Empirical Analysis of the Nursing Effect of Intelligent Medical Internet of Things in Postoperative Osteoarthritis.

In order to analyze the effect of postoperative nursing for bones and joints, this paper combines the intelligent medical Internet of Things technology to construct a postoperative nursing system for bones and joints and conducts research on postoperative nursing methods for bones and joints. Moreover, this paper realizes the integration of "voice data + video data + software data" and the integration of "wired network + RFID sensor network + WIFI wireless network." In this paper, this paper constructs an intelligent medical IoT nursing analysis system, combines actual cases to analyze the effect of postoperative nursing of bones and joints, and selects an intelligent IoT system and statistical software SPSS23.0 to complete statistical processing.

1. Introduction

Osteoarthritis (OA) refers to a degenerative joint disease caused by a variety of factors that cause fibrosis, chapped, ulcer, and loss of articular cartilage. The pathogenesis and etiology are not yet fully understood. At present, studies have shown that the etiology is related to factors such as gender, age, obesity, injury, inflammation, and genetics. In Chinese medicine, it belongs to the category of “Bone Bi” and “Bi Syndrome.” Moreover, it has a higher incidence in the human body joints with high frequency of use, large range of motion, and more weight bearing, such as knee joints, hip joints, spine joints, and finger joints. The knee joint has the highest incidence. In addition, relevant epidemiological investigations and studies have shown that with the aging of the population, the incidence of OA has gradually increased [1].

At present, for the treatment of osteoarthritis, both Chinese and Western medicine focus on relieving pain and reducing symptoms, and the effect is not satisfactory. Most patients with osteoarthritis are in mild disease, mainly mild to moderate. The treatment is still based on conservative treatment, such as medicine, acupuncture, massage, and physical therapy. However, these can only temporarily relieve the symptoms, and it is easy to recur in the later period, and the condition gradually worsens. If things go on like this, some patients even have psychological problems such as decreased concentration, tension, anxiety, and depression, which cause great physical and mental harm to the patients [2]. For some severely ill patients, surgical treatment is often required. The surgical methods include arthroscopy and artificial joint replacement. Surgery can effectively relieve the pain of patients, improve function, and improve the quality of life of patients after surgery [3].

While exploring and developing the health management model, the implementation process of health management is interfered by various factors, such as long intervals, single methods, elderly patients, poor memory, low education level, inconvenience, lack of multiparticipation of family members and caregivers, lack of good communication between patients and patients, and teamwork, which lead to poor patient compliance and poor health management effects. To adapt to the modern medical model's transition from “biomedical model” to “physiology-psychology-society-ecology” medical model, medical activities must not only pay attention to the biological attributes of people, but also to their social attributes in medical activities, and to fully realize the comprehensive effect of environmental factors, social factors, and psychological factors on health. It is required to establish a new type of health model with “medical care, patient, family belonging to society” interactive management, physiology and psychology, and an educational intervention platform with multiparticipation, multiparty management, and mutual supervision, so as to improve patient health management compliance. Therefore, we need to base on the characteristics of knee osteoarthritis manifold and high-risk factors, take TCM's “prevention of disease” and health maintenance as the guiding ideology, and take the high-risk population as the focus of the implementation of knee osteoarthritis prevention and treatment interventions. At the same time, we need to establish an effective community health management system with traditional Chinese medicine characteristics based on the basic strategies of community work by regulating the mind, regulating diet, reasonable exercise, regular daily life, and active and reasonable Chinese medicine prevention and treatment. In addition, it is necessary to take effective measures to improve the compliance of patients' health management, improve patients' understanding of the nature and prognosis of the disease, pay attention to self-preservation and health care, and reduce or avoid risk factors related to osteoarthritis. Establishing a health management model for patients with osteoarthritis suitable for national conditions is of great practical significance for effectively reducing the incidence of osteoarthritis, comprehensively improving the awareness, management, medication and control rate of patients with osteoarthritis, alleviating patients' pain, improving functions, improving the quality of life of the elderly, and reducing the economic and psychological burden of family and society's health.

This article combines the intelligent medical Internet of Things technology to construct a postoperative nursing system for bones and joints and conducts research on postoperative nursing methods of bones and joints, which provides a reference for subsequent research on postoperative nursing of bones and joints.

