基于罗伊适应模式的综合护理在腰椎间盘突出症患者中的应用效果

Application effects of comprehensive nursing based on Roy’s adaptation model in patients with lumbar disc herniation

目的:观察基于罗伊适应模式(RAM)的综合护理在腰椎间盘突出症(LDH)患者中的应用效果。方法:回顾性分析2021—2022年该院收治的100例LDH患者的临床资料,按护理方法不同将其分为观察组(n=48)与对照组(n=52)。对照组给予常规护理,观察组在对照组基础上给予基于RAM的综合护理。比较两组护理前后疼痛程度[McGill疼痛问卷简表(SF-MPQ)]评分、康复锻炼依从性(LDH患者锻炼依从性量表)、腰椎功能[下腰痛日本骨科协会评估治疗(JOA)]评分和自护能力[自护能力量表(ESCA)]评分。结果:护理后,两组疼痛分级指数、视觉模拟评分法、现在疼痛强度等SF-MPQ评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);两组锻炼效果监督、主动寻求建议、参与锻炼等康复锻炼依从性评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);两组临床体征、主观症状、日常活动受限等下腰痛JOA评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);两组自我概念、健康知识水平、自护技能、自我责任感等ESCA评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:在常规护理基础上应用基于RAM的综合护理可提高LDH患者康复锻炼依从性评分、腰椎功能评分和自护能力评分,以及降低疼痛程度评分的效果优于单纯常规护理。

Objective:To observe application effects of comprehensive nursing based on Roy’s adaptation model(RAM)in patients with lumbar disc herniation(LDH).Methods:The clinical data of 100 patients with LDH admitted to the hospital from 2021 to 2022 were retrospectively analyzed.According to different nursing methods,they were divided into observation group(n=48)and control group(n=52).The control group was given routine nursing,while the observation group was given the comprehensive nursing based on RAM on the basis of that of the control group.The scores of pain degree[McGill pain questionnaire(SF-MPQ)],the rehabilitation exercise compliance(LDH patients’exercise compliance scale),the lumbar function[Japanese Orthopaedic Association(JOA)for low back pain],and the self-care ability[exercise of self-care agency scale(ESCA)]were compared between the two groups before and after the nursing.Results:After the nursing,the SF-MPQ scores of pain grading index,visual analogue scale and current pain intensity in the two groups were lower than those before the nursing,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the nursing,the compliance scores of rehabilitation exercise such as exercise effect supervision,active advice seeking and participation in exercise in the two groups were higher than those before the nursing,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the nursing,the JOA scores of low back pain such as clinical signs,subjective symptoms and limited daily activities in the two groups were higher than those before the nursing,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,after the nursing,the ESCA scores of self-concept,health knowledge level,self-care skills and self-responsibility in the two groups were higher than those before the nursing,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:RAM-based comprehensive nursing on the basis of the routine nursing can improve the rehabilitation exercise compliance scores,the lumbar function scores and the self-care ability scores of the LDH patients,and reduce the pain scores.Moreover,it is superior to simple routine nursing.