Application Of Multidisciplinary Collaboration In Patients With Kinesiophobia After Total Hip Arthroplasty

Objective:To develop an intervention plan for multidisciplinary collaborative nursing for patients with kinesiophobia after total hip arthroplasty,and to evaluate the effect of this plan on pain,fear of movement,anxiety,hip function,and length of stay in this group.Methods:According to the inclusion and exclusion criteria,patients with kinesiophobia after total hip arthroplasty in the Orthopedics Department of a third-class hospital in Baise City,Guangxi Zhuang Autonomous Region from September 2020 to September 2021 were selected as the research subjects.The patients from September 2020 to March 2021 were the control group and received routine nursing measures;the patients from April 2021 to September 2021 were the observation group and received multidisciplinary collaborative interventions.The general data of the research subjects were collected,and the evaluation indicators such as pain,fear of movement,anxiety and hip joint function within 12 hours after surgery,on the day of discharge,1 month after surgery and 3 months after surgery were recorded,and the length of hospital days and the occurrence of complications were recorded.Statistical analysis of digital forthputting SPSS 22.0.The measurement data conforms to the normal distribution,use the mean and standard deviation to describe,use two independent samples t-test for comparison between groups,and use repeated measures analysis of variance for the comparison of two groups of patients at different time points.It is skewed distribution,use the median(Percentile)description,nonparametric rank sum test was used for comparison between groups,and Friedman test was used for comparison within groups.The count data were described by frequency and composition ratio,and the chi-square test was used,and the rank data was analyzed by the rank sum test,P<0.05 indicated that the difference was statistically significant.Results:(1)A total of 127 patients with kinesiophobia after total hip arthroplasty were included in the study,65 in the observation group and 62 in the control group.There was no significant difference in baseline data between the two groups of subjects(P>0.05).(2)Repeated measures analysis of variance was performed on the kinesiophobia scores of the two groups of subjects at different time points,and the time effect(F=1176.102,P<0.001),group effect(F=5.127,P=0.025<0.05)and interaction effect(F=12.788,P<0.001)were statistically significant.Pairwise comparisons within groups showed that the differences were all statistically significant(P<0.05).(3)The pain scores of the observation group on the day of discharge and 1 month after the operation were lower than those of the control group,and the difference was statistically significant(P<0.05),but there was no significant difference between the two groups at 3 months after the operation(Z=-1.165,P=0.244>0.05).The nonparametric Friedman test was used to compare the pain scores of the two groups at different time points,and the results showed that were statistically significant(control group?~2=178.610,P<0.001;observation group?~2=172.571,P<0.001).Pairwise comparison within the group showed that there was no significant difference between the observation group on the day of discharge and 1 month after the operation(?~2=0.477,P=0.211>0.05),and the other comparisons were all statistically significant(P<0.001).(4)Repeated-measures analysis of variance was performed on the hip function scores of the two groups of subjects at different time points.The time effects(F=2812.604,P<0.001),group effect(F=6.496,P=0.012<0.05)and interaction effect(F=23.622,P<0.001)were all statistically significant.(5)Repeated measures analysis of variance was performed on the anxiety scores of the two groups of subjects at different time points,and the time effect(F=432.578,P<0.001)and interaction effect(F=5.192,P=0.008<0.001)were all statistically significant.The group effect was not statistically significant(F=2.114,P=0.148>0.05).The pairwise comparison within the group showed that only the observation group had no significant difference in the anxiety score between 1 month and 3 months after the operation(P>0.05),and the other showed that the difference was statistically significant(P<0.05).(6)The length of hospital stay in the observation group was 9.00(7.00,12.50)days,less than 10.00(7.75,15.00)days in the control group,and the difference was not significant(Z=-1.594,P=0.111>0.05).The complication rate in the test group was 7.7%,including 2 cases of infection and 3 cases of prosthesis loosening and dislocation;the comparison group was 14.5%,including 4 cases of infection and 5 cases of prosthesis dislocation,with no significant difference(?~2=1.506,P=0.220>0.05).Conclusion:Compared with the conventional nursing mode,the application of multidisciplinary collaboration in patients with motion phobia after total hip arthroplasty can effectively reduce the degree of motion phobia,reduce the pain level of the hip joint,improve anxiety,and improve hip function.