Orem自我护理模型在脊柱骨折合并脊髓损伤高位截瘫患者中的应用  

Application of Orem’s self-care model in high paraplegia patients with traumatic spinal fractures and spinal cord injury

作　　者：沈嘉俐 余晶晶 诸葛恒艳[1] 陶峰琴[1] 周晓吉 缪青 SHEN Jiali;YU Jingjing;ZHUGE Hengyan(Department of Orthopedics,904th Hospital of The Joint Service Support Force,Jiangsu,Wuxi 214044,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院骨科,江苏省无锡市214000

出　　处：《河北医药》2023年第4期622-625,共4页Hebei Medical Journal

基　　金：无锡市卫生健康委科技成果与适宜技术推广项目(编号:T202145)。

摘　　要：目的 分析Orem自我护理模型在脊柱骨折合并脊髓损伤高位截瘫患者的应用。方法 选取2016年1月至2021年7月收治的脊柱骨折合并脊髓损伤高位截瘫患者96例随机分为对照组和观察组,每组48例。对照组术后进行常规护理,观察组进行Orem自我护理模型护理,2组均干预至术后3个月。比较2组术后1周和术后3个月自我护理行为、心理状态和睡眠质量、生活质量,统计2组术后3个月功能锻炼依从性及干预期间并发症发生情况。结果 术后3个月与术后1周比较,2组日常行为、处理行为、控制行为、检测行为评分及独立性、生理、心理、环境、社会关系、精神支持评分均升高(P<0.05),且观察组高于对照组(P<0.05)。术后3个月与术后1周比较,2组SAS、SDS、PSQI评分降低(P<0.05),且观察组低于对照组(P<0.05)。术后3个月,观察组功能锻炼总依从率(93.75%)显著高于对照组(79.17%,P<0.05)。干预期间,对照组总并发症发生率高于观察组(P<0.05)。结论 Orem自我护理模型护理可有效提高脊柱骨折合并脊髓损伤高位截瘫患者自我护理行为、生活质量、功能锻炼依从性,改善患者心理状态和睡眠质量,降低并发症的发生,具有较好的干预效果。Objective To analyze the application of Orem’s self-care model in high paraplegia patients with traumatic spinal fractures and spinal cord injury.Methods A total of 96 high paraplegia patients with traumatic spinal fracture and spinal cord injury who were admitted to our hospital from January 2019 to July 2021 were randomly assigned in 1∶1 ratio to receive routine nursing(the control group)or Orem’s self-care model(the observation group)for 3 months.The key observation was self-care behavior,psychological state,sleep quality,quality-of-life,functional exercise compliance,as well as the complications during 1 week and 3 months after surgery.Results Compared with 1 week after operation,the 3-month scores of daily behavior,handling behavior,control behavior,test behavior,as well as independence,physiology,psychology,environment,social relations and spiritual support of the two groups were increased,and which were higher in the observation group than the control group(P<0.05).The 3-month scores of Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Pittsburgh Sleep Quality Index(PSQI)in the two groups were decreased,which in the observation group were prevalent relative to the control group(P<0.05).The total compliance rate of functional exercise in the observation group was significantly higher than the control group(93.75%VS 79.17%;P<0.05,respectively).The complications were significantly lower in observation group than the control group(P<0.05).Conclusion For high paraplegia patients with traumatic spinal fracture and spinal cord injury,Orem’s self-care model can effectively improve self-care behavior,quality-of-life,functional exercise compliance,psychological state and sleep quality,reduce the occurrence of complications,and with a better intervention effect.

关 键 词：脊柱骨折 脊髓损伤 高位截瘫 Orem自我护理模型 护理 自护行为 

分 类 号：R473.6[医药卫生—护理学]