通过奥瑞姆自理理论提高创伤性脑损伤患者的日常生活和认知功能。

Enhancing daily living and cognitive functions in traumatic brain injury patients through Orem's self-care theory.

作者信息

Sha Pei, Gao Xing, Yu Ran, Li Ying, Zhang Yameng, Zhu Ziyu, Wu Ting, Liu Chang

机构信息

Department of Orthopedics and Emergency Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

出版信息

Front Neurol. 2024 Aug 20;15:1449417. doi: 10.3389/fneur.2024.1449417. eCollection 2024.

DOI:10.3389/fneur.2024.1449417

PMID:39228512

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11368751/

Abstract

INTRODUCTION

This research seeks to investigate how early rehabilitation nursing, guided by Orem's self-care theory, affects cognitive function, neurological function, and daily living skills in individuals who have suffered a traumatic brain injury (TBI).

METHODS

A study was conducted with 108 patients with traumatic brain injury who were hospitalized at our facility from January 2021 to March 2023. Based on their admission dates, the participants were separated into a control group ( = 56) and an observation group ( = 52). The control group received standard nursing care, while the observation group received a combination of conventional treatment and nursing interventions based on Orem's self-care model. The research assessed alterations in the ability to perform daily tasks (Activities of Daily Living, ADL), neurological health (National Institutes of Health Stroke Scale, NIHSS; Glasgow Coma Scale, GCS), and cognitive abilities (Montreal Cognitive Assessment Scale, MoCA; Mini-Mental State Examination, MMSE) in both sets of participants prior to and following 4 and 8 weeks of nursing assistance.

RESULTS

Following the intervention, the group being observed showed notably increased ADL scores at 4 weeks ( < 0.001) and 8 weeks ( < 0.001) in comparison to the control group. At 4 weeks and 8 weeks after nursing, the observation group had significantly lower NIHSS scores compared to the control group (4 weeks after nursing, = 0.03; 4 weeks after nursing, < 0.001). GCS score comparison showed the similar results (4 weeks after nursing, = 0.013; 4 weeks after nursing, = 0.003). Moreover, the participants in the observation group had notably higher MoCA and MMSE scores in comparison with the control group 4 and 8 weeks after nursing (all < 0.001).

CONCLUSION

Orem's self-care theory improves patients' cognitive, neurological, and daily living functions of TBI patients during early rehabilitation nursing. This method helps enhance the level of care given by healthcare professionals, leading to more thorough and compassionate nursing care for patients.

摘要

引言

本研究旨在探讨在奥瑞姆自理理论指导下的早期康复护理如何影响创伤性脑损伤（TBI）患者的认知功能、神经功能和日常生活技能。

方法

对2021年1月至2023年3月在我院住院的108例创伤性脑损伤患者进行了一项研究。根据入院日期，将参与者分为对照组（n = 56）和观察组（n = 52）。对照组接受标准护理，而观察组接受基于奥瑞姆自理模式的常规治疗和护理干预相结合的治疗。该研究评估了两组参与者在护理协助4周和8周之前及之后的日常生活活动能力（ADL）、神经健康状况（美国国立卫生研究院卒中量表，NIHSS；格拉斯哥昏迷量表，GCS）和认知能力（蒙特利尔认知评估量表，MoCA；简易精神状态检查表，MMSE）的变化。

结果

干预后，观察组在4周（P < 0.001）和8周（P < 0.001）时的ADL评分与对照组相比显著提高。护理后4周和8周，观察组的NIHSS评分显著低于对照组（护理后4周，P = 0.03；护理后8周，P < 0.001）。GCS评分比较显示了类似的结果（护理后4周，P = 0.013；护理后8周，P = 0.003）。此外，观察组参与者在护理后4周和8周时的MoCA和MMSE评分显著高于对照组（均P < 0.001）。