Application and efficacy evaluation of a multidimensional assessment system in the postoperative rehabilitation of elderly gynecological patients
多维度评估体系在妇科老年患者术后康复中的应用与效果评估

摘要

目的 就当前人口老龄化的背景而言，老年妇科术后康复要应对生理衰退、心理脆弱、认知障碍和社会资源缺乏等诸项困难，单纯生理判断不能说明全部恢复情况。文中提出以生理、心理、认知、社会为四要素的综合评估思路，分析其对术后康复的实际意义。方法 按前瞻性队列方式收集2024年1月至2025年12月期间某三甲医院所接治的老年妇科手术病例（年龄≥60岁），将干预组置于多维评估和个体化照护之下，对照组只作一般护理，在术前及术后1、3、6个月使用PRI、HADS、GDS、MMSE、SF-36和SSQ来做测评，对比两组康复结果。结果 干预组术后6个月PRI评分（92±5vs80±6，p<0.01），并发症比例（2%vs18%，p<0.01），HADS-焦虑评分（6.0±1.8vs9.2±2.5），GDS阳性数（15%vs28%），MMSE改善量（10.2%vs1.5%）都比对照组好很多。结论 多维评估是改善老年妇科术后整体状况的有效方法，心理及社会类指标尤具价值，可望得到较广的临床运用。

Abstract

Objective Against the backdrop of an aging population, postoperative rehabilitation for elderly gynecological patients faces challenges such as physiological decline, psychological vulnerability, cognitive impairment, and a lack of social resources; relying solely on physiological assessments fails to capture the full picture of recovery. This paper proposes a comprehensive assessment framework incorporating four elements—physiological, psychological, cognitive, and social—and analyzes its practical significance for postoperative rehabilitation.
Methods A prospective cohort study was conducted on elderly patients (aged ≥60) undergoing gynecological surgery at a tertiary Grade-A hospital between January 2024 and December 2025. The intervention group received multidimensional assessment and individualized care, while the control group received standard nursing care. Assessments were performed preoperatively and at 1, 3, and 6 months postoperatively using PRI, HADS, GDS, MMSE, SF-36, and SSQ scales to compare rehabilitation outcomes.
Results At six months post-surgery, the intervention group demonstrated significantly better outcomes than the control group across several metrics: PRI score (92±5 vs. 80±6, p<0.01), complication rate (2% vs. 18%, p<0.01), HADS-Anxiety score (6.0±1.8 vs. 9.2±2.5), GDS positive rate (15% vs. 28%), and MMSE improvement (10.2% vs. 1.5%).
Conclusion   Multidimensional assessment is an effective method for improving the overall postoperative status of elderly gynecological patients. Psychological and social indicators are particularly valuable, suggesting promising potential for widespread clinical application.