| Objective:To understand the current status of frailty in elderly perioperative thoracic surgery patients and combine the theory of health belief model to formulate a nursing intervention plan suitable for elderly patients with frailty during perioperative thoracic surgery.Effects of interventions for debilitating conditions.Methods:1.HBM nursing intervention plan formulation(1)Literature research: Through literature research analysis,literatures and guidelines related to this study were selected,and the HBM nursing intervention plan was preliminarily formulated.(2)Expert group meeting method: The preliminary proposed HBM nursing intervention plan was discussed and revised by the expert group meeting method.(3)Pre-trial: Select elderly patients with frailty in the perioperative period of thoracic surgery who meet the inclusion and exclusion criteria for pre-trial,further revise and improve the HBM nursing intervention plan,and finally formulate the "Training Instruction Manual" and determine the final HBM nursing intervention plan.2.Application of HBM nursing intervention programA quasi-experimental study was used to conveniently select 80 patients from the cardiothoracic surgery department of a tertiary hospital in a certain city in Inner Mongolia who met the admission and discharge standards as the research objects from January 2021 to September 2021.In order to avoid clinical contamination,the enrolled patients were grouped according to wards(The two wards A and B have the same types of diseases),the patients in the intervention group will be collected from the area of cardiothoracic surgery,and the patients in the control group will be collected from the area of cardiothoracic surgery,with 40 samples in each group.The intervention group was given HBM nursing intervention on the basis of routine nursing in thoracic surgery,and the control group was given routine nursing in thoracic surgery.The study period was 3 months.The Chinese version of Tilburg Frailty Scale,Simple Body Function Assessment Scale,grip strength,blood gas analysis,six-minute walk test,pace,and brief health status questionnaire were mainly used.Months to evaluate the effect of the patients.Statistical analysis was performed using SPSS 22.0 software.Results:1.HBM nursing intervention plan formulation(1)Literature research: 10 literatures were finally included through literature research analysis,and the first draft of the HBM nursing intervention plan was preliminarily formulated according to the details of the included literatures.(2)Expert group meeting method: After a round of expert group meetings,a total of 7 experts discussed and revised the first draft of the proposed HBM nursing intervention plan.The positive coefficient of experts was 100%,and the authority coefficient of experts was 0.89.(3)Pre-trial: The final draft of the HBM nursing intervention plan was finally determined by pre-experimenting 10 elderly patients with perioperative frailty in the perioperative period of the chest,including the HBM health education plan and HBM training guidance.2.Application of HBM nursing intervention programAmong the 80 subjects in this study,5 patients were lost to follow-up during the intervention process,and the final effective sample size was 75 cases,including 38 cases in the intervention group and 37 cases in the control group.(1)The gender,age,educational level,occupational status,payment method,marital status,monthly family income,body mass index,lifestyle(smoking history,drinking history,regular exercise),type of combined chronic diseases,and surgery of the two groups of patients The types were not statistically significant(P>0.05)and were comparable.(2)The group and time interaction of the total score of the Chinese version of the Tilburg Frailty Scale and the physical frailty score of the two groups were statistically significant(P<0.001);3 months after the intervention,the Chinese version of the intervention group The differences in the total score and physical frailty score of the Belburgh Frailty Scale were lower than those in the control group(P<0.001);the differences in the psychological frailty scores and social frailty scores in different time and different groups were not statistically significant(P>0.05).(3)The total score of the simplified body function assessment scale,the scores of each dimension,the interaction of grip strength group and time in the two groups were all statistically significant(P<0.001);3 months after the intervention,the simplified body of the intervention group The total score of the functional assessment scale,the scores of each dimension,and the difference in grip strength were higher than those in the control group(P<0.001).(4)The interaction of arterial blood oxygen partial pressure,six-minute walking distance,pace of group and time in the two groups was statistically significant(P<0.001),1 month and 3 months after intervention,the intervention group The differences in arterial partial pressure of oxygen,six-minute walking distance and pace were higher than those in the control group(P<0.001);the differences in arterial partial pressure of carbon dioxide in different time and different groups were not statistically significant(P>0.05).(5)The interaction between the total score of the brief health status questionnaire and the five dimensions of general health,physiological function,physiological function,energy,and physical pain in the two groups and time was statistically significant(P<0.001).At 1 month and 3 months,the differences in the total score of the brief health status questionnaire and the five dimensions of general health,physiological function,physiological function,energy,and physical pain in the intervention group were higher than those in the control group(P<0.001);There were no significant differences in the three dimensions of social function,emotional function and mental health among different groups(P>0.05).Conclusion:1.HBM nursing intervention can improve the frail state of elderly patients with frailty during perioperative chest surgery,especially in physical frailty.2.HBM nursing intervention can improve the physical function of elderly patients with frailty during perioperative chest surgery,especially in improving the muscle strength of the upper and lower limbs.3.HBM nursing intervention can improve the pulmonary function of elderly patients with frailty during perioperative period of thoracic surgery,especially in improving pulmonary ventilation and cardiopulmonary adaptability.4.HBM nursing intervention can accelerate the recovery of elderly patients with frailty during perioperative period of thoracic surgery and improve their quality of life. |
PDF Full Text Request