基于患者健康参与模型的产后腹直肌分离病人运动康复方案的构建及应用

    Construction and application of the exercise rehabilitation program for postpartum patients with rectus abdominis muscle separation based on patient health participation model

    • 摘要:
      目的: 构建基于患者健康参与模型的产后腹直肌分离病人运动康复方案并探讨在临床中的应用效果。
      方法: 以患者健康参与模型作为理论框架,结合文献研究、参考国内外指南、质性访谈、专家函询及小组讨论,构建产后腹直肌分离病人运动康复方案,包括行为干预、情感干预及认知干预三部分。采用便利抽样法选取86例产后腹直肌分离病人,按照就诊时间分组进行干预,比较2组病人干预前后的腹围、腹直肌间距、康复参与情况、自我效能感及临床疗效。
      结果: 干预后,干预组腹围短于对照组(P < 0.05);干预组腹直肌分离间距脐上2 cm处、平脐处、脐下2 cm处均短于对照组(P < 0.05);干预组自我效能感量表评分及匹兹堡康复参与量表评分均高于对照组(P < 0.01);干预组总有效率与对照组;差异有统计学意义(P < 0.05)。
      结论: 基于患者健康参与模型的产后腹直肌分离病人运动康复方案具有科学性、可行性及实用性,能够有效促进病人康复,可以为临床医护人员进行针对性的运动指导提供参考依据。

       

      Abstract:
      Objective To construct an exercise rehabilitation programm for postpartum patients with rectus abdominis muscle separation based on the patient health participation model, and explore the effects of its application in clinical practice.
      Methods The exercise rehabilitation programm (including behavioural, emotional and cognitive interventions) for postpartum patients with rectus abdominis muscle separation was constructed using the patient health participation model as the theoretical framework combined with literature research, domestic and international guidelines, qualitative interviews, expert correspondence and group discussion. The convenience sampling method was used to select 86 postpartum patients with rectus abdominalis dissociation, and the patients were divided into groups according to the time of visit for intervention. The abdominal circumference, rectus abdominalis spacing, rehabilitation participation, self-efficacy and clinical efficacy between two groups were compared before and after intervention.
      Results After intervention, the abdominal circumference of the intervention group was shorter than that of control group (P < 0.05). The rectus abdominis muscle separation spacing in the intervention group at 2 cm above the umbilicus, umbilicus, and 2 cm below the umbilicus were shorter than those in control group (P < 0.05). The self-efficacy scale score and Pittsburgh Rehabilitation Involvement Scale score in intervention group were higher than those in control group (P < 0.01), and the difference of the total effective rate bewteen the intervention group and control group was statistically significant (P < 0.05).
      Conclusion The exercise rehabilitation programme for postpartum rectus abdominis muscle separation patients based on the patient health participation model is scientific, feasible and practical, and can effectively promote patients' rehabilitation, which can provide a reference basis for clinical medical personnel to conduct targeted exercise guidance.

       

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