of elderly patients after hip replacement,and improve the hip function and quality of life of patients.3.The nursing intervention model based on the symptom management theory has a good effect on the continuous nursing of elderly hip replacement patients.