2. Related Work

Literature [4] shows that most patients with bone and joint diseases are discharged early due to hospital policies, family economic conditions, and other factors. Although medical staff have given patients discharge education, informing them that there are not only many and complicated postoperative precautions for bone and joint diseases. Persistent, timely, and correct exercise are also required, but many patients disconnected from the hospital after being discharged from the hospital and carried out functional rehabilitation exercises at home. The lack of knowledge about rehabilitation exercises after surgery for bone and joint diseases has a negative impact on the range of motion and muscle strength of the joints. The training methods are also not mastered enough, because the pain reduces the number of times of getting out of bed every day, or the use of auxiliary tools and crutches is not appropriate, which leads to easy access or neglect of some misunderstandings, thus failing to protect and promote effective and rapid recovery of joint function, and even in more serious cases, joint dysfunction, infection around the prosthesis, dislocation, or loosening will occur, shortening the service life of the joint or early scrapping, and ultimately failing to achieve the purpose of replacing the artificial joint. Medical staff, patients and their families must deeply realize that bone and joint diseases require not only ultra-sophisticated technology, but also a long-term rehabilitation process. In the process of improving the daily life function of joints and the self-care ability of patients, rehabilitation exercises cannot be blindly carried out, and must be guided by professionals, otherwise it will only achieve twice the result with half the effort [5].

There are many things to pay attention to after bone and joint disease; otherwise, complications such as joint dislocation, infection, and unequal length of the lower limbs will occur due to the weight bearing of the prosthesis. Before 6 months after the operation, pay special attention to the following aspects: Do not bend the affected hip more than 90 degrees; do not sit on a chair without arm support; do not stand with feet parallel; when standing up, the healthy leg should be behind, and the affected leg should be in front; do not use the chairs without armrests; do not sit on the toilets or chairs that are too low; do not bend to walk and hold heavy objects; put soft pillows between your legs when sleeping; do not sit for more than 1 hour at a time; and do not drive for 6 months after surgery [6].

Literature [7] pointed out that there are great differences in the places for rehabilitation treatment of patients with bone and joint diseases after discharge. In some developed countries such as the United States and the United Kingdom, some patients will go to some doctors, nurses, rehabilitation therapists, massage therapists, and social workers by authoritative orthopedic physicians. The community or rehabilitation medical center composed of organizers will carry out postoperative rehabilitation function exercises; the other part will return home, and a team composed of doctors, specialist nurses, rehabilitation therapists, massage therapists, and other multidisciplinary personnel will communicate through telephone, chat software (Nursing intervention for patients with tools such as Facebook, WhatsApp, Line, Skype), network management platform, and online video, that is, continuous nursing intervention in the form of online interaction, providing patients with postoperative exercise guidance, medication guidance, dietary guidance, psychological guidance, and other content. Make them perform correct rehabilitation exercises, and orthopedic physicians and specialist nurses regularly visit at home to give some professional assessments on the recovery of joint function and guide the content and precautions to be exercised in the next step. In this way, the treatment and nursing are extended from the hospital to the rehabilitation institution or the family, which effectively ensures the continuity of information, management, and relationship between the hospital and the patient and also meets the nursing needs of the patient at home after discharge, improved the patient's functional exercise dependence and compliance behavior, improved the recovery of the patient's hip joint function, and reduced the incidence of complications and readmission rates. Literature [8] applied online interactive continuous care to home patients with chronic diseases, stroke, depression, etc. The results found that these patients' disease recovery speed, quality of life, medical compliance behavior, and treatment dependence were improved and they were discharged within 30 days after discharge. The readmission rate also fell by around 20%, lower than in previous studies. Literature [9] has relatively many and mature studies on the implementation of online interactive continuous nursing care for patients with bone and joint diseases and has achieved good results and patients' recognition, but found that there are still some disputes and doubts in the implementation process. Due to geographical differences or ethical issues, many research designs do not adopt the principle of randomization. At the same time, when many disciplines participate in the research, there will inevitably be many problems, such as the inability to distinguish their roles in the research, or the avoidance of responsibility, and the lack of sense of teamwork. Therefore, they are still innovating and exploring new methods to improve and improve the rigor of the design of online interactive continuous care research for patients with bone and joint diseases.

