A Study On The Construction Of A Remote Home Rehabilitation Model For Patients With Knee Osteoarthritis Based On A Persuasive Design

Objective:To investigate the inner experience and supportive care needs of patients with knee osteoarthritis in home rehabilitation,to investigate the knee joint function and quality of life of patients at home,and to construct a remote home rehabilitation model for patients with knee osteoarthritis based on a persuasive design based on the findings,in order to enhance the effectiveness of home rehabilitation and improve the quality of life of patients with knee osteoarthritis.Methods:(1)A qualitative study was conducted using a purposive sampling of 12 patients with knee osteoarthritis attending or being discharged from an orthopedic outpatient clinic in a tertiary care hospital in Nanchang to conduct semi-structured interviews,and content analysis was used to extract the inner experiences and needs of patients with knee osteoarthritis for home rehabilitation and analyze their potential facilitating and hindering factors.(2)A cross-sectional survey was conducted with a convenience sample of 329 patients with knee osteoarthritis attending or being discharged from orthopedic outpatient clinics in two tertiary hospitals in Nanchang.The general information questionnaire,the knee osteoarthritis disease awareness questionnaire,the social support scale,the osteoarthritis index scale and the brief health survey scale were used to investigate the patients’ functional status of knee osteoarthritis and quality of life,and to analyze the influencing factors of the quality of life of the patients at home.(3)Integrating and analyzing the results of qualitative research and cross-sectional surveys to construct a tele-home rehabilitation model for patients with osteoarthritis of the knee using a persuasive design as a guide.Results:(1)The interview data of 12 patients with knee osteoarthritis were analyzed and summarized,and a total of 5 themes and 17 sub-themes were obtained: perceptions of home rehabilitation(little role of home rehabilitation,need for home rehabilitation);motivations for home rehabilitation(reducing family caregiving burden,pain relief);facilitators of home rehabilitation(family support,peer support,establishing individualized health management methods);barriers to home rehabilitation hindering factors(lack of professional knowledge,interference from somatic discomfort symptoms,lack of perceived benefits,fear of safety hazards,lack of interest);needs for home rehabilitation(health education,exercise training guidance,offline services,counseling services,nutrition and diet guidance).(2)The mean total osteoarthritis index score for patients with knee osteoarthritis was(96.76±19.14)and the mean quality of life score was(61.76±13.94),with a physical health dimension score of(42.75±14.05)and a mental health dimension score of(62.21±16.49).The differences in quality of life scores among KOA patients with different marital status,education level,residence status,disease location,disease grade,disease duration,and knowledge about the disease were statistically significant(P<0.05);social support and disease perception were positively correlated with quality of life;osteoarthritis index was negatively correlated with quality of life.(3)Based on the results of qualitative research and cross-sectional survey,a remote home rehabilitation model for patients with osteoarthritis of the knee based on persuasive design was constructed,consisting of a hardware device and a telemedicine platform,with the hardware device being an auxiliary smart device for osteoarthritis of the knee,and the application platform including five modules on the patient side(home page,health record,online consultation,mutual support circle,and personal center)and four modules on the medical care side(information management,data management,rehabilitation guidance,and online learning).Conclusion:(1)Patients with knee osteoarthritis have poor bone and joint function,and their quality of life is generally at a low to moderate level,especially in terms of physical health.The majority of patients expressed an urgent desire for home rehabilitation guidance to meet their needs for health information,life care,and emotional support.In the future,medical professionals should clarify the facilitating and hindering factors of home rehabilitation and quality of life for patients with knee osteoarthritis and apply them rationally,provide individualized rehabilitation guidance,and improve the level of joint function and overall quality of life of patients.(2)This study constructs a remote home rehabilitation model for patients with osteoarthritis of the knee based on a persuasive design based on current research,which is scientifically sound and feasible,and is expected to improve patients’ ability to cope with the disease and quality of life,and can provide reference for the rehabilitation guidance of patients with osteoarthritis of the knee at home and explore new paths for home rehabilitation services for patients with chronic diseases.