Orem 自理理论在急性白血病患儿心理护理中的应用

Application of Orem self-care theory in the mental nursing of children with acute leukemia

目的：探讨Orem自理理论在儿科急性白血病患儿心理护理中的临床应用价值。方法将55例急性白血病患儿按入院单双序号半随机分为对照组（ n＝27）和观察组（ n＝28）。对照组采用常规护理，观察组在常规护理基础上应用Orem自理理论进行护理，采用症状自评量表（ SCL-90）、汉密尔顿焦虑量表（ HAMA）、汉密尔顿抑郁量表（ HAMD）及护理工作满意度调查表比较两组患儿的心理状态变化和对护理的满意度。结果白血病患儿SCL-90症状分布特点以抑郁和焦虑为主。干预1周后，观察组患儿HAMA评分从（18±6）分减少到（12±5）分，且低于对照组的（16±3）分，HAMD评分从（23±8）分减少到（17±3）分，且低于对照组的（20±4）分，差异均有统计学意义（ t分别为3．50，2．39，2．68，1．87；P＜0．05）。观察组对护理工作满意度为96．4％，高于对照组的85．2％，差异有统计学意义（χ2＝3．47，P＜0．05）。结论应用Orem自理理论能明显减轻急性白血病患儿住院后焦虑和抑郁情绪，并对临床护理工作更为满意。

Objective To explore the clinical application value of Orem self-care theory in the mental nursing of children with acute leukemia .Methods Fifty-five children with acute leukemia were randomly divided into the control group （ n=27 ） and the experimental group （ n=28 ） according to single and double number .The control group received the routine nursing , and the experimental group received the nursing intervention according to Orem self -care theory on the basis of the routine nursing .The changes of mental status and the nursing satisfaction were evaluated and compared between two groups through the Symptom Checklis-90 （ SCL-90 ） , Hamilton Anxiety Scale （ HAMA ） , and Hamilton Depression Scale （ HAMD ） . Results The anxiety and depression were mainly dominated in children with leukemia .One week after the intervention, the score of HAMA in the experimental group decreased from （18 ±6）to （12 ±5）,and was lower than （16 ±3）in the control group; the score of HAMD in the experimental group decreased from （23 ±8） to （17 ±3）, and was lower than （20 ±4） in the control group, and the differences were statistically significant （t=3.50, 2.39, 2.68, 1.87, respectively;P〈0.05）.The nursing satisfaction in the experimental group was＆amp;nbsp;96.4%, and was higher than 85.2%in the control group, and the difference was statistically significant （χ2 =3.47, P〈0.05）.Conclusions The application of Orem self-care theory in children with acute leukemia can obviously alleviate their anxiety and depression , and improve clinical nursing satisfaction .