The research on the quality of life of patients after hip arthroplasty in literature [10] shows that the patients with bone and joint diseases need to be discharged about a week after surgery due to medical insurance policy reform and economic burden. Lack of manpower, material resources, weak professional knowledge, and other factors, resulting in patients, had to go home to continue recuperation and functional exercise. However, most patients disconnected from the hospital after being discharged from the hospital and carried out the rehabilitation exercises at home alone, without the guidance of rehabilitation specialists at home, lack of publicity, education, assistance in rehabilitation-related knowledge, and supervision, guidance, and evaluation of exercise, which affected the patients. Joint function recovery and quality of life. It can be seen that after the patients with bone and joint diseases are discharged from the hospital, the medical staff continue to follow up on them, which is helpful for the recovery of patients after surgery. At present, with the rapid development of mobile network information technology and its integration with medical treatment, the continuous nursing methods adopted in home rehabilitation for patients with bone and joint diseases mainly include telephone follow-up, rehabilitation clinics, home visits, and regular rehabilitation on online social platforms [11]. Literature [12] has proved that a telephone follow-up is the most common and most popular follow-up method in continuing care, which may be related to the large number of telephone users. Telephone follow-up is time-saving, labor-saving, material-saving, cost-effective, and easy to implement. The medical staff call patients regularly to ask about their rehabilitation progress and problems encountered during exercise, and provide them with suggestions, programs and guidance to help prevent complications. However, there are still some problems in the implementation process. Due to the patient's own reasons, such as older age and poor memory, as well as the postoperative functional exercises for bone and joint diseases, there are many technical terms and complexities. Remember, the specific exercise steps are also not intuitive. Although home visits are also a common form of continuous care, compared with telephone follow-up, they still lack some support [13]. Literature [14] studied the effect of continuous nursing on functional exercise dependence of patients with bone and joint diseases and showed that although the implementation effect of home visit was good, it still had a great effect due to the ratio of nurses to beds and the ratio of patients to the international standard level. The large gap, coupled with the heavy duty and busy work of clinical nurses during their shifts, with no redundant staff being sent to carry out the home approach, and also increasing the workload and burden of nurses, is undoubtedly a huge challenge. Nursing clinics have only been implemented in recent years, and the effect is not optimistic. This may be related to factors such as weak professional knowledge of nursing staff, imperfect process management design, poor patient dependence, and noncompliance with doctor's orders.

3. Materials and Methods

3.1. Smart Medical Internet Nursing

This paper realizes the integration of “voice data + video data + software data” and the integration of “wired network + RFID sensor network + WIFI wireless network” and realizes the promotion of electronic medical records and nursing systems from desktop applications to mobile applications. This makes the work efficiency of medical staff higher, improves the shortcomings of previous nursing work, reduces medical errors, avoids medical disputes, and makes the relationship between patients and medical staff more harmonious. The overall architecture diagram is shown in Figure 1 [15].

Figure 1

Overall architecture diagram.

The sensor equipment can collect the vital signs information of the patient, and the zigbee coordinator transmits the collected information to the upper computer PC, and the PC processes the received data and displays it to the medical staff. After that, the medical staff use the collected information as an aid to issue, modify, and abolish medical orders. Then, the nursing staff holds the smart mobile terminal in combination with the barcode information printed out on the PC to perform operations such as placing, dispensing, and executing the medical order.

The functions of each part of the architecture are described as follows.

The vital sign information of the patient is collected and transmitted to the upper computer PC through the coordinator, which is used to monitor the vital sign information of the patient as a reference basis for the doctor to judge the patient's condition. By controlling the wireless sensor network, the patient's vital signs monitoring data is written to the server for archives; the doctor prescribes, modifies, and abolishes the doctor's order and prints the barcode and the barcode related to the patient. The structure operation mechanism is shown in Figure 2 [16].

Figure 2

Architecture operation mechanism diagram.

The IoT application system architecture of the platform mainly includes three parts: IoT data collection terminal, general IoT data analysis platform, and various IoT applications, as shown in Figure 3.

