奥马哈系统在老年慢性心力衰竭患者延续护理中的应用效果

Effects of the Omaha system intervention on transitional care in elderly patients with chronic heart failure

目的探索奥马哈系统在老年慢性心力衰竭患者延续护理中的应用效果.方法采用方便取样方法选取老年慢性心力衰竭患者42例,从出院前3 d至出院后3个月进行5次连续的护理干预活动,应用奥马哈系统从环境、生理、心理、健康相关行为4个领域对患者的认知、行为和状况(K-B-S)方面进行结局评价.结果经过连续护理干预,至出院后3个月,患者在循环、呼吸、消化-水合问题、神经-肌肉-骨骼功能、社交、精神健康、睡眠、药物治疗方案及卫生方面,与出院前3 d比较均有改善,K-B-S评分差异均有统计学意义(P<0.01或P<0.05).排便状况和医疗费用支出问题改善不明显,K-B-S评分差异无统计学意义.结论以奥马哈系统为理论依据的老年慢性心力衰竭患者延续护理方案,可以反映患者的护理问题及干预方向,改善患者的护理结局.

To explore the effectiveness of Omaha system on transitional care in elderly patients with chronic heart failure.Methods A total of 42 elderly patients with chronic heart failure were selected by convenient sampling method,and five consecutive nursing interventions were conducted from 3 days before discharge to 3 months af-ter discharge.The Omaha system was applied to evaluate the outcome of the patients'cognition,behavior and condition(K-B-S)from four aspects of environment,physiology,psychology and health-related behaviors.Results After contin-uous nursing intervention,3 months after discharge,the patients showed improvement in circulation,respiration,diges-tion-hydration problems,neuro-muscle-skeletal function,social interaction,mental health,sleep,drug treatment pro-gram and hygiene compared with 3 days before discharge,and the difference in K-B-S score was statistically significant(P<0.01 or P<0.05).The improvement of defecation status and medical expenses was not obvious,and the difference of K-B-S score was not statistically significant.Conclusions The transitional care plan for elderly patients with chronic heart failure based on Omaha system can reflect the nursing problems of patients and the direction of intervention,and improve the nursing outcome of patients.