Objective: The objectives of this study were to revise the Kinesiophobia Causes Scale (KCS) to make it suitable for Chinese cultural context and to verify its applicability in Chinese Total knee arthroplasty (TKA) patients. Methods: TKA patients in Henan Province, China (N = 418, average age >= 64 years). Exploratory and confirmatory factor analysis was performed on two samples randomly selected from the population (each N = 208). Psychometric properties, including the content, construct, predictive and concurrent validity was evaluated for KCS. Results: The KCS scale showed desirable internal consistency (Cronbach's alpha: 0.927), test-retest reliability (0.936), and content validity (0.958). A seven-factor structure was revealed and confirmed using exploratory and confirmatory factor analysis. The area under the curve was 0.852. The optimal cutoff score for KCS was 3.68. Conclusions: The developed Chinese version of KCS is both reliable and valid when applied in Chinese setting of TKA patients. (c) 2024 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

目的 基于运动危险分层评估构建心脏起搏治疗患者运动康复方案,并评价其应用效果.方法 将行心脏起搏治疗的 108 例患者按入院时间分为对照组和观察组各 54 例,对照组给予常规活动指导,观察组在常规活动指导基础上制订并实施基于运动危险分层的康复方案.术后第 1 天和出院前评价患者运动恐惧、上肢功能、活动状况指数、自我管理效能.结果 对照组 49 例、观察组 53 例完成全程研究.干预后观察组运动恐惧、上肢功能、活动状况指数、自我管理效能评分显著优于对照组(均P＜0.05).结论 心脏起搏治疗术后患者实施基于运动危险分层的康复方案,可减轻患者的运动恐惧心理,提高自我管理效能,促进患者功能康复.

Life-space, as a multidimensional structure, is an important indicator for measuring individual movement. Since the first proposal of life-space in 1985, it has gradually been applied in multiple fields. At present, the development of life-space in foreign countries is becoming increasingly mature, while there is little research on this aspect in China. This article reviews the definition, evaluation tools, and application progress of life-space in cardiac rehabilitation, so as to provide reference for the research and application of life-space in home-based cardiac rehabilitation in China.

Objective To develop and validate the Knowledge-attitude-practice Scale for Sarcopenia Prevention and Control for Older Adults in Community. Methods The primary item pool was constructed according to the literature analysis and findings of semi-structured interviews with 16 older adults in community. In two rounds of Delphi technique,16 experts were consulted by letter,and the contents of the scale were adjusted according to the experts’ opinions to form the first draft. Revision was further made by a pilot survey with 30 community older adults. A total of 336 elderly people from 5 communities in Zhengzhou were recruited to test the reliability and validity of the questionnaire. A total of 40 community older adults were invited to complete the questionnaire for the second time at two weeks after their first completion. Results The developed scale consists of 25 items in three dimensions:knowledge,attitude and practice. The cumulative contribution rate was 66.027%,the S-CVI of the scale was 0.933,the total Cronbach’s coefficient was 0.825,the retest reliability was 0.917. Conclusion The questionnaire has good reliability and validity and can be used to evaluate the knowledge-attitude-practice of sarcopenia prevention and control among older adults in community.

质性研究是以构建主义为前提、文字叙述为材料,归纳法为论证步骤,研究者本人为研究工具,通过系统、主观的方法描述生活体验并赋予其含义的研究方法[1],因其更注重以人为本、情境参与,更加关注研究对象在治疗、护理、康复中的体验和感受,在我国护理科研领域越来越受到重视.

目的 对髋关节置换术后患者体力活动的相关证据进行总结和评价,为医护人员开展髋关节置换术后患者体力活动指导提供参考.方法 系统检索国内外指南网、相关数据库及骨科相关专业协会网站中关于髋关节置换术后患者体力活动的临床决策、推荐实践、指南、证据总结、专家共识及系统评价.检索时限为2013年2月24日至2023年2月24日.根据纳入与排除标准对文献进行筛选,对纳入的研究进行评价和证据分级,提取并汇总最佳证据.结果 共纳人文献10篇,包括2篇临床决策、3篇证据总结、1篇专家共识、1篇系统评价、3篇Meta分析,形成包括体力活动的类型、评估、恢复及时机、重要性、安全性及随访共5个类别的21条最佳证据.结论 总结的证据可指导医护人员制定髋关节置换术后患者体力活动方案,以提高髋关节置换术后患者体力活动水平,改善患者康复结局.