Figure 3

The IoT system architecture of the platform.

This paper adopts a modular design and subdivides the platform functions into functional modules such as user management module, authentication management module, service module, ECA rule module, data visualization module, and general IoT data model. The basic structure is shown in Figure 4 [17]:

Figure 4

Basic structure of platform function modules.

By using the above smart medical Internet of Things to collect and process bone and joint postoperative nursing data, the effect of bone and joint postoperative nursing can be improved.

3.2. Research Methods

This article selected 100 patients with bone and joint tuberculosis admitted to the hospital as the research object. The patients were diagnosed through clinical diagnosis and met the diagnostic criteria for bone and joint tuberculosis. At the same time, they signed an informed consent with the patients. According to the order of admission, all patients were divided into observation group and control group, each with 50 cases. The differences between the two groups of patients in terms of gender, age, and combination position are not statistically significant (P > 0.05) and are comparable [18].

The nursing methods are as follows: patients in the control group receive routine nursing after the operation, and patients in the observation group receive comprehensive nursing intervention after the operation. The specific nursing methods are as follows: first, posture nursing. After the surgical treatment of bone and joint tuberculosis patients is completed, the nursing staff first need to implement targeted postural care for them, and the effect of postural care will also have an important impact on the patient's postoperative pain. The patients need to stay in bed after the operation, and the posture must be comfortable and correct during bed rest; otherwise, it will aggravate the pain symptoms of the patient and cause the patient to have varying degrees of psychological problems. In this regard, it is particularly important for the nursing staff to propose personalized and targeted postural care programs based on the patient's postoperative recuperation requirements. Once it is found that the patient's posture in bed is inaccurate, it is necessary to promptly provide correct posture guidance to the patient to help the patient change to a comfortable lying posture and reduce postoperative pain. In addition, if the patient stays in bed for a long time after the operation, the blood flow will not be smooth, and the patient's pain will increase significantly. Therefore, the nursing staff can instruct patients to perform mild limb exercises to speed up blood circulation and reduce pain. Second is the psychological care. The nursing staff first need to let the patient know that it is normal to have pain symptoms 24-48 hours after surgery so that the patient does not have to worry too much, so as to avoid the aggravation of pain caused by hypertension and sensitivity. Moreover, many patients have low pain tolerance, and postoperative pain can cause extreme behaviors in patients and cause huge physical and mental pain. In response to this problem, the nursing staff should do a good job of psychological counseling for patients. In particular, it is necessary to pay attention to patient and cordial communication with patients, understand their thoughts, effectively assess and grasp the psychological characteristics of patients, and improve the pertinence of psychological care. Through patient communication and explanations, the patients can understand the changes in their own diseases and related coping methods for postoperative pain. At the same time, it is necessary to encourage patients to express their own feelings in the communication between the two parties and to propose methods to stabilize the patient's emotions through appropriate guidance and reason analysis, so as to win the cooperation of patients. Among them, the nursing staff can choose the method of distraction to find the patient's interest so that they can shift from paying too much attention to physical pain to paying attention to interest, so as to further relieve mental tension and relieve pain symptoms. Third is the analgesic care. The analgesic care is aimed at intense pain and pain that the patient cannot tolerate, so it needs to be handled by the analgesic nursing intervention by the nursing staff. The nursing staff should pay attention to assessing the degree of pain of the patient and prepare corresponding pain medications based on the specific evaluation results. The types and dosages of medications need to adhere to scientific principles. If the amount of the medicine is too large or the patient is taken too many times, it is easy to cause the patient to become dependent on analgesics, and the patient's health will be adversely affected. Therefore, the nurses need to strictly follow the doctor's advice to take painkillers for patients and control the amount and frequency of use. At the same time, acupuncture, massage, music, etc. can also be used to achieve analgesic effects. Fourth, instruct patients to master self-analgesia methods. In the implementation of postoperative nursing work for patients with bone and joint tuberculosis, since the nursing staff cannot follow up and accompany the patient 24 hours a day, it is necessary to teach the patient self-relief methods and guide the patient's family to coordinate and cooperate. The patients can use warm water to soak their feet to promote blood circulation and reduce pain. In addition, the correct breathing method should be selected when the pain is strong, and deep breathing should be used to relax the body and mind, reduce pain sensitivity, effectively improve the patient's postoperative pain care effect and quality of life, and speed up the patient's recovery. The nursing evaluation standard is as follows: After the nursing of the two groups of patients, the pain degree of the patients before and after the nursing is scored, and the SD-PS scoring method is selected. The pain score ranges from 1 to 100. The higher the score, the more intense the pain, and vice versa. In addition, a self-made questionnaire is used to collect patients' evaluations of nursing satisfaction.

