奥马哈问题分类系统在居家腹膜透析患者门诊随访中的应用

Application effects of Omaha problem classification system on clinical follow-up in patients with peritoneal dialysis at home

目的 探讨奥马哈问题分类系统在腹膜透析（PD）患者门诊随访评估中的应用,为PD患者提供一种更有效、系统的健康管理模式.方法 选取2016年5月—9月广西医科大学第一附属医院腹膜透析门诊随访的居家腹膜透析患者60例为研究对象.以奥马哈问题分类系统为依据,从生理、社会心理、健康相关行为以及环境等领域对其存在的主要护理问题进行评估和分析. 结果 60例患者共存在护理问题436个,平均每个患者存在7.27个;65.6%护理问题属于生理领域,23.2%属于健康相关行为领域,7.8%属于环境领域,3.4%属于社会心理领域;发生率最高的护理问题分别是循环（90.0%）、疼痛（80.0%）、皮肤（71.7%）和消化-水合（63.3%）.结论 奥马哈问题分类系统能够全面评估居家腹膜透析患者存在的健康问题,有利于临床护理评估的科学化和规范化,为实施整体护理提供依据.

Objective To explore the application effects of Omaha problem classification system on clinical follow-up in patients with peritoneal dialysis （PD） at home. Methods 60 outpatients with PD at home were selected into the study from May to September 2016. Based on Omaha problem classification system, problems referred to physiology,social psychology,health-related behavior and environmental issues of nursing care were assessed. Results A total of 436 nursing problems were found,with about 7.27 problems per patient on average. Approximately 65.6% problems for physiology,23.2% for health-related behavior,7.8% for environmental issues,and 3.4% for social psychology. The most common nursing problems referred to circulation （90.0%）,pain （80.0%）,skin （71.7%）,and digestion （63.3%）. Conclusions Omaha problem classification system can comprehensively assess nursing problems in outpatients with PD at home. The system is beneficial for normalizing the clinical nursing assessment and providing evidence for integrated nursing care.