老年腰椎退变性疾病手术患者衰弱干预方案的临床应用与效果分析

Clinical Application and Effect Analysis of a Frailty Intervention Program in Elderly Patients Undergoing Surgery for Lumbar De-generative Diseases

摘要: 目的：基于信息–动机–行为技巧理论，构建老年腰椎退变性疾病手术患者的衰弱干预方案，探讨老年腰椎退变性疾病手术患者衰弱干预方案的临床应用与效果分析。方法：运用德尔菲法构建老年腰椎退变性疾病手术患者衰弱干预方案。选取老年腰椎退变性疾病手术患者120例，随机分为对照组和干预组各60例。对照组实施常规护理，干预组在常规护理的基础上实施连续3个月衰弱干预。比较两组患者的JOA分数、Oswestry功能障碍指数、生活质量量表SF36、Fried评分、Likert 5级评分。结果：治疗后两组患者JOA评分升高，Oswestry功能障碍指数降低，且干预组变化较对照组更为显著(P < 0.05)。干预组的Fried评分较治疗前显著降低，生活质量评分显著升高(P < 0.05)。干预组的衰弱管理依从性得分显著高于治疗前和对照组(P < 0.05)。结论：基于信息–动机–行为技巧理论构建老年腰椎退变性疾病手术患者的衰弱干预方案有利于改善老年腰椎退变性疾病患者术后腰椎功能的恢复，降低衰弱状态进展，提高患者生活质量，增加患者衰弱管理依从性。

Abstract: Objective: Based on the theory of information motion-behavioral skills, a frailty intervention plan for elderly patients undergoing surgery for lumbar degenerative diseases was constructed, and the clinical application and effect analysis of the frailty intervention plan for elderly patients undergo-ing surgery for lumbar degenerative diseases were discussed. Method: Constructing a debilitating intervention program for elderly patients undergoing surgery for degenerative lumbar spine dis-ease using the Delphi method. 120 elderly patients with degenerative lumbar spine surgery were included and randomly divided into a control group and an intervention group. The control group implemented conventional care, and the intervention group implemented a frailty intervention program for 3 consecutive months based on conventional care. Comparison of JOA scores and Oswestry dysfunction index, Quality of Life Scale SF36, Fried score and Likert 5 scale scores between the two groups. Results: JOA scores increased and the Oswestrydysfunction index decreased in both groups after treatment and was more significant in the intervention group (P < 0.05). In addition, the Fired score was lower and the quality-of-life score was significantly higher in the intervention group compared to the pre-treatment group (P < 0.05). Finally, the intervention group had signifi-cantly higher quality management adherence scores than the pre-treatment and control groups (P < 0.05). Conclusion: The construction of a frailty intervention program for elderly patients under-going surgery for degenerative lumbar spine diseases based on the infor-mation-motivation-behavior skill theory is conducive to the recovery of postoperative lumbar spine function, reducing the progression of frailty states, improving patients’ quality of life, and increasing patients’ compliance with debilitating management.