In this study, the statistical software SPSS23.0 is used to complete the statistical processing, and the intelligent medical wireless network system of this paper is used for data collection and processing to improve the effect of postoperative nursing of bones and joints.

4. Result

The comparison table of the pain scores before and after nursing of the two groups of patients is shown in Table 1 and Table 2 [19].

Table 1

Comparison table of the pain scores of the two groups of patients before nursing.

Number	Control group	Test group	Number	Control group	Test group
1	73.57	72.27	26	72.57	70.88
2	71.74	72.83	27	72.55	71.47
3	73.14	73.25	28	71.56	73.86
4	71.49	73.33	29	72.41	71.79
5	71.29	71.93	30	70.90	72.77
6	71.13	72.93	31	72.47	72.22
7	72.33	71.51	32	73.56	71.74
8	72.89	73.74	33	73.40	70.86
9	71.91	72.00	34	73.16	70.64
10	73.55	72.76	35	71.20	71.37
11	73.03	71.96	36	72.02	72.94
12	73.14	71.57	37	73.50	71.71
13	72.68	70.84	38	71.17	70.74
14	72.13	71.71	39	73.68	71.00
15	71.80	72.52	40	71.17	73.18
16	73.57	71.34	41	71.59	70.69
17	71.86	73.75	42	72.74	72.15
18	71.10	73.48	43	72.50	71.99
19	72.25	73.16	44	71.14	71.91
20	72.97	73.55	45	72.35	72.71
21	73.05	70.72	46	73.46	73.69
22	72.91	73.55	47	73.38	72.08
23	72.43	71.52	48	71.37	71.17
24	73.38	72.14	49	71.45	72.27
25	73.19	73.05	50	71.28	71.26

Table 2

Comparison table of pain scores of the two groups of patients after nursing.

Number	Control group	Test group	Number	Control group	Test group
1	68.51	41.16	26	68.15	40.17
2	68.30	41.52	27	68.20	41.27
3	67.17	40.91	28	67.94	40.42
4	67.64	39.40	29	68.79	40.20
5	68.98	41.03	30	68.13	41.05
6	68.38	41.15	31	68.40	40.69
7	67.70	39.53	32	67.38	39.91
8	68.11	41.21	33	67.00	41.54
9	68.20	39.16	34	67.78	40.43
10	68.74	40.92	35	68.70	39.52
11	67.58	41.00	36	68.97	41.02
12	69.01	40.75	37	68.25	39.25
13	68.68	39.08	38	68.90	41.31
14	69.09	41.43	39	68.21	40.95
15	67.14	40.05	40	68.52	39.97
16	68.21	39.29	41	67.01	40.96
17	67.14	39.24	42	66.93	39.99
18	68.89	41.31	43	67.77	41.19
19	68.14	40.98	44	68.13	39.53
20	68.65	40.37	45	67.46	41.28
21	68.19	41.19	46	66.96	40.56
22	67.94	41.43	47	67.35	39.30
23	66.96	39.24	48	67.30	41.47
24	68.16	39.20	49	68.55	41.29
25	68.41	41.32	50	68.70	39.85

From the statistical results in Table 1 and Table 2 above, the postoperative pain of the observation group is significantly lower than that of the control group, and the nursing satisfaction is significantly higher than that of the control group. The difference between the two groups is statistically significant.

The comparison table of the nursing satisfaction of the two groups of patients is shown in Table 3.

Table 3

Comparison table of nursing satisfaction between the two groups of patients.

