老年髋部骨折术后患者随访清单的制订与应用研究

doi:10.3761/j.issn.1672-9234.2025.05.015

摘要/Abstract

摘要：

目的制订科学、规范的老年髋部骨折术后患者随访清单，为老年髋部骨折术后患者随访工作提供科学的工具，验证其可行性。方法通过文献回顾、半结构式访谈初步制订老年髋部骨折术后患者随访清单；采用德尔菲法对13名专家进行2轮专家函询，形成随访清单终稿。采用便利抽样法，选取山东省某三级甲等医院12例老年髋部术后患者作为研究对象，科室护士采用随访清单进行随访，收集患者与护士的反馈意见。结果 2轮函询专家权威系数分别为0.88、0.91，专家意见趋于一致，最终形成的老年髋部骨折术后患者随访清单包含4个一级条目（生理评估与日常生活支持、信息支持、心理支持、社会支持）、12个二级条目及32个三级条目。经过初步应用，患者与护士均认为随访清单内容详尽且具备高度的专业性和临床应用价值。结论老年髋部骨折术后患者随访清单结构合理，内容较全面，可为老年髋部骨折术后患者出院后的随访提供科学、规范的工具支持。

关键词: 老年护理, 髋部骨折, 清单, 延续性护理, 德尔菲技术

Abstract:

Objective To develop a scientific and standardized follow-up checklist for elderly patients with hip fractures after surgery，providing a reliable tool for the follow-up work for elderly patients with hip fractures after surgery. Methods The preliminary follow-up list of elderly patients with hip fractures after surgery was formulated through literature review，and semi-structured interviews. Through Delphi method，two rounds of expert consultations with 13 experts was conducted to collect their opinions to form the final version of follow-up list. A total of 12 elderly patients who underwent hip surgery in a tertiary Grade A hospital in Shandong Province in May 2024 were selected as the research participants using convenience sampling method. Nurses with follow-up experience were trained uniformly，and postoperative follow-up checklists were applied，and the formulated follow-up checklists were evaluated. Results The expert authority coefficients was 0.88 and 0.91，respectively. The final follow-up list of elderly patients with hip fractures after surgery included four primary indicators （physiological assessment and daily life support，information support，psychological support，and social support），12 secondary indicators，and 32 tertiary indicators. After initial application，both patients and nurses believed that the follow-up list was detailed and held high professional and clinical application value. Conclusion The follow-up list for elderly patients with hip fractures after surgery owns a reasonable structure，comprehensive content. It can provide scientific and standardized tool support for the follow-up of elderly patients with hip fractures after discharge.

Key words: Geriatric care, Hip fracture, List, Continuing care, Delphi method

魏贝贝, 王斐, 周丽莉, 张灵芝. 老年髋部骨折术后患者随访清单的制订与应用研究[J]. 中华护理教育, 2025, 22(5): 604-610.

WEI Beibei, WANG Fei, ZHOU Lili, ZHANG Lingzhi. Development and application of a follow-up checklist for elderly patients with hip fractures after surgery[J]. Chinese Journal of Nursing Education, 2025, 22(5): 604-610.

图/表 1

参考文献 12

[1]	刘天岳. 老年髋部骨折患者骨质疏松诊疗现状及再次骨折相关因素分析[D]. 济南: 山东大学, 2023.
	Liu TY. Diagnosis and treatment of osteoporosis in elderly patients with hip fracture and analysis of related factors of re-fracture[D]. Jinan: Shandong University, 2023.
[2]	Zhang CG, Feng JN, Wang SF, et al. Incidence of and trends in hip fracture among adults in urban China:a nationwide retrospective cohort study[J]. PLoS Med, 2020, 17(8):e1003180.
[3]	范彩丽. 基于骨科损害控制的精准护理在老年髋关节置换患者早期康复中的应用研究[D]. 遵义: 遵义医科大学, 2020.
[4]	王敬. 老年髋部骨折延续护理的研究现状[J]. 临床护理杂志, 2022, 21(4):59-62.
	Wang J. Research status of continuing nursing care of hip fracture in the elderly[J]. J Clin Nurs, 2022, 21(4):59-62.
[5]	傅丽琴, 戚华丽, 范凯杰. 多模式互动延续护理在老年脆性髋部骨折术后居家期的应用与效果分析[J]. 护士进修杂志, 2023, 38(1):77-80.
	Fu LQ, Qi HL, Fan KJ. Application of multimodal interactive extension care in the home period after elderly fragile hip fracture and its effect analysis[J]. J Nurses Train, 2023, 38(1):77-80.
[6]	钟小娟, 钟青, 杨玉青. 基于“互联网+”的延续护理管理在老年髋部骨折患者术后的应用效果评价[J]. 当代护士(下旬刊), 2023, 30(12):139-143.
	Zhong XJ, Zhong Q, Yang YQ. Evaluation of the effect of continuous nursing management based on “Internet plus” in elderly patients with hip fracture after operation[J]. Mod Nurse, 2023, 30(12):139-143.
[7]	金秀. 延续性护理方案在老年骨质疏松性髋部骨折术后患者中的应用研究[J]. 当代护士(下旬刊), 2023, 30(2):88-91.
	Jin X. Study on the application of continuous nursing scheme in elderly patients with osteoporotic hip fracture after opera-tion[J]. Mod Nurse, 2023, 30(2):88-91.
[8]	孙微. 护士主导的宫颈环扎术后患者随访清单的构建[D]. 沈阳: 中国医科大学, 2023.
	Sun W. Construction of nurse-led follow-up list for patients after cervical cerclage[D]. Shenyang: China Medical University, 2023.
[9]	Gong XF, Li XP, Zhang LX, et al. Current status and distribu-tion of hip fractures among older adults in China[J]. Osteoporos Int, 2021, 32(9):1785-1793. doi: 10.1007/s00198-021-05849-y pmid: 33655399
[10]	王璞. 老年髋部骨折流行病学特征及致伤因素分析[D]. 西安: 空军军医大学, 2022.
[11]	张华果, 司文腾, 何宇迪, 等. 老年髋部骨折术后患者跌倒恐惧心理体验的质性研究[J]. 中华护理杂志, 2021, 56(4):527-533. doi: 10.3761/j.issn.0254-1769.2021.04.008
	Zhang HG, Si WT, He YD, et al. Experiences of fear of fall-ing in elderly patients following hip fracture surgery:a qua-litative descriptive study[J]. Chin J Nurs, 2021, 56(4):527-533. doi: 10.3761/j.issn.0254-1769.2021.04.008
[12]	梁小芹, 邵小珍, 陶颖, 等. 老年髋部骨折患者照顾者延续护理需求的质性研究[J]. 护理管理杂志, 2018, 18(2):97-101.
	Liang XQ, Shao XZ, Tao Y, et al. A qualitative study on the continuity nursing needs of elderly hip fracture patients' caregivers[J]. J Nurs Adm, 2018, 18(2):97-101.

