基于奥瑞姆自护理论的个体化护理在肾纤维化终末期血液透析患者中的应用  

Application of individualized nursing based on Orem's self-care theory on hemodialysis patients with end-stage renal fibrosis

作　　者：樊晶晶 卢鹏[1] 张俞 宋亚琦[1] 梁学正 FAN Jingjing;LU Peng;ZHANG Yu;SONG Yaqi;LIANG Xuezheng(Cangzhou Central Hospital,Cangzhou 061001,China)

机构地区：[1]沧州市中心医院,河北省沧州市061001

出　　处：《护理实践与研究》2024年第1期92-97,共6页Nursing Practice and Research

基　　金：河北省2022年度医学科学研究课题(编号:20220364)。

摘　　要：目的探讨基于奥瑞姆自护理论的个体化护理对肾纤维化终末期血透患者肾功能、生活质量及心理状态的影响。方法根据慢性肾脏病终末期的诊断标准,纳入2020年7月—2021年12月医院收治的肾纤维化终末期血透患者90例为研究对象,在组间基础特征匹配的基础上分为观察组与对照组,每组45例。对照组给予常规护理,观察组进行基于奥瑞姆自护理论的个体化护理。对比两组患者尿蛋白(Upro)浓度、血肌酐(Scr)浓度、血尿素氮(BUN)浓度、尿微量白蛋白(mALB)浓度、生存质量(WHOQOL-BREF)、汉密尔顿焦虑(HAMA)评分、汉密尔顿抑郁(HAMD-17)评分、自我护理能力测量表(ESCA)评分及护理满意率,并进行统计学分析。结果护理干预2个月后,观察组患者Upro浓度、Scr浓度、BUN浓度、mALB浓度、HAMA评分、HAMD-17评分均低于对照组,差异有统计学意义(P<0.05)。护理干预2个月后,观察组患者WHOQOL-BREF、ESCA评分和护理满意率高于对照组,差异有统计学意义(P<0.05)。结论将基于奥瑞姆自护理论的个体化护理模式,用于肾纤维化终末期患者,能够更利于患者自我能力提高,有效改善肾功能,提高生活质量,缓解负面心理状态,营造良好的护患关系。Objective To explore the impact of individualized nursing based on Orem's self-care theory on renal function,quality of life and psychological state in hemodialysis patients with end-stage renal fibrosis.Methods According to the diagnostic criteria for end-stage chronic kidney disease,90 hemodialysis patients with endstage renal fibrosis admitted to the hospital from July 2020 to December 2021 were included as research subjects.Based on the matching of basic characteristics between groups,they were divided into an observation group and a control group,with 45 cases in each group.The control group received routine care,while the observation group received individualized care based on Orem's self-care theory.The urinary protein(Upro)concentration,serum creatinine(Scr)concentration,blood urea nitrogen(BUN)concentration,microalbuminuria(mALB)concentration,quality of life(WHOQOL-BREF),Hamilton anxiety scale(HAMA)score,Hamilton depression scale(HAMD-17)score,exercise of self-care agency scale(ESCA)score and nursing satisfaction rate were compared between the two groups,and statistical analysis was performed.Results After 2 months of nursing intervention,the Upro concentration,Scr concentration,BUN concentration,mALB concentration,HAMA score,and HAMD-17 score of patients in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 2 months of nursing intervention,the WHOQOL-BREF score,ESCA score,and nursing satisfaction rate of patients in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The individualized nursing model based on Orem's self-care theory can be used for patients with end-stage renal fibrosis,which can be more conducive to improving patients'self-ability,effectively improving renal function,improving quality of life,alleviating negative psychological states,and creating a good nurse-patient relationship.

关 键 词：奥瑞姆自护理论 个体化护理 肾纤维化终末期 血液透析 生活质量 

分 类 号：R473.5[医药卫生—护理学]