Number	Control group	Test group	Number	Control group	Test group
1	75.33	94.18	26	74.29	88.75
2	81.03	94.50	27	78.78	94.38
3	80.90	89.89	28	79.71	93.76
4	74.43	91.35	29	77.96	94.24
5	73.04	93.81	30	78.11	91.56
6	80.59	95.99	31	80.68	88.17
7	78.83	88.81	32	80.63	94.84
8	80.58	94.67	33	76.38	88.49
9	80.79	91.56	34	79.93	94.79
10	80.10	94.94	35	81.54	93.12
11	74.52	95.14	36	77.36	93.54
12	76.60	91.66	37	76.33	91.19
13	81.74	88.60	38	75.45	95.31
14	74.91	95.36	39	76.66	92.67
15	73.91	93.44	40	81.30	90.19
16	73.18	94.07	41	80.23	93.17
17	76.80	91.43	42	76.40	88.92
18	76.90	93.24	43	76.17	89.30
19	77.60	95.94	44	77.64	91.80
20	76.44	92.67	45	74.31	91.98
21	73.83	91.62	46	80.98	93.13
22	73.28	94.70	47	81.39	92.45
23	81.54	93.92	48	75.77	95.53
24	81.96	91.34	49	79.70	95.26
25	76.22	91.06	37	76.33	91.19

5. Analysis and Discussion

This article uses intelligent medical IoT technology to analyze the effect of bone and joint postoperative nursing. Compared with traditional methods, intelligent methods have greater advantages in data processing efficiency and data processing accuracy.

Pain after bone and joint surgery is moderate to severe pain. Many patients are unwilling to perform functional exercises of the limbs due to unbearable pain, which affects sleep. This reduces the patient's initiative in rehabilitation training, which in turn affects the patient's limb motor function recovery and long-term surgical results. Moreover, patients even experienced complications such as postoperative joint stiffness and deep vein thrombosis. This study shows that the implementation of standardized analgesic nursing intervention can effectively control the emergency pain of patients after bone and joint surgery and is beneficial to early rehabilitation training for patients in a painless state.

Clinically, bone and joint tuberculosis is a more serious disease with a higher incidence and greater harm to patients. In the clinical treatment of bone and joint tuberculosis, surgical treatment is mainly used. However, the patient has a strong postoperative pain, which has a greater impact on the patient's postoperative recovery. Many patients commit suicide because they cannot bear the pain, which seriously affects the safety of clinical treatment and is not conducive to the rapid recovery of the disease. Therefore, the effective nursing measures should be taken for patients with bone and joint tuberculosis after surgery. Through targeted nursing interventions, the patients' postoperative pain can be reduced so that the patients can rest at ease and recover as soon as possible.

Bone and joint tuberculosis is a common clinical chronic disease of bone and joint, which is related to the decline of the patient's physical fitness and external force factors. Affected by these factors, the latent tuberculosis bacteria will multiply, which will affect the normal joint function of the patient, and eventually form bone and joint tuberculosis and bring great pain to the patient. In addition, surgical treatment is an important treatment method for the disease. Postoperative incision pain is very common and common, which seriously affects the patient's physical and mental health. Moreover, pain can cause a series of stress reactions, which is extremely unfavorable for the recovery of the patient's incision and pain relief, especially affecting the postoperative rehabilitation effect. Therefore, in order to effectively reduce the pain of patients and improve the quality of life and the prognosis of surgery, it is necessary to implement comprehensive nursing interventions for patients to solve the problem of postoperative pain. In the context of the gradual improvement in the level of medical and health care, people's requirements for the quality of nursing service have been significantly improved, and it is difficult for conventional nursing to meet the actual nursing needs of patients. Therefore, it is necessary to use comprehensive nursing intervention methods to improve patients' nursing satisfaction and clinical nursing quality. The methods of postoperative nursing, psychological nursing, and analgesic nursing selected in this study significantly reduced the postoperative pain of patients and improved patient satisfaction. To sum up, the nursing intervention has a significant effect in the postoperative pain care of patients with bone and joint tuberculosis, which can significantly reduce the pain level of the patient, improve the patient's nursing satisfaction, and promote the patient's rapid recovery. Therefore, it is worthy of clinical nursing application and promotion.