人工股関節全置換術における入院前患者教育の実施と評価

Intervention and Evaluation of Preadmission Patient Education for Patients Underdoing Total Hip Arthroplasty

要旨

　目的：初回人工股関節全置換術（THA）を受ける患者の準備性を高めるために入院前患者教育を実施し，評価することである．

　研究方法：介入群は研究者による入院前患者教育を受け，対照群は看護スタッフによる従来教育を受けた評価研究デザインをとった．対象施設は，近畿圏内に位置する2つの大学病院であった．THA予定患者は，入院1～4週前に担当医から紹介を受けた．評価尺度は，POMS気分尺度，SF-36健康関連QOL尺度，入院前の情報に対する満足度尺度を使用した．介入群にはTHAについてのビデオテープの視聴とパンフレットを提供した．評価は，入院前，入院後1～3日以内，退院前1～3日以内に実施した．

　結果および考察：対象者は，すべて女性であり，介入群17名，対照群18名であった．分析には，繰り返しのある分散分析を用いた．情報満足度において，グループと時間の有意な交互作用（p＜0.001），SF-36尺度では，日常役割機能（身体）と日常役割機能（精神）においてグループと時間の交互作用に有意な傾向性（p＜0.10）がみられた．POMS尺度では，有意な交互作用は認められなかった．入院前に患者に情報を提供することは，患者の準備性を高める効果が示唆された．

Abstract

　Purpose: The purpose of this study was to conduct and evaluate a trail run for a preadmission education program that prepares patients undergoing primary total hip arthroplasty（THA） surgery.

　Design: An evaluation research design was used. The experimental group received preadmission education from the researcher, and the control group received routine preoperative education from the nursing staff.

　Setting: This study was conducted at two university hospitals in the Osaka metropolitan district.

　Methods: Patients scheduled to undergo THA were introduced to the preadmission education program by their doctors, 1.4 weeks before hospitalization. During preadmission, patients were assessed on the Profile of Mood States（POMS）, the 36-item Short-Form Health Survey（SF-36）, and an information satisfaction scale. After the baseline data was established, the experimental group was given an information videotape and a pamphlet about THA. Both groups were investigated at the preadmission stage, 1.3 days after hospitalization, and 1.3 days before discharge.

　Results: All subjects were female. The experimental group consisted of 17 patients and the control group had 18 patients. A repeated measures analysis of variance（ANOVA）was used to analyze the effects of the program. Information satisfaction showed a significant group×time interaction（p＜0.001）. On the SF-36, role physical and role emotional showed a significant group×time interaction（p＜0.10）. On the POMS, there was no significant interaction between group and time.

　Discussion: Recent efforts to shorten the length of stay in the hospital by providing education prior to the stay may promote the acceptance of shorter hospital stays by THA patients.