基于奥马哈系统构建肾造瘘患儿延续护理模式效果分析  

Effect of continuous care mode based on Omaha system in the care of child patients who underwent nephrostomy

作　　者：陈懿[1] 吴明花 戈晓华[3] 俞群[3] 宗雯 王瑛[1] 李玉玲[1] 耿红全[1] 贺雷[1] Chen Yi;Wu Minghua;Ge Xiaohua;Yu Qun;Zong Wen;Wang Ying;Li Yuling;Geng Hongquan;He Lei(Department of Pediatric Surgery,Xinhua Hospital Affiliated to School of Medicine,Shanghai Jiaotong University,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院小儿泌尿外科,上海200092 [2]解放军第四一一医院耳鼻喉科 [3]上海交通大学医学院附属新华医院护理部

出　　处：《海军医学杂志》2018年第1期79-84,共6页Journal of Navy Medicine

基　　金：上海交通大学医学院附属新华医院科研项目(2015-15YJ27);上海交通大学医学院科研项目(ZT201706)

摘　　要：目的探讨以奥马哈系统为框架应用于先天性肾积水施行肾造瘘手术患儿延续性护理的效果。方法选取2016年7-12月42例初诊先天性肾积水行肾造瘘手术的患儿为试验组,在常规照护基础上应用基于奥马哈系统的延续性护理模式进行管理;2016年1-6月48例初诊先天性肾积水行肾造瘘手术的患儿为对照组,按照临床路径采取常规照护和随访。比较2组干预效果和家庭疾病管理能力。试验组肾造瘘患儿42例,应用奥马哈系统的环境、社会心理、生理及健康相关行为4个领域评估常见护理问题,实施护理干预,并在干预前后评分,数据录入SPSS l9.0统计软件进行统计学分析。结果除人际关系外,试验组在干预前后主要护理问题的认知-行为-状况得分差异有统计学意义(P<0.05);出院后3个月试验组SAS评分[(39.35±7.18)分]低于对照组评分[(44.80±8.16)分],差异有统计学意义(P<0.05)。试验组在尿路感染发生率和家庭疾病管理能力的改善优于对照组,差异均具有统计学意义(P<O.05)。结论对先天性肾积水行肾造瘘手术的患儿在延续护理中应用奥马哈系统,能够从生理、心理和社会等方面全面评估患儿,从而制定相应的延续护理干预方案,有利于整体护理和家庭延续性照护模式的信息整合、分析和利用,为疾病的延续性管理提供有效工具。To explore the effect of the continuous care mode based on Omaha system in child patients who underwent nephrostomy.A total of 42 child patients with congenital hydronephrosis who underwent nephrostomy in the hospital from July to December in 2016 were enrolled as the experimental group that received continuous care mode based on Omaha system in addition to routine care.From January to June,2016,a total of 48 child patients,who were initially confirmed to have congenital hydronephrosis and underwent nephrostomy,were recruited as the control group that received routine nursing and medical follow-ups in accordance with clinical treatment path.Intervention effects and management ability of patient home care were compared between the 2 groups.In the 42 child patients with nephrostomy,nursing intervention by using Omaha system was given from the perspectives of environment,social psychology,physical and health-related behaviors to assess common nursing problems.The scores both before and after intervention were obtained and analyzed by using SPSS 19.0 statistical software.There was statistical significance in the scores of recognition and behavior,except interpersonal relationship for the experimental group,when comparisons were made between pre and post intervention(P<0.05).SAS scores of the experimental group(39.35±7.18)3 months after discharge from hospital were lower than those of the control group(44.80±8.16),and statistical significance could be found,when comparisons were made between them(P<0.05).For the experimental group,incidence of urinary tract infection was lower and the management ability of patient home care was obviously superior as compared with those of the control group,also with statistical significance(P<0.05).In child patients with congenital hydronephrosis after nephrostomy,comprehensive assessment could be made from the perspectives of physiology,psychology and social relationship,thus facilitating the development of related continuous nursing intervention protocol.In short,it was beneficial

关 键 词：奥马哈问题分类系统 肾造瘘患儿 延续护理 护理问题 

分 类 号：R473.72[医药卫生—护理学] R726.9[医药卫生—临床医学]