Objective:To construct a risk prediction model for unplanned readmission of patients undergoing cardiac resynchronization therapy (CRT) and verify the performance of the model.Methods:Using convenience sampling, patients who underwent CRT at the Department of Cardiovascular of the First Affiliated Hospital of Zhengzhou University from July 2017 to July 2020 were selected as the modeling group ( n=279) and the internal validation group ( n=120). CRT patients admitted to the Department of Cardiovascular of the First Affiliated Hospital of Zhengzhou University from August 2021 to August 2022 due to the same or related diseases were selected as the external validation group ( n=86). Multivariate Logistic regression was used to explore the influencing factors of unplanned readmission of CRT patients and establish the prediction model. The fitting effect and discrimination of the model were evaluated through the Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve. The nomogram was established based on R-4.1.2 and Rstudio software. Results:The multivariate Logistic regression analysis showed that creatinine, left atrial diameter, pulmonary artery systolic pressure, New York Heart Association (NYHA) classification, and body mass index (BMI) were risk factors for unplanned readmission in CRT patients, with statistically significant differences ( P<0.05). The prediction model formula was: P=1/{1+exp[- (0.792×creatinine+1.408×left atrial inner diameter+0.887×pulmonary artery systolic pressure+0.769×NYHA classification-0.970×BMI-2.266) ]}. The area under the ROC curve was 0.874, the maximum value of the Jordan index was 0.636, the optimal threshold was 0.256, the sensitivity was 0.826, and the specificity was 0.810. The accuracy of internal validation and external validation was 90.00% and 90.70%, respectively. Conclusions:The constructed prediction model for unplanned readmission of CRT patients has good predictive performance, and the visualized nomogram improves the practical performance of the model. It helps medical and nursing staff identify high-risk groups of unplanned readmission of CRT patients in the early stage and provides a basis for formulating nursing strategies for different risk groups.

目的 探讨下肢康复机器人用于全膝关节置换术后患者康复训练的效果.方法 将96例全膝关节置换术患者按照入院时间分为对照组与观察组各48例.对照组给予常规人工辅助康复训练,观察组实施基于下肢康复机器人的康复训练.比较两组干预前后主动和被动膝关节活动度、美国特种外科医院膝关节评分、改良Barthel指数评分以及住院天数和相关费用的差异.结果 出院时观察组主动和被动膝关节活动度、膝关节功能评分及日常活动能力评分显著高于对照组(P＜0.05,P＜0.01);住院天数及总住院费用显著低于对照组(均P＜0.01).结论 下肢康复机器人用于全膝关节置换术后患者康复训练,可促进膝关节功能恢复,提高康复效果.

对国内外生酮饮食在难治性癫痫病人中的应用现状进行综述,包括生酮饮食定义、机制、方案、疗效判定标准、治疗效果、不良反应等,以期为我国生酮饮食方案的制订和应用提供参考.

目的:构建心力衰竭病人延续性容量负荷评估护理质量评价指标体系,旨在为评价心力衰竭容量监测护理质量提供依据.方法:以"结构-过程-结果"三维质量模式为框架,通过文献回顾、半结构化访谈法、课题组讨论制订心力衰竭病人延续性容量负荷评估护理质量评价指标体系初稿,采用专家函询法确定心力衰竭病人延续性容量负荷评估护理质量评价指标体系,并通过层次分析法得出各指标权重.结果:共进行了2轮专家函询,专家积极系数为90.91％和90.00％,专家权威系数为0.805和0.911,肯德尔协调系数分别为0.311和0.158.最终构建的心力衰竭病人延续性容量负荷评估护理质量评价指标体系包括3个一级指标、10个二级指标和41个三级指标.结论:构建的心力衰竭病人延续性容量负荷评估护理质量评价指标体系具有科学性、系统性,对心力衰竭容量管理护理质量的改进具有重要的意义.

目的 了解河南省某中医院校本科在读男护生对从事护理职业的认知及感受,为男护生职业规划及培养提供参考依据.方法 选取2021年7月-12月河南省某中医院在读的20名男护生为研究对象,对其进行半结构式深入访谈,采用Colaizzi 7步分析法对访谈资料进行分析、归纳及提炼主题.结果 男护生对护理职业的认知、感受及发展规划可归纳为3个主题:(1)专业选择认知不同;(2)职业情感体验多样化;(3)多种因素影响男护生的职业规划.结论 男护生在职业规划发展上存在心理、社会等多方面的困扰和需求,高校和医院应密切关注其情感体验及发展需求,并提供针对性地心理疏导和多层次地支持.

