Localization And Clinical Application Of The Post Total Hip Replacement Discharge Scoring Scale

Objective: Translate the PTHRDSS English version into Chinese and analysis it’s reliability and validity.Then investigate current condition of the THR patients discharge readiness by using the Chinese version scale to provide theoretical basis for improving THR patients discharge guidance.Methods:(1)The PTHRDSS English version was introduced and revised by empowerment,translation,back translation and cultural adjustment.168 THR patients in department of orthopedics in the first,second,third and fourth affiliated hospital of Anhui medical university and the 105 PLA hospital and Hefei second hospital were selected to investigate the reliability and validity of the scale and formed the ultimate PTHRDSS Chinese version(PTHRDSS-C).(2)Investigate the THR patients status on the day of discharge from hospital through our own general situation questionnaire and PTHRDSS-C.Results:(1)From the Assessment item identification of the Extreme group we can see the scores of all item in these two groups were statistically significant(P<0.05)except the sixth item.It suggests that the items have good identification;Reliability analysis of scale.The Reliability analysis of scale: the Cronbach’s alpha of the PTHRDSS-C is 0.682 means it has a good internal consistency reliability;The Validity analysis of scale:the correlation coefficient between all the items and the dimension is between 0.83 ~ 1.00,the average score is 0.91 which means it has a good Content validity;KMO test coefficient is 0.652,Bartlett’s Test of Sphericity P < 0.001,indicating that can do further factor analysis;the Principal component factor analysis: first five factor eigenvalues greater than 1,the cumulative variance contribution rate is 59.549%,contribution rate is 59.549%,the entries on the factors which have larger load,reasonable factor structure.(2)Of all the 168 cases,the number of discharge Readiness equal or greater than 25 accounted for 73.2%,the others accounted for 26.8%,further statistical analysis to the nine dimensions of PTHRDSS-C shows the scores of some dimension are lower such as total hip preventive measures(1.46 + 0.52),daily living function(1.54 + 0.29),home exercise program(1.55 + 0.53);discharge readiness difference between postoperative Harris score and some dimensions was statistically significant(P < 0.05)such as marital status,nationality,prosthetic material,fixation,and drainage 。 Multivariate analysis showed that married patients have more sufficient preparation compared to the widowed patients,patients without drainage tube and with lower postoperative Harris score have higher risk of insufficient discharge readiness.Conclusion:(1)PTHRDSS-C has good reliability and Validity so it can be used as a assessment tool in related domain at home.(2)Discharge readiness of some THR are insufficient especially in the dimension such as total hip preventive measures,daily living function and home exercise program,which means medical staff should enhance discharge education and guidance to help the patients return to society and family better.