The Construction And Clinical Effect Of Structured Skin Care Intervention Program For Children With Hip Spica Cast Fixation

Objective: To construct a structured intervention regimen for skin care in children after hip spica cast fixation and verify its application effect in clinical work,to provide theoretical basis and practical guidance for clinical care.Methods:1.A preliminary draft of "structured intervention regimen for skin care in children after hip spica cast fixation" was formulated by consulting the domestic and foreign literatures,after screening information by the research team.After two rounds of Delphi expert consultations,the research team modified,added and deleted relevant items of the regimen for all dimensions based on expert opinions and finally formulated the "structured intervention regimen for skin care in children after hip spica cast fixation".2.A total of 144 children who were treated with hip spica cast fixation in the Orthopedics Department of Hebei Children’s Hospital from March 2019 to December 2019 were enrolled in this study and randomized into the intervention group and the conventional group.The intervention group received the "structured intervention regimen for skin care in children after hip spica cast fixation",while the conventional group received routine care for hip spica cast fixation,and the cast contamination rate,the incidence of skin lesions,the sleep conditions and the comfort level were compared between the two groups to see if there were differences.All data were statistically analyzed using the SPSS 22.0 software.Results:1.The positive coefficient of the two rounds of expert consultations was93.33% and 100%,the authority coefficient was 0.918,the variation coefficient of items in the two rounds of expert consultations was 0.05-0.17 and 0-0.17,the Kendall’s W was 0.129 and 0.137,respectively,all P<0.05,and the intervention regimen with 3 dimensions and 25 items was finally formulated.2.The differences in the baseline data between the two groups were not statistically significant(P>0.05),and they were comparable;the cast contamination rate was 21.74% in the intervention group and 39.44% in the conventional group,the cast contamination rate in the intervention group was significantly lower than that in the conventional group,and the difference was statistically significant(P<0.05);the incidence of skin lesions was 11.59% in the intervention group and 33.96% in the conventional group,the incidence of skin lesions in the intervention group was significantly lower than that in the conventional group,and the difference was statistically significant(P<0.05);the differences in sleep depth(F=10.100,P=0.002),sleep quality(F=6.458,P=0.012),sleep satisfaction(F=8.573,P=0.004),frequency of night waking(F=10.083,P=0.002)and sleep disorder(F=8.625,P=0.004)between the intervention group and the conventional group were statistically significant(P<0.05),there was no statistically significant difference in daytime function between the two groups on the first day after surgery(P>0.05),there were statistically significant differences in daytime function between the two groups at other time points(P<0.05);The differences in comfort level(F=6.004,P=0.016)between the intervention group and the conventional group were statistically significant(P<0.05).Conclusions:1.After two rounds of Delphi expert consultations,the “structured intervention regimen for skin care in children after hip spica cast fixation” can ensure its scientificity and reliability.2.After clinical efficacy verification,this regimen can reduce the cast contamination rate and the incidence of skin lesions and improve the sleep quality and comfort level of children,so is worthy of clinical application.