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奥瑞姆自理模式联合早期康复训练对ICU机械通气患者的影响:一项回顾性队列研究

Effect of Orem Self-Care Model Combined with Early Rehabilitation Training on Mechanically Ventilated Patients in ICU: A Retrospective Cohort Study.

作者信息

Zhang Lin, Dong Mingcong

机构信息

Intensive Care Medicine Department, Heilongjiang Provincial Hospital, Harbin, Heilongjiang, 150036, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2025 Sep 9;18:2967-2975. doi: 10.2147/RMHP.S510804. eCollection 2025.

Abstract

OBJECTIVE

To evaluate the effectiveness of integrating Orem self-care mode with early rehabilitation training in mechanically ventilated ICU patients.

METHODS

This retrospective cohort study included 142 patients who underwent mechanical ventilation at the Department of Intensive Care Medicine from January to December 2023. Patients were divided into two groups based on documented nursing interventions: the control group (n=62) received standard care, while the experimental group (n=62) received Orem-based nursing combined with structured early rehabilitation training. Respiratory function, psychological status, and adverse event incidence were compared between groups.

RESULTS

The experimental group showed significantly improved respiratory parameters including respiratory rate, partial pressure of oxygen (PaO), partial pressure of carbon dioxide (PaCO), and PaO/FiO ratio (P < 0.05). Mechanical ventilation duration and ICU length of stay were significantly shorter in the experimental group (P < 0.001). Psychological assessments revealed significantly lower scores for delirium, anxiety (HAMA), and depression (HAMD) in the experimental group post-intervention (P < 0.001). Additionally, the incidence of adverse events such as pressure ulcers and delirium was markedly reduced (P < 0.001).

CONCLUSION

Integrating Orem self-care model with early rehabilitation training demonstrates significant benefits in improving respiratory outcomes, mental health, and clinical safety for mechanically ventilated ICU patients, offering a promising approach for critical care nursing.

摘要

目的

评估奥瑞姆自理模式与早期康复训练相结合对重症监护病房(ICU)机械通气患者的有效性。

方法

这项回顾性队列研究纳入了2023年1月至12月在重症医学科接受机械通气的142例患者。根据记录的护理干预措施将患者分为两组:对照组(n = 62)接受标准护理,而实验组(n = 62)接受基于奥瑞姆理论的护理并结合结构化早期康复训练。比较两组患者的呼吸功能、心理状态和不良事件发生率。

结果

实验组的呼吸参数显著改善,包括呼吸频率、氧分压(PaO)、二氧化碳分压(PaCO)和PaO/FiO比值(P < 0.05)。实验组的机械通气时间和ICU住院时间显著缩短(P < 0.001)。心理评估显示,干预后实验组的谵妄、焦虑(汉密尔顿焦虑量表,HAMA)和抑郁(汉密尔顿抑郁量表,HAMD)得分显著降低(P < 0.001)。此外,压疮和谵妄等不良事件的发生率明显降低(P < 0.001)。

结论

将奥瑞姆自理模式与早期康复训练相结合,在改善机械通气ICU患者的呼吸结局、心理健康和临床安全性方面显示出显著益处,为重症护理提供了一种有前景的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dec7/12433231/92921208f4dd/RMHP-18-2967-g0001.jpg

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