奥瑞姆自理模式对老年髋部骨折患者生活质量的影响。
Effects of Orem's Self-Care Model on the Life Quality of Elderly Patients with Hip Fractures.
机构信息
Department of Orthopedics, China-Japan Friendship Hospital, Beijing 100029, China.
Department of Orthopedic Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China.
出版信息
Pain Res Manag. 2020 May 20;2020:5602683. doi: 10.1155/2020/5602683. eCollection 2020.
BACKGROUND
Hip fractures of elderly patients are a public health problem worldwide, mostly lying in bed for a long time; therefore, the importance of life quality in such patients is an issue beyond question. Orem's self-care model is a nursing pattern which is introduced with the purpose of improving the self-care ability of individuals, especially the patients suffering from diseases with limits on activity.
OBJECTIVE
The aim of this study was to determine the effects of Orem's self-care program on life quality of senile patients with hip fractures.
METHODS
A randomized clinical trial study was conducted on 130 eligible old patients suffering from hip fractures who were selected using easy sampling methods and allocated randomly into two groups of experiment and control. The data were collected through validated questionnaires including visual analogue scale (VAS) and Barthel index for them. The experiment group was treated according to Orem's self-care model, and the control group was treated on the basis of the traditional care model. The data of complications including pneumonia, deep venous thrombosis, urinary infection, wound problem, and bedsore were also gathered.
RESULTS
As revealed, mean scores of VAS and Barthel index one week after operation in the experiment group were significantly different from the control one ( < 0.05, ≤ 0.001). The changes of VAS and Barthel index six weeks postoperatively of the two groups were also statistically significant ( < 0.05, ≤ 0.001). Compared with the control group, the difference of complications reduced significantly in the experiment group ( < 0.05). Accordingly, educational intervention according to Orem's self-care model seemed to be effective in promoting self-care ability for these senile patients.
CONCLUSIONS
According to the obtained results, a self-care program based on Orem's model for elderly patients with hip fractures can improve life quality and reduce perioperative complications significantly. Therefore, it is recommended that this nursing program should be taken into account as a part of treatment measures for these patients.
背景
老年人髋部骨折是一个全球性的公共卫生问题，大多数患者需要长期卧床；因此，此类患者的生活质量至关重要。奥瑞姆的自我护理模式是一种旨在提高个体自理能力的护理模式，尤其适用于活动受限的疾病患者。
目的
本研究旨在探讨奥瑞姆自我护理模式对老年髋部骨折患者生活质量的影响。
方法
采用便利抽样法选取 130 例符合条件的老年髋部骨折患者进行随机临床对照试验研究，将患者随机分为实验组和对照组。采用视觉模拟评分量表（VAS）和巴氏指数对患者进行评估，收集数据。实验组按照奥瑞姆自我护理模式进行治疗，对照组则采用传统护理模式。同时收集两组患者的并发症（肺炎、深静脉血栓、尿路感染、伤口问题、压疮）数据。
结果
术后一周，实验组 VAS 和巴氏指数评分均明显高于对照组（ < 0.05， ≤ 0.001）。两组术后六周 VAS 和巴氏指数评分的变化均具有统计学意义（ < 0.05， ≤ 0.001）。与对照组相比，实验组并发症明显减少（ < 0.05）。因此，根据奥瑞姆自我护理模式进行教育干预，似乎可以有效提高老年髋部骨折患者的自理能力。
结论
基于奥瑞姆模式的自我护理方案可显著提高老年髋部骨折患者的生活质量，减少围手术期并发症。因此，建议将该护理方案纳入此类患者的治疗措施中。
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