Orem自理模式在慢性肾衰竭腹膜透析患者延续性护理中的应用

Application of Orem self-care program in continuing care of patients undergoing peritoneal dialysis for chronic renal failure

目的探讨Orem自理模式在慢性肾衰竭腹膜透析患者延续性护理中的应用效果。方法慢性肾衰竭腹膜透析患者80例依据实施护理方案的不同分为对照组39例和研究组41例。腹膜透析治疗期间,对照组接受常规护理和随访,研究组在对照组基础上实施基于Orem自理模式的延续性护理。评估患者日常生活活动能力(ADL)与腹膜透析治疗自理能力,了解患者健康知识知晓情况,统计并发症发生情况。结果干预后,2组Barthel指数(BI)评分均较干预前提高(P<0.05),且研究组BI评分高于对照组(P<0.05)。干预后,研究组患者腹膜透析换液操作能力与定期在门诊随诊能力优于对照组(P<0.05)。干预后,2组健康知识知晓评分较干预前增高(P<0.05),且研究组高于对照组(P<0.05)。研究组腹膜炎、感染、腹痛发生率低于对照组,但差异无统计学意义(P>0.05)。结论针对慢性肾衰竭腹膜透析患者实施基于Orem自理模式的延续性护理,能促进患者自理能力的提升,改善疾病认知程度和日常生活能力。

Objective To investigate the application efficacy of Orem self-care program in continuing care of patients undergoing peritoneal dialysis for chronic renal failure(CRF). Methods Totally 80 CRF patients with peritoneal dialysis were assigned to the control group(n=39) and the study group(n=41). All patients received routine care and follow-up during peritoneal dialysis, and patients in the study group were given continuing care based on Orem self-care program. The Activity of Daily Living(ADL) by Barthel Index(BI), self-care ability of peritoneal dialysis, awareness of dialysis-related knowledge and dialysis-related complications were compared between two groups. Results The BI score was increased in both two groups after intervention, and there was a better improvement of BI score in the study group than that in the control group(P<0.05). Patients in the study group had better self-care ability of peritoneal dialysis solution-exchange and regular outpatient visits compared with those in the control group(P<0.05). Patients in the study group achieved a better outcome of dialysis-related knowledge assessment compared with those in the control group(P<0.05). The incidences of peritonitis, infection and abdominal pain were lower in the study group than those in the control group, with no significant difference(P>0.05). Conclusion The continuing care based on Orem self-care program can effectively improve the self-care ability of CRF during peritoneal dialysis, and improve patients’ awareness of dialysis-related knowledge and activity of daily living.