Objective:To construct an early rehabilitation program suitable for patients with cervical spondylosis after minimally invasive cervical laminoplasty and explore its clinical effect, in order to promote postoperative spinal cord function recovery and reduce complications.Methods:The early rehabilitation program after minimally invasive cervical laminoplasty was constructed by literature search, research group discussion and two rounds of Delphi expert correspondence. The convenient sampling was used to select 136 patients who underwent minimally invasive cervical laminoplasty by the posterior cervical approach who were admitted to the First Affiliated Hospital of Zhengzhou University from May 2018 to May 2020. They were divided into control group and observation group by the random number table method, with 68 cases in each group. The control group underwent rehabilitation according to the conventional rehabilitation methods after cervical spine surgery, while the observation group was given the early rehabilitation program intervention after minimally invasive cervical laminoplasty. They were followed up 12 months after surgery. The differences in Japanese Orthopaedic Association Scores (JOA) score, Neck Disability Index (NDI) score and Visual Analogue Scale (VAS) for axial pain were compared between the two groups before intervention and 12 months after surgery.Results:There were no statistically significant differences in the JOA, NDI and VAS scores between the two groups before intervention ( P>0.05) . After 12 months of follow-up, there was no statistically significant difference in the cervical spine JOA score between the two groups ( t=1.655, P=0.101) . The NDI score of the observation group [ (17.68±5.73) ] was lower than that of the control group [ (27.39±11.01) ] , and the difference was statistically significant ( t=-5.846, P<0.01) . The VAS score of the observation group [ (1.59±0.86) ] was lower than that of the control group [ (2.31±1.12) ] , and the difference was statistically significant ( t=-3.801, P<0.01) . Conclusions:The early rehabilitation program after minimally invasive cervical laminoplasty constructed in this study is scientific and reliable, which is helpful to improve the cervical spine function and daily activities of patients with cervical spondylosis after surgery and reduce the occurrence of axial pain.

Objective:To explore effects of health education based on teach-back method on functional exercise compliance in patients with kinesophobia after total knee arthroplasty (TKA) .Methods:Using the convenient sampling method, a total of 104 patients with TKA kinesiophobia who were admitted to First Ward of Department of Orthopedics in the First Affiliated Hospital of Zhengzhou University from August 2019 to November 2020 were selected as the research objects. Among them, 52 patients admitted from August 2019 to March 2020 were set as the control group, while 52 patients admitted from April to November 2020 were set as the experimental group. They were respectively given routine health education and health education based on teach-back method. Before the intervention and 2 weeks after the intervention, the differences in Functional Exercise Compliance Scale for Orthopedic Patients, Hospital for Special Surgery Knee Score (HSS) and Modified Barthel Index (MBI) scores were compared between the two groups.Results:After implementing the health education intervention program based on the teach-back method, the total score of Functional Exercise Compliance Scale for Orthopedic Patients of patients and dimensions scores of exercise compliance related to physical aspects, the exercise compliance related to psychological aspects and the exercise compliance related to active learning in the experimental group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The scores of HSS and MBI in the experimental group were higher than those in the control group after intervention, and the differences were statistically significant ( P<0.01) . Conclusions:The health education intervention program based on the teach-back method is scientific and reliable, which can effectively improve the functional exercise compliance of TKA patients with kinesiophobia, promote recovery of knee joint function and improve their activities of daily living.

To evaluate the effects of robot-assisted rehabilitation training on knee function and the daily activity ability of older adults following total knee arthroplasty (TKA). Eighty-eight patients who underwent TKA were randomly assigned to a robot-assisted rehabilitation or traditional therapy group. The patients in the control group were treated with traditional manual rehabilitation therapy, while the patients in the experimental group were subjected to the robot-assisted rehabilitation program. Range of motion of the knee joint, Hospital for Special Surgery Knee Rating Score, and the modified Barthel Index were assessed on the first or second day after TKA (preintervention) and the discharge day (postintervention). Additionally, the length of hospital stay and related hospitalization expenses of the two groups were collected on the discharge day. Improvements in the active range of motion (p < 0.001), passive range of motion (p = 0.001), Hospital for Special Surgery Knee Rating Score (p < 0.001), and modified Barthel Index score (p = 0.004) were significantly better in the robot-assisted rehabilitation group than in the traditional therapy group. Interestingly, the length of hospital stay in the experimental group (9 days) was shorter than that in the control group (13 days), and the total cost of hospitalization was lower (p = 0.002). The robot-assisted rehabilitation training program is an effective intervention that significantly improves the daily activity ability and knee function of older adults following TKA.

综述乳腺癌患者社交回避与苦恼的概念、评估工具、研究的现状、影响因素以及干预措施,并指出现有问题和未来研究方向,为国内开展乳腺癌患者社交回避与苦恼问题的研究提供参考.

目的:利用CiteSpace软件对近5年周内外膝关节置换领域文献数据进行可视化分析,为国内学者更全面的掌握该领域的研究热点及趋势,为进一步深入研究提供参考.方法:通过中国知网(CNKI)和Web of Science数据库收集2015至2019年中英文膝关节置换领域文献,运用CiteSpace软件分析该领域文献的国内外发文量、作者机构、作者国别、共被引期刊及文献、关键词及研究热点等结果:近5年有关膝关节置换的中英文文献发文量呈现上升的趋势.作者机构以高校及其附属医院为主发文较多的国家为美国、中国、英国、德国和日本.被引频次最高的期刊是《Journal of bone and joint surgery-American volume》.中文关键词Burst值激增强度最高的是"骨科植入物",英文关键词Burst值激增强度最高的是"deep venous thrombosis".结论:近5年膝关节置换领域发文量不断增长,研究热点集中于静脉血栓的防治、围手术期的出血管理及护理干预.

