Orem自我照顾模式在骨性关节炎患者围术期的应用效果

Analysis of application effects of Orem self-care model in perioperative period of patients with osteoarthritis

目的:分析Orem自我照顾模式在膝关节骨性关节炎患者围术期的应用效果。方法:纳入2016年6月至2018年6月期间我院收治的86例膝关节骨性关节炎行关节镜治疗术的患者进行研究,采用随机数字表法将其随机分为观察组、对照组各43例,对照组予以骨科常规围术期干预,观察组应用Orem自我照顾模式进行围术期干预。比较两组患者术后恢复情况(术后下床活动时间、术后住院时间),入院时、出院时心理应激反应[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]评分,以及术前、术后6个月自我效能[一般自我效能感(GSES)量表]评分、HSS膝关节评分、日常生活活动量表(ADL)评分变化。结果:两组患者下床活动时间对比差异无统计学意义(t=-1.346,P=0.182),观察组术后住院时间短于对照组(t=-10.909,P<0.001);观察组出院时HAMA、HAMD评分以及对照组出院时HAMA、HAMD评分均较入院时降低(t=-7.200,-8.975,-4.643,-3.369;P<0.001),且观察组HAMA、HAMD评分均低于对照组(t=-2.555,-4.621;P<0.05);对照组患者GSES评分较出院时无明显变化(t=1.649,P=0.103),观察组较术前评分显著升高(t=4.179,P<0.001),术后6个月观察组评分显著高于对照组(t=2.806,P=0.006);观察组术后6个月HSS、ADL评分与对照组术后术后6个月HSS、ADL评分均高于术前(t=40.584,61.359,30.435,50.979;P<0.001),且观察组高于对照组(t=12.250,10.713;P<0.001)。结论:膝关节骨性关节炎围术期应用Orem自我照顾模式可改善患者负性心理应激反应,提高自我效能水平与日常生活能力,于其术后恢复有利。

Objective:To analyze the application effects of Orem self-care model in perioperative period of patients with knee osteoarthritis.Methods:A total of 86 patients with knee osteoarthritis who underwent arthroscopic treatment in our hospital from June 2016 to June 2018 were included in the study and divided into observation group and control group according to the random number table method,with 43 cases in each group.Control group was given orthopedic routine perioperative intervention,and observation group was treated with Orem self-care mode for perioperative intervention.The postoperative recovery status(postoperative ambulation time,postoperative hospital stay),scores of psychological stress response[Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)]at admission and at discharge,and self-efficacy[general self-efficacy scale(GSES)]score,HSS knee joint score and activities of daily living(ADL)score before operation and at 6 months after operation were compared between the two groups.Results: There was no significant difference in the ambulation time between two groups(t=-1.346,P>0.05),and the postoperative hospital stay in observation group was shorter than that in control group(t=-10.909,P<0.001).The HAMA score and HAMD score in the two groups at discharge were decreased compared with those at admission(t=0-7.200,-8.975,-4.643,-3.369;P<0.001) and the scores in observation group were lower than those in control group(t=-2.555,-4.621;P<0.05).The GSES score in control group was not significantly different from that at discharge,and the score in observation group was significantly higher than that before operation(t=4.179,P<0.001),and the score in observation group was significantly higher than that in control group at 6 months after operation(t=2.806,P<0.05).The scores of HSS and ADL in the two groups at 6 months after operation were higher than those before operation(t=40.584,61.359,30.435,50.979;P<0.001),and the scores in observation group were higher than those in control group(t=12.250,10.713;P<0.001).Conclusion:Orem self-care model in perioperative period of knee osteoarthritis can improve the negative psychological stress response,and enhance self-efficacy level and daily living ability,and it is beneficial to postoperative recovery.