Orem自我护理模型在颈脊髓损伤截瘫患者术后康复中的应用  

Clinical application of orem self-care model in rehabilitation of the patients with cervical spinal cord injury

作　　者：吕春子[1] 朱丽瑜 陈会容 黄惠娟[1] 宋璇 周雪瑜 周晨曦 韩康 Lü Chunzi;ZHU Liyu;CHEN Huirong;HUANG Huijuan;SONG Xuan;ZHOU Xueyu;ZHOU Chenxi;HAN Kang(Operating Room,Southern Medical University Southern Hospital,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院手术室,广州510515 [2]解放军第九六〇医院脊髓修复科,济南250000

出　　处：《实用医学杂志》2019年第11期1841-1845,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81702935);广东省科技计划项目(编号:2017ZC0087)

摘　　要：目的分析和评价Orem自我护理模型在颈脊髓损伤截瘫患者中对于患者自我护理能力以及心理和社会适应能力方面的影响。方法依据预先制定的纳入及排除标准,将2016年1月至2018年1月于我院住院并诊断为颈脊髓损伤致截瘫的共计32例患者按照随机数字表分为两组。观察组16例,对照组16例。对于观察组,采用Orem自我护理模型进行人为干预。对照组采用颈脊髓损伤术后常规护理。于出院1、3个月通过《患者自我护理行为问卷》及德克萨斯社会行为问卷(TSBI)对患者出院后的自我护理的水平及心理、社会适应能力进行分析和评定。结果在出院1个月时,两组患者在日常行为和处理行为两项指标的比较中差异无统计学意义(P> 0.05),但是在控制及检测行为的比较中显示差异有统计学意义(P <0.05)。在出院3个月后,两组患者在日常行为等四个指标的比较中均发现差异有统计学意义(P <0.05)。观察组患者在出院后1、3个月时的心理及社会适应能力均显著优于对照组。且其优势随着时间的推移日益增加。结论 Orem自我护理模型在颈脊髓损伤致截瘫患者中可以有效地提高患者的自我护理能力,提高治疗效果,增加自我信心和社会适应能力。Objective To analyze and evaluate the clinical effects of the orem self-care model in self-care capacity,psychological and social adaptability of the patients with cervical spinal cord injury. Methods A total of32 patients with cervical spinal cord injury in our hospital from 2016.01 to 2018.01 were conducted,randomly divided into two groups(experimental group and control group). The experimental group accepted comprehensive self-care behavior intervention and the control group accepted routine health education methods. Investigate self-care behavior level and psychological and social adaptability of patients after discharge by using Digital Replantation Patients Self-care Behavior Scale(DRPSBS)and Texas Social Behavior Inventory(TSBI)in 1 month and3 months. Results There were no significant difference in daily behavior and processing behavior dimensions1 month after discharging from the hospital(P > 0.05),while statistical difference in control behavior and inspecting behavior dimensions(P < 0.05). The investigation showed that experimental group patients got advantage over the control group in all of the four dimensions 3 months after discharging from hospital(P < 0.05),Psychological and social adaptability in experimental group had advantage over the control group 1 months as well as 3 months after discharging from hospital,and had much more advantage with time passing. Conclusion Orem self-care behavior model can significantly arouse patients′ self-nursing capacity,enhance patients′ confidence and improve their social adaptability.

关 键 词：颈脊髓损伤 自我护理 社会适应能力 

分 类 号：R473.6[医药卫生—护理学]