Orem自理护理模式对老年股骨近端骨折患者围术期应激反应及整体功能恢复的影响

Effect of Orem self-care theory on the perioperative stress reaction and allomeric function recovery in elderly patients with fracture of proximal femur

目的 探讨Orem自理护理模式对老年股骨近端骨折患者围术期应激反应及整体功能恢复的影响.方法 将吉林大学第二医院收治的股骨近端骨折患者分为观察组和对照组,对照组采用常规护理,观察组在常规护理基础上采取Orem自理护理.对比分析两组患者围术期焦虑、抑郁等负性应激反应变化、功能锻炼依从性、髋关节功能以及日常生活功能的变化.结果 出院时,观察组患者焦虑及抑郁评分分别为（14.9±6.2）、（13.3±4.8）分,均低于对照组,差异有统计学意义（t值分别为2.303、3.347;P〈0.05）.出院后3个月,观察组髋关节功能优良率为66.7%,对照组为46.7%,观察组优于对照组,但差异无统计学意义（χ2=2.443,P〉0.05）.出院后3个月,观察组患者日常生活功能总分（68.4±9.2）分,对照组（62.2±8.4）分,差异有统计学意义（t=2.726,P〈0.01）.结论 Orem自理护理模式能有效改善老年股骨近端骨折患者围术期的负性心理应激反应,提高自身行为依从性及自护能力,对促进患者术后整体功能恢复具有重要意义.

Objective To investigate the impact of Orem self-care mode on perioperative stress response and overall functional recovery of elderly patients with proximal femoral fractures nursing. Methods The elderly patients with proximal femoral fractures of the Second Hospital of Jilin University were divided into experimental group and control group, and the control group patients were given conventional nursing, when the experimental group patients were given Orem self-care nursing on the basis of conventional nursing. Contrastively analysis were implemented in the perioperative anxiety, depression and other negative stress reaction change, functional exercise compliance, hip joint function and daily life function change of the two group patients.Results When the patients were out of hospital, the anxiety （14.9±6.2） and depression （13.3±4.8）scores of the experimental group patients were significantly lower than that in the control group （t=2.303, 3.347;P〈0.05）. 3 months after discharge, the good rates of hip joint were 66.7% in experimental group and 46.7% in control group, but the difference of two groups had no statistical significance （χ2=2.443, P〉0.05）. After 3 months discharge, the daily life function total score was （68.4±9.2）in experimental group and （62.2±8.4） in control group （t=2.726,P〈0.01）.Conclusions Orem self-care nursing mode can effectively improve the perioperative negative psychological stress reaction of the old patients with proximal femoral fractures, improve their behavior compliance and self-nursing ability, and it also has great significance on promoting the overall patients postoperative function recovery.