Objective:To explore the effects of smart cloud follow-up platform in home care for elderly patients with pacemakers.Methods:Totally 120 elderly patients who received pacemaker implantation in a ClassⅢ Grade A hospital in Henan province between August 2018 and August 2019 were selected by convenient sampling. The 60 patients admitted from August 2018 to February 2019 were included into the control group, while the 60 patients admitted from March to August 2019 were selected into the experimental group. Patients in the experimental group received home care based on the cloud follow-up platform, while patients in the control group received routine continuing care at home. After 3 months of intervention, the complication rate, functional exercise compliance and quality of life were compared between the two groups using χ 2 test and t test. Results:Totally 59 patients in the experimental group and 58 patients in the control group completed the study. After intervention, the complication rate in the experimental group was 32.2% (19/59) , lower than 89.7% (52/58) in the control group, and the difference was statistically significant (χ 2=9.307, P< 0.05) ; the scores of physical exercise compliance after pacemaker implantation, postoperative precautions compliance and compliance of initiative advice seeking in the experimental group were (26.05±3.07) , (15.42±1.24) and (11.85±1.96) , higher than those in the control group (18.53±2.93) , (9.66±2.40) and (6.05±1.58) in the control group, and the differences were statistically significant ( t=13.548, 16.331, 17.558; P< 0.01) ; the total quality of life score in the experimental group was (161.12±9.94) , higher than (132.50±9.20) in the control group, and the difference was statistically significant ( t=16.149, P < 0.01) . Conclusions:The home management model based on the smart cloud follow-up platform improves home follow-up experience of elderly patients with pacemaker, the compliance of home functional exercises, and their quality of life.

目的 设计心血管介入远程支持平台,探讨在跨区域农村行冠状动脉介入手术诊疗中的应用效果.方法 将首次就诊于基层心血管联盟医院,后转诊至上级医院行冠状动脉介入手术的118例农村患者按照诊治时间分为A组与B组各59例.A组按照传统模式实施会诊与转诊;B组通过心血管介入远程支持平台实施会诊与转诊,制定区域协同术后运动康复方案.比较两组患者的救治效率.结果 B组转诊决策时间、冠状动脉介入手术治疗决策时间、术后卧床时间及住院时间显著短于A组,康复锻炼依从性显著高于A组(均P＜0.01).结论 基于心血管介入远程支持平台的应用可规范联盟医院间远程会诊、转诊流程,减少农村冠状动脉介入手术患者治疗决策延迟和转诊决策延迟时间,促进患者早期康复.

目的 了解复杂性视网膜脱离患者的疾病感受与围手术期体验,以期为患者制订个体化的护理干预措施提供参考依据.方法 采用现象学研究法,选取2020年7-12月四川省某三级甲等综合医院眼科收治的14例复杂性视网膜脱离手术患者作为研究对象,对其进行半结构式深入访谈,并应用Colaizzi 7步分析法分析、提炼主题.结果 复杂性视网膜脱离患者的疾病感受与围手术期体验可归纳为5个主题:(1)疾病自我管理能力不足;(2)舒适度改变;(3)自我感受负担重;(4)生活质量降低;(5)支持系统薄弱.结论 复杂性视网膜脱离患者围手术期容易产生生理、心理和社会诸多方面的问题与需求,临床医护人员应重视此类患者的疾病感受与围手术期体验,给予必要的心理、社会支持和专业技术指导.

目的:探讨基于自我情绪管理的个性化早期干预在腰椎间盘突出症术后患者中的应用.方法:将2019年5月1日～2020年4月30日收治的131例腰椎间盘突出症患者按入院先后顺序分为对照组65例和观察组66例.对照组实施常规护理干预,观察组在对照组基础上实施基于自我情绪管理的个性化早期干预.比较两组干预前、干预后1、3、6个月的自我情绪管理能力[采用情绪智力量表(EIS)]、腰部功能(JOA下腰痛评定量表)及心理状态[采用心理状态评估量表(MSSNS)].结果:干预后1、3、6个月的EIS、JOA下腰痛评定量表及MSSNS评分均高于干预前,且观察组高于对照组(P<0.05).结论:对腰椎间盘突出症术后患者实施基于自我情绪管理的个性化早期干预,可提高患者自我情绪管理能力,改善其心理状态,加快患者术后腰部功能恢复.