基于奥瑞姆自理理论的个体化自我护理方案的有效性：对冠状动脉搭桥术后学习需求和自我护理行为的影响——一项随机对照试验。
Effectiveness of the Individualized Self-Care Program Based on Orem's Self-Care Theory: Impact on Learning Needs and Self-Care Behaviors Following Coronary Artery Bypass Surgery - A Randomized Controlled Trial.
作者信息
Jamil Alkuwaisi Mohannad, Alsaqri Salman Hamdan, Al-Rashidi Awatif Mansour, Ali Alshowkan Amira, Mostoles Romeo P, Terence Ong Cornejo Larry
机构信息
Medical Surgical Department, College of Nursing, University of Hail, Saudi Arabia.
Medical Surgical Department, College of Nursing, University of Hail, Saudi Arabia.
出版信息
Asian Nurs Res (Korean Soc Nurs Sci). 2024 Dec;18(5):516-524. doi: 10.1016/j.anr.2024.10.008. Epub 2024 Nov 2.
PURPOSE
This study aimed to investigate the specific learning needs of patients within the experimental group after receiving the Individualized Self-Care Program (ISCP) at two key time points: Time 2 (Day 2, Week 1) and Time 3 (Day 15, Week 3). Furthermore, it aimed to compare the effectiveness of the ISCP in improving self-care behavior between the experimental group and the control group, which received standard health education.
METHODS
The study utilized a randomized controlled trial (RCT) design and included a consecutive sample of 128 patients who had undergone their first Coronary Artery Bypass Graft (CABG) procedure. These patients were randomly divided into two groups: the experimental group (n = 64) and the control group (n = 64). The experimental group received an ISCP at Time 2 and Time 3 after being discharged, whereas the control group received standard health education. Statistical analyses included paired t-tests to assess differences in learning needs over time and Repeated Measures Analysis of Variance (ANOVA) to evaluate the effectiveness of the ISCP on self-care behavior.
RESULTS
A paired t-test indicated a statistically significant difference in the total number of learning needs identified within the experimental group between Time 2 and Time 3 assessments. Patients in the experimental group initially identified more learning needs at Time 2 (4.3 ± 1.5), but their knowledge significantly improved at Time 3, leading to fewer learning needs (2.6 ± 1.1). Furthermore, an ANOVA comparing the experimental and control groups showed that the ISCP effectively improved self-care behavior in the experimental group, with significantly greater improvements compared to the control group, which received standard health education.
CONCLUSION
ISCP delivered in early recovery enhances self-care behaviors and addresses postdischarge gaps. The study also revealed that patients' learning needs change over time during home recovery, emphasizing the importance of tailored self-care programs for CABG patients after discharge.
TRIAL REGISTRATION
IRCT registration number: ISRCTN96836216.
目的
本研究旨在调查实验组患者在接受个性化自我护理计划（ISCP）后的两个关键时间点（时间2：第1周第2天；时间3：第3周第15天）的具体学习需求。此外，还旨在比较ISCP与接受标准健康教育的对照组在改善自我护理行为方面的效果。
方法
本研究采用随机对照试验（RCT）设计，纳入了128例首次接受冠状动脉搭桥术（CABG）的患者连续样本。这些患者被随机分为两组：实验组（n = 64）和对照组（n = 64）。实验组在出院后的时间2和时间3接受ISCP，而对照组接受标准健康教育。统计分析包括配对t检验，以评估学习需求随时间的差异，以及重复测量方差分析（ANOVA），以评估ISCP对自我护理行为的效果。
结果
配对t检验表明，实验组在时间2和时间3评估之间确定的学习需求总数存在统计学显著差异。实验组患者在时间2时最初确定的学习需求更多（4.3±1.5），但在时间3时他们的知识显著提高，导致学习需求减少（2.6±1.1）。此外，比较实验组和对照组的ANOVA表明，ISCP有效地改善了实验组的自我护理行为，与接受标准健康教育的对照组相比有显著更大的改善。
结论
早期康复阶段实施的ISCP可增强自我护理行为并弥补出院后的差距。该研究还表明，患者在家庭康复期间学习需求会随时间变化，强调了为CABG患者出院后量身定制自我护理计划的重要性。
试验注册
IRCT注册号：ISRCTN96836216。
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