[1]	曹常乐, 梁润威, 郭琼. 口腔癌术后患者随访清单的构建与初步应用研究[J]. 中华护理教育, 2025, 22(4): 486-493.
[2]	张思苑, 高欢玲, 刘利红, 李红梅, 马彩虹, 崔彩彩, 吕旭晶, 陈薇镜, 杜晓龙. 直肠癌预防性回肠造口高排量健康教育效果评价指标体系的构建研究[J]. 中华护理教育, 2025, 22(3): 348-354.
[3]	李健芝, 胡丽, 李忠玉, 万艳平, 伍春, 赵琼兰, 曾谷清, 吕毅, 刘梦艺. 护理学混合式教学质量多主体评价指标体系的构建研究[J]. 中华护理教育, 2025, 22(2): 177-184.
[4]	袁葵, 黄金银, 余锡芬, 郭丽芬, 王娟娟, 陈燕. 职业教育新形态活页式教材《老年人综合照护实训指导》的开发与应用研究[J]. 中华护理教育, 2025, 22(1): 32-36.
[5]	陈媛, 吴林静, 喻海燕, 王历刚. 心血管专科护士再评价管理体系的构建研究[J]. 中华护理教育, 2024, 21(9): 1126-1131.
[6]	姜园园, 曹英娟, 管祥云, 张锦欣, 王美娟, 李黎. 以胜任力为导向的临床护士呼吸治疗培训目标与内容的构建研究[J]. 中华护理教育, 2024, 21(8): 968-975.
[7]	肖乐, 戴蕾, 彭徐云, 黄飞燕. 叙事教学法联合项目驱动教学法在高职老年护理学课程中的应用[J]. 中华护理教育, 2024, 21(4): 415-420.
[8]	盖莹, 李唱, 张继敏, 耿小婷, 姜海龙, 李淑英, 郭艳巍. 妊娠期糖尿病产妇产后随访清单的构建与应用[J]. 中华护理教育, 2024, 21(4): 389-396.
[9]	李安安, 侯云英, 李惠玲, 汪小华, 邬青, 钱红英, 吴茵, 王丽, 龚兵艳. 基于任务驱动的翻转课堂在本科老年护理学教学中的应用[J]. 中华护理教育, 2024, 21(4): 397-403.
[10]	林雁, 张旋, 肖惠敏. 老年人安全居家环境创设虚拟仿真实验的设计与应用[J]. 中华护理教育, 2024, 21(4): 404-409.
[11]	张蒙, 冯冬梅, 任静, 淳雪丽, 张雪梅. 沉浸式模拟体验教学在本科老年护理学课程中的应用[J]. 中华护理教育, 2024, 21(4): 410-414.
[12]	张倩, 杨与珍, 李俊英. 参与癌症患者生命末期讨论的护理实践方案构建研究[J]. 中华护理教育, 2024, 21(12): 1510-1516.
[13]	史莉, 罗丽燕, 刘金莲, 宋东红. 辅助生殖科护士岗位胜任力评价指标体系的构建研究[J]. 中华护理教育, 2024, 21(11): 1358-1363.
[14]	陈媛, 蔡真真, 林碧霞, 李开新, 吴林静, 张博论. 护士信息领域核心能力框架的构建研究[J]. 中华护理教育, 2024, 21(10): 1211-1217.
[15]	张艳萍, 严芳, 王海岭, 黄燕青, 郭正军, 李全会, 王剑英. “互联网+”延续性护理服务模式在严重精神障碍稳定期患者中的应用[J]. 中华护理教育, 2024, 21(1): 96-103.