Construction Of Perioperative Rehabilitation Training Program For Children With Developmental Dysplasia Of The Hip

Objective:The purpose of this study is to construct a perioperative rehabilitation training program for children with developmental dysplasia of the hip undergoing open reduction,in order to guide clinical practice,improve hip joint function and improve children’s quality of life.Methods:1.China National Knowledge Infrastructure(CNKI),Wan Fang database,VIP Chinese sci-tech periodical database,Cochrane Library,Web of Science,Pub Med and Embase database were searched by computer,and the related literatures about rehabilitation of children with DDH undergoing open reduction were screened.The contents of guiding significance for the construction of DDH rehabilitation training program were extracted and analyzed by self-made data extraction table.2.The method of qualitative interview was used to interview 11 medical staff and 6 families of children with developmental dysplasia of the hip in the Department of Orthopaedics of a third-grade class-A children’s hospital.After the interview,the interview recording was translated into text,and the Colaizzi phenomenological data seven-step analysis method was used to analyze the interview results.3.On the basis of literature analysis and qualitative interviews,the first draft of perioperative rehabilitation training program for children with developmental dysplasia of the hip undergoing open reduction surgery was constructed.Seventeen experts in related fields were invited to supplement and modify the program by Delphi method,and the final program was formed to guide clinical practice.Results:1.Through searching Chinese and English databases,a total of 586 literatures were obtained.According to the inclusion and exclusion criteria of literatures,15 literatures were finally included,including 4 intervention studies and 11 observation studies.After analysis,the rehabilitation training for developmental dysplasia of the hip can be divided into four stages:pre-operation,plaster/brace external fixation period,plaster removal to pre-weight-bearing walking period,and weight-bearing walking period,which is the first-level item of rehabilitation training program for developmental dysplasia of hip.2.According to the interview data of medical staff,five topics are extracted: the understanding of the importance of rehabilitation training,the lack of standardization of rehabilitation training content,the lack of continuity of rehabilitation training guidance,the insufficient implementation of parents affecting the effect of rehabilitation training,and the related contents of perioperative rehabilitation training for children with developmental dysplasia of the hip;According to the interview data of family members,four themes are extracted: lack of understanding of diseases,lack of rehabilitation training knowledge and skills,heavy care burden,and family needs of children with developmental dysplasia of the hip.3.17 questionnaires were sent out in each of the two rounds of expert letter inquiries,and 17 valid questionnaires were recovered,with an effective recovery rate of 100%.The expert authority coefficients of the two rounds of expert letters were 0.93 and 0.915,respectively.Kendall’s coordination coefficient was 0.209(P < 0.001)and 0.233(P < 0.001),respectively.The final perioperative rehabilitation training program for children with developmental hip dysplasia undergoing open reduction includes 4 first-level items and 62 second-level items.Conclusions:1.The families of children with developmental dysplasia of the hip lack the knowledge and skills of rehabilitation training,and the medical staff lack of standardization and continuity of rehabilitation training guidance.Therefore,the content of rehabilitation training should be standardized to improve the effect of rehabilitation training for children.2.The rehabilitation training program for developmental dysplasia of the hip in this study is reliable and scientific,which can provide reference for the perioperative rehabilitation training of children with developmental dysplasia of the hip undergoing open reduction surgery and improve the joint function of children.