基于奥马哈系统延续护理在脊髓损伤神经源性膀胱患者的应用观察

Application of Omaha system-based continuous care in patients with neurogenic bladder with spinal cord injury

目的探讨脊髓损伤神经源性膀胱患者运用基于奥马哈系统延续护理模式干预的效果。方法选取联勤保障部队第九〇八医院2019年6月至2022年6月收治的72例脊髓损伤神经源性膀胱患者作为研究对象,采用随机数字表法将其分为对照组36例,观察组36例,对照组给予常规护理,观察组在常规护理基础上实施基于奥马哈系统延续护理模式,出院后3、6个月使用效果/结局评价系统对观察组患者认知、行为、状况进行评分;使用简易膀胱残余尿量及容量测定比较2组患者出院后6个月膀胱功能;通过尿液实验室检查,比较2组患者出院后6个月尿路感染情况;采用生活质量综合评定问卷-74比较2组患者出院后6个月生活质量水平;采用医院自制护理满意度问卷比较2组患者护理满意度。结果经半年随访,观察组患者认知、行为、状况评分较干预前均显著提高,差异均有统计学意义(P<0.01);观察组患者膀胱功能、生活质量评分、满意度均高于对照组,但尿路感染发生率低于对照组,差异均有统计学意义(P<0.05)。结论基于奥马哈系统延续护理模式干预脊髓损伤神经源性膀胱患者可有效改善患者膀胱功能,提高患者的生活质量及护理满意度,降低尿路感染发生率,改善护理结局。

Objective To explore the effect of Omaha system-based continuous care intervention in patients with neurogenic bladder with spinal cord injury.Methods A total of 72 patients with neurogenic bladder due to spinal cord injury were selected from June 2019 to June 2022 in the No.908th Hospital of Joint Logistic Support Force.The patients were randomly divided into the control group(36 cases)and the observation group(36 cases)by random number table method.The control group received routine nursing care,while the observation group received Omaha system-based continuous care on the basis of routine nursing care.The cognition,behavior and status of the patients in the observation group were scored by the effect/outcome evaluation system at three and six months after discharge.Simple residual urine volume and volume of bladder were used to compare the bladder function of the two groups at six months after discharge.Urinary tract infection six months after discharge was compared between the two groups by urine laboratory examination.The quality of life in six months after discharge of the two groups was compared by using the comprehensive assessment questionnaire-74.The nursing satisfaction of the two groups was compared with the nursing satisfaction questionnaire made by the hospital.Results After half a year follow-up,the scores of cognition,behavior and condition in the observation group were significantly improved compared with those before intervention,with statistical significance(P<0.01).The bladder function,quality of life score and satisfaction in observation group were higher than those in control group,but the incidence of urinary tract infection was lower than that in control group,with statistical significance(P<0.05).Conclusion Omaha system-based continuous care model can effectively improve the bladder function,quality of life and nursing satisfaction of patients,reduce urinary tract infection and improve the outcome of nursing care.