1 Effect of health education on patients with intertrochanteric fracture and tibial tubercle bone traction
Health education is an educational activity and process that helps individuals and groups to master health knowledge, establish health concepts and voluntarily adopt healthy behaviors and lifestyles through information dissemination and behavioral intervention.
1. 1 evaluation of patients' knowledge level It is very important for patients to master the knowledge about intertrochanteric fracture of femur for the rehabilitation of the disease. According to a survey, 92. 1% patients don't know the posture they should take after traction of tibial tubercle bone, 93.2% patients don't know how to exercise patella and ankle joint, 65% patients don't know how to exercise gluteus muscles, and 53.3% patients don't know when to carry weight [1]. It can be seen that the proportion of lack of knowledge is high.
1.2 The influence of health education on tibial tubercle bone traction in patients with intertrochanteric fracture of femur was studied. It is pointed out that the intertrochanteric fracture of femur complicated with various diseases and limb dysfunction is related to the poor functional recovery of the fracture, but the functional recovery has little to do with the fracture type and treatment, and is closely related to the psychological and general health status. The mental state of patients is the main factor that determines whether patients can recover effectively. Through the psychological test survey of 50 patients, 82. 1% patients have anxiety and 67.3% patients have depression. Another survey showed that after health education, all functional exercises in the observation group were carried out correctly, which was significantly different from that in the control group. There were 65438 0 cases of constipation in the observation group and 7 cases (20%) of complications in the control group, including 2 cases of lung infection, 2 cases of constipation and 3 cases of bedsore [2]. It shows that health education has a positive effect on changing patients' behavior and preventing complications.
2 methods of health education
2. 1 Language education Choose appropriate educational content according to patients' educational level, psychological status and cultural background, and communicate with patients in language. Including self-introduction, hospital and ward environment introduction, schedule arrangement, attending doctors and patients in the same ward, so that patients can adapt to the environment as soon as possible, eliminate strangeness and enter the therapeutic role.
2.2 Text education will sort out the common causes, symptoms, treatment and other knowledge of intertrochanteric fracture of femur, and write easy-to-understand popular science articles in the form of health bulletin boards and blackboard newspapers for patients to read.
2.3 Illustrated Clinical Nursing Pathway Education Illustrated Clinical Nursing Pathway is a missionary method expressed in graphic form based on nursing procedures and according to the pathological mechanism and treatment and nursing points of different types of clinical diseases.
3 Health education plan
In order to improve the quality and ensure the effective implementation of education, the educational content is formulated as an educational plan, as shown in table 1. Table 1 Health Education Schedule
4 Health education content
4. 1 psychological rehabilitation 8 ~ 10 weeks to guide the traction of tibial tubercle to treat intertrochanteric fracture of femur. Long-term bed traction not only causes discomfort, but also leads to monotonous life, the pain caused by various treatments and the heavy burden of disease prognosis, which is easy to cause negative emotional reactions of patients. Staying in bed for a long time will also cause various complications and affect the smooth recovery of the disease. Therefore, psychological rehabilitation guidance is very necessary. Psychological rehabilitation determines the recovery of limb function, fully relieves patients' ideological concerns, educates patients that only by overcoming themselves can they overcome diseases, puts patients in the best psychological state, and actively cooperates with treatment and nursing. Nurses use psychological knowledge to provide special psychological comfort, including self-introduction, hospital ward environment introduction, schedule arrangement, attending doctor and patient sharing the ward, so that patients can adapt to the environment as soon as possible, eliminate strangeness and enter the therapeutic role. Introduce the traction function of similar cases, let similar patients talk in the ward, and enhance the confidence and determination of patients to cure diseases. During hospitalization, patients are advised to listen to music and read newspapers and magazines. And watch TV if possible, so that patients can always maintain a good attitude and spend the long-term traction stage. At this stage, pay attention to frequent communication with patients and accurately use communication skills to achieve effective communication.
4.2 Keep traction correctly and effectively guide the patient to take the semi-recumbent position, straighten the pelvis, keep traction in abduction neutral position of the affected limb, and the traction hammer should be suspended; The end of the bed is raised about15 ~ 20 cm; Inform patients and their families not to change their body position or increase or decrease their weight without authorization, otherwise the traction will fail and the treatment will be affected.
4.3 Dietary guidance for the elderly gastrointestinal dysfunction, coupled with long-term bed rest and depression, decreased digestive function and poor diet. Eat light and digestible semi-liquid within 1 ~ 3 days after admission, and ban milk and sugar to avoid bloating. Drink more water and eat more fruits and vegetables. After 3 days, gradually eat general food, and eat more foods rich in protein and calcium, such as milk, eggs, lean meat and fish, so as to enhance physical fitness and promote fracture healing. Chew slowly when eating, and avoid glutinous rice products and jelly, so as not to block the airway and cause suffocation.
4.4 Guidance on prevention of various nursing complications (1) Prevention of bedsore: massage the buttocks, back and heel once every 2 hours, or use a sponge with a thickness of 30 cm×50 cm and 8 ~ 10 cm, cover it with a cloth, pad it under one hip, and rotate the buttocks once every 2 hours; Do a good job of defecation care and keep the bed clean and dry. Make a bottle receiver with a 2 L Coke or Sprite bottle, which is convenient for defecation, relieves the pain of patients and does not raise the hips. Single hip pad, easy to replace at any time; Always take a bath with warm water. (2) prevention of constipation: urge patients to drink more water, and the daily drinking amount is not less than1500ml; Eat a balanced diet, eat more cellulose-rich fresh vegetables and fruits; Massage the abdomen several times a day; For patients with constipation tendency, you can take an appropriate amount of honey or cassia seed orally to make tea. (3) Prevention of lung infection: Encourage patients to do chest enlargement, deep breathing, cough and other exercises to exercise lung function; Maintain oral hygiene, clean indoor air and appropriate temperature.
4.5 Functional exercise guides patients to do some exercises in bed, such as upper limb exercise and healthy lower limb exercise, and practice "three-point support", that is, hip lifting exercise. The affected limb mainly exercises passive patellar movement, ankle flexion and extension and foot movement. After the traction is released, the knee joint and hip joint should be gradually flexed and extended. Please note that the affected limb should still be placed outside the booth. When lying on your back, put a pillow between your thighs, and don't lie on the healthy side when lying on your side. Functional exercise should be done step by step, according to your abilities, and don't feel tired.
4.6 discharge guidance to continue reasonable diet and functional exercise. After 3 months, help the crutch to move to the ground, without load, until the fracture heals, and follow up in clinic.