应用Orem自理理论指导肾移植术后患者68例

Kidney transplantation using Orem self-nursing theory in 68 cases

目的:以Orem自理理论为指导对肾移植术后患者实行护理干预,观察患者的生活自理能力。方法:选择2003-01/2006-06在广西中医学院附属瑞康医院和湖南省益阳市人民医院行肾移植手术的肾移植术后患者118例,均知情同意。采用随机数字表法分为2组:①Orem自理理论组(n=68)以Orem自理理论为指导,评估患者的自理能力及自理缺陷,采用不同护理系统及健康教育对患者实行护理干预,让患者共同参与护理计划的制定和所有护理活动。②对照组(n=50)进行常规护理服务。术后1,3,6个月对两组患者的生活自理能力进行评估,Ⅰ级:完全恢复日常工作;Ⅱ级:恢复半量日常工作,正常日常生活,Ⅰ级,Ⅱ级为生活质量良好。结果:118例肾移植术后患者全部进入结果分析,无脱落。①Orem自理理论组患者无一例发生护理并发症。②Orem自理理论组患者术后3个月的生活质量良好率(Ⅰ级+Ⅱ级)显著高于术后1个月(59%,13%,P<0.01),术后6个月的生活质量良好率(91%)显著高于术后3个月(P<0.01)。Orem自理理论组患者术后3,6个月的生活质量良好率均显著高于同时段对照组(24%,62%,P均<0.01)。结论:以Orem自理理论为指导对肾移植术后患者实行护理干预可提高患者的自理能力及生存质量。

AIM： To instruct the self-care ability of patients underwent the kidney transplant with Orem self-nursing theory. NIETHODS： A total of 118 patients received kidney transplant were recruited from the Ruikang Hospital Affiliated to Guangxi College of Traditional Chinese Medicine and the Yiyang Municipal People＇s Hospital from January 2003 to June 2006, with all the patients＇ informed consents. The subjects were divided into two groups：（1） Orem self-nursing theory group （n =68）： Taking the Orem self-nursing theory as the instruction, the self-care ability and self-care defect of patients were appraised. They were treated with different nursing systems and healthy educations, participated in designing the nursing plan and activity.（2）Control group （n =50）： The patient of this group received usual care. The self-care ability of patients in the two groups were evaluated 1, 3, 6 months after the kidney transplant, grading Ⅰ as completely recovery to routine work; Ⅱ as semi-recovery to routine work and daily life was revived. Both Ⅰ and Ⅱ grades indicated the good quality of life （QOL）. RESULTS. All the 118 postoperative patients were involved in the result analysis. （1）None of Orem self-nursing theory group appeared the complication.（2）The good and excellent rate of QOL in patients of Orem self-nursing theory group was significantly higher 3 months postoperationthan 1 month postoperation （59%, 13%, P〈0.01）, and significantly higher 6 months postoperation than 3 months postoperation （91%, P〈 0.01）. Compared with Orem self-nursing theory group, the good and excellent rate of QOL in patients of the control group was remarkably enhanced 3, 6 months postoperation （24%, 62%, P〈 0.01）. CONCLUSION： Implement of Orem self-nursing theory will enhance the self-care ability and QOL of patients after the kidney transplant.