Influence Of Nursing Intervention Based On The Theory Of Goal Attainment On Rehabilitation Exercise Of Patients With Tibial Plateau Fracture

Objective To explore the Influence of nursing intervention based on the theory of goal attainment on the incidence of deep vein thrombosis of the lower extremities,rehabilitation exercise compliance,knee range of motion and knee function of patients with tibial plateau fracture.Methods Convenience sampling was used to select 70 tibial plateau fracture patients who met inclusion criteria in orthopaedic trauma department of a third Grade A hospital from October 2020 to November 2021 and divide them into observation group and control group according to random number table method(35 cases in each group).The control group used conventional nursing methods,and the observation group used nursing intervention based on the theory of goal attainment on the basis of conventional nursing methods.One day before surgery,the blood vessels of both lower extremities were examined by color Doppler ultrasound to observe the presence of deep vein thrombosis of lower extremities,and the incidence of deep vein thrombosis of lower extremities was compared between the two groups.On the 5th day,1 month and 3months after surgery,the compliance of rehabilitation exercise and the range of motion of knee joint were compared between the two groups.Knee function was assessed 3months postoperatively in an outpatient clinic.SPSS23.0 was used for statistical analysis.The test level is α = 0.05.Results Complete data were collected in 68 patients,34 in the observation group and 34 in the control group.(1)General demographic information and disease information: There were no significant differences between the two groups in gender,age,occupation,education level,payment method,marital status,cause of injury,fracture type and family income(P > 0.05),indicating comparability between the two groups.(2)Incidence of deep venous thrombosis of lower limbs: The incidence of DVT in the control group was 32.4%,including 2 cases of posterior tibial vein thrombosis and 9cases of intermuscular vein thrombosis.In the observation group,the incidence was 11.8%,and all 4 cases had intramuscular venous thrombosis.The incidence of DVT in the observation group was lower than that in the control group,and the difference was statistically significant(P < 0.05).(3)Rehabilitation exercise compliance: The compliance of patients in the observation group was significantly higher than that in the control group on the 5th day,1 month and 3 months after surgery,with statistical significance(P < 0.05).There was no statistical significance in the compliance of the observation group at three measuring time points,and the compliance of the control group at 3 months after surgery was lower than that at 1 month after surgery,the difference being statistically significant(P< 0.05).(4)Knee range of motion: The active knee activity in the observation group was higher than that in the control group on the 5th day,1 month and 3 months after operation,with statistical significance(P < 0.05).(5)Knee function: Evaluation of Hospital for Special Surgery(HSS)score 3 months after Surgery showed that function,activity,muscle strength dimension and total score in the observation group were higher than those in the control group,the difference was statistically significant(P < 0.05).There were no significant differences in pain,flexion deformity and joint stability(P > 0.05).ConclusionsNursing intervention based on the theory of goal attainment can effectively reduce the incidence of lower extremity deep vein thrombosis,improve rehabilitation exercise compliance of patients with tibial plateau fracture,increase the range of motion of knee joint,and enhance the function of knee joint.This program can be used to guide rehabilitation exercise for patients with tibial plateau fracture.