| Objective1.To construct a frailty intervention scheme for elderly patients undergoing surgery for lumbar degenerative diseases.2.To investigate the clinical application effect of the frailty intervention program in elderly patients undergoing surgery for lumbar degenerative diseases.Methods1.Using the theoretical model of Information-Motivation-Behavioral skill(IMB)as the framework,based on the literature review and the discussion of the expert group meeting,the first draft of the frailty intervention plan for elderly patients with lumbar degenerative diseases was constructed.According to the Delphi expert consultation method,18 experts in related fields were consulted for two rounds of correspondence,and the frailty intervention plan was revised and improved based on expert opinions,then the frailty intervention plan for elderly patients with degenerative diseases of the lumbar spine was finally determined.2.Using the convenient sampling method,120 elderly patients with lumbar degenerative diseases hospitalized in spine surgery in a third-grade class-A general hospital in Qingdao were selected as research subjects.Using the historical control research design,the 60 study subjects admitted from October 2021 to January 2022 were set as the control group,and the 60 study subjects admitted from February 2022 to May 2022 were set as the intervention group.The control group practiced routine nursing intervention for lumbar degenerative diseases in spine surgery.The intervention group implemented a frailty intervention program for elderly patients with lumbar degenerative diseases on the basis of routine nursing care.The frailty intervention period was from admission to 3 months after surgery.After the intervention,Fried Frailty Phenotype scale,the Japanese Orthopaedic Association(JOA)low back pain scale and The MOS item of short Form Health Survey scale were used for the analysis.Before and after the intervention,the t test was used to compare the differences between the two groups of patients in terms of frailty degree,lumbar spine function,and quality of life,and the clinical application effect of frailty intervention programs for elderly patients with degenerative diseases of the lumbar spine based on the IMB model was discussed.Results1.Construction of frailty intervention program for elderly patients undergoing surgery for lumbar degenerative diseasesTwo rounds of Delphi expert consultation were conducted in this study,and the effective recovery rates were 90% and 100%,respectively.The expert authority coefficients of 2 rounds of correspondence were 0.819 and 0.853,respectively.Kendall’s W was 0.249 and 0.281(both P < 0.05)for the two rounds of correspondence.According to the expert opinions,the frailty intervention program for elderly patients undergoing surgery for lumbar degenerative diseases was modified and finally formed,including 4 primary indexes,8secondary indexes and 28 tertiary indexes.2.Clinical application effect of a frailty intervention program in elderly patients undergoing surgery for lumbar degenerative diseases(1)After intervention,the score of Fried Frailty Phenotype scale of the intervention group was significantly lower than that of the control group,with statistical significance(P <0.05).(2)After intervention,the JOA low back pain score of the control group and the intervention group was increased,but the JOA low back pain score of the intervention group was significantly higher than that of the control group(P < 0.05),and the increase of the intervention group was more significant than that of the control group(P < 0.05).(3)After intervention,the MOS item of short Form Health Survey scale increased in both the control group and the intervention group,and patients in the control group showed significant improvement in the five dimensions of overall health,vitality,social function,emotional function and mental health(P < 0.05).Seven dimensions of physiological function,somatic pain,general health,vitality,social function,emotional function and mental health in the intervention group were significantly improved compared with those before intervention(P < 0.05),and three dimensions of vitality,emotional function and mental health in the intervention group were significantly improved compared with the control group(P < 0.05).Conclusions1.In this study,the Delphi expert consultation method was used to construct a frailty intervention plan for elderly patients with lumbar degenerative diseases based on the IMB model.The enthusiasm and authority of the experts in the consultation were high,and the experts’ evaluation opinions on the frailty intervention plan tended to be consistent,and this study is of certain scientific nature and feasibility.2.Compared with conventional nursing interventions,the frailty intervention program for elderly patients with lumbar degenerative diseases constructed based on the IMB model is conducive to improving the degree of frailty of patients,promoting the recovery of lumbar spine function after surgery,and improving the quality of life of patients.It has clinical promotion significance. |
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