The ABC-X model is a systematic intervention approach based on stress source analysis and adaptation theory. It emphasizes the dynamic interaction between stressors (A), coping resources (B), cognitive appraisal (C), and crisis outcomes (X). By systematically assessing patients' psychosocial stress, integrating family and social support resources, and optimizing disease cognition, it helps patients and their families alleviate psychological pressure and cope with disease challenges. This study aims to explore the impact of nursing interventions based on the ABC-X model on coping styles and family functioning in patients after total knee arthroplasty.
Total Knee Arthroplasty (TKA) is primarily indicated for patients with knee joint diseases that are unresponsive to conservative treatment and significantly impair daily life and work, such as osteoarthritis, rheumatoid arthritis, traumatic arthritis, osteonecrosis, or other inflammatory joint conditions. It is one of the widely used and well-established surgical procedures in the field of orthopedics. This surgery can effectively alleviate pain, correct joint deformities, and restore joint function. However, TKA may still be associated with various postoperative complications. Coupled with the prolonged off-hospital rehabilitation period, patients often exhibit insufficient compliance and limited coping strategies, which can adversely affect their postoperative recovery outcomes. Current routine nursing care primarily focuses on consolidating surgical outcomes, preventing complications, and promoting functional recovery. While it helps improve patients' daily activity levels and facilitates postoperative rehabilitation, it lacks systematic intervention in addressing patients' psychological stress, family support, and the integration of social resources. Moreover, patients often experience varying degrees of impaired self-care ability in the short term after surgery, necessitating reliance on family members for daily assistance. Therefore, when patients transition from hospital to family and social life, providing them with a professional and multifaceted nursing model is crucial, as it directly influences the speed and quality of their recovery.
Study Type
OBSERVATIONAL
Enrollment
117
Establish a Nursing Team Based on the ABC-X Model Implement the Nursing Intervention Plan: 1. A - Stressor Assessment, including physiological assessment, assessment of life challenges, and evaluation of the social support network. 2. B - Coping Resources, involving organizing medical system resources, individual internal resources, and family and social resources. 3. C - Cognitive Appraisal: Use open-ended questioning to help patients understand the normality of stress responses, reduce fear of negative emotions, and minimize self-blame. 4. X - Crisis Outcome, assessing the patient's emotional state, behavioral responses, physiological reactions, and family functioning. The intervention will be conducted over a period of 6 months.
Postoperative recovery effectiveness
Postoperative recovery effectiveness: Six months after surgery, the modified Macnab criteria are used for therapeutic evaluation: Excellent indicates complete symptom relief with return to normal daily life and work; Good indicates mild symptoms with slight limitations on daily activities, without adverse effects on daily life and work; Fair indicates significant symptom relief but with limitations on daily activities and adverse effects on daily life and work; Poor indicates no improvement or worsening of symptoms before and after treatment.
Time frame: The intervention will be conducted over a period of 6 months.
Psychological resilience
Psychological resilience：Evaluated using the Resilience Scale (CD-RISC), which has a Cronbach's α coefficient of 0.875, including three dimensions: strength (10 items, 40 points), optimism (8 items, 32 points), and 韧性 (7 items, 28 points). Each item is scored from 0 to 4 points, with a total score of 100 points, with higher scores indicating better psychological resilience.
Time frame: Intervention will take place within 6 months.
Self-care ability
The Self-Care Ability Scale (ESCA) was used for evaluation, with a Cronbach's α coefficient of 0.86\~0.92. It consists of 4 dimensions and 43 items, with each item scored on a scale of 0 to 4 points. The total score ranges from 0 to 172, with higher scores indicating stronger self-care ability.
Time frame: Intervention will take place within 6 months
Rehabilitation exercise adherence
The Functional Exercise Adherence Scale for Orthopedic Patients was used for assessment. This scale consists of 3 dimensions and 15 items, covering exercise adherence related to physical aspects, psychological aspects, and active learning. A 1-5 point Likert 5-point rating scale is used, with a total score of 75 points. Scores \<20 points, 20-55 points, and ≥55 points respectively indicate low adherence, partial adherence, and high adherence.
Time frame: Intervention will take place within 6 months
Family functions
The Family Function Assessment Scale (APGAR) was used for evaluation, with a Cronbach's α coefficient of 0.856. It consists of 5 items: cooperativeness, adaptability, emotional quality, maturity, and intimacy. Each item is scored out of 10, with higher scores indicating better family function.
Time frame: Intervention will take place within 6 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.