基于奥马哈系统对慢性乙型肝炎患者实施延续护理的效果研究  

Application of Omaha system in transitional care for patients with chronic hepatitis B

作　　者：顾晓菊[1] 胡霞[2] 孙美芳[1] 朱月华[1] 储旭东[2] 

机构地区：[1]东台市人民医院护理部,江苏东台224200 [2]东台市人民医院感染科,江苏东台224200

出　　处：《医药高职教育与现代护理》2018年第1期39-43,46,共6页Medical Higher Vocational Education and Modern Nursing

摘　　要：目的探讨奥马哈系统在慢性乙型肝炎患者延续护理中的应用效果。方法采用方便抽样法,选取2016年10月至2016年12月东台市人民医院感染科住院的60例慢性乙型肝炎患者为观察对象,以奥马哈系统为理论框架,应用其问题分类系统条目制订评估表评估患者从出院前1天至出院后3个月生理、心理和社会功能等方面存在的主要护理问题。针对问题,以干预系统为指引,结合临床实践经验,在患者出院前1天,出院后1周、1个月、2个月、3个月进行连续5次干预活动。干预后从认知、行为和状况(K-B-S)三方面进行效果评价。结果医疗费用支出问题在出院3个月时行为有所改善,差异有统计学意义(P<0.05),但认知和状况改善无统计学意义(P>0.05);其他护理问题干预前后的认知、行为、状况差异均有统计学意义(P<0.05)。结论基于奥马哈系统对慢性乙型肝炎患者的延续护理,可以提高患者结局,促进患者的院外康复。Objective To investigate the effects of Omaha system in transitional care for patients with chronic hepatitis B( CHB) and provide the basis for the development of transitional care. Methods Taking the Omaha system as a theoretical basis,we developed an evaluation form according to the problem classification system entry. Sixty patients with CHB from Dongtai People's Hospital during Oct. to Dec. in 2016 were selected by using the method of convenient sampling. The major nursing problems in terms of physiology,psychology and social functions from 1 daybefore discharge to 3 months afterdischarge were evaluated. Based on the problems,with the guidanceof intervention system and clinical practice experience,five consecutive intervention activities were performed respectively in thelast day before discharge,as well as 1 week,2 weeks,2 months,and 3 months after discharge. Theapplication effects from patients' knowledge cognition,behavior and status( K-B-S) after intervene were evaluated. Results The healthcare costs had been cutted significantly in the third month after discharge( P< 0. 05). However,the improvement of cognition and status showed no difference( P > 0. 05). There were significant differencesin other nursing issues including the patients' cognition,behavior and status between before and after intervention( P < 0. 05). Conclusion The application of the Omaha system in transitional care for patients with CHB improves the quality of nursing and promotes recovery of outpatients.

关 键 词：奥马哈系统 慢性乙型肝炎 延续护理 效果评价 

分 类 号：R473.5[医药卫生—护理学]