Impact of an emergency department nursing intervention on continuity of care, self-care, and psychological symptoms

BACKGROUND The emergency department plays a crucial role in providing acute care to patients.Nursing interventions in this setting are essential for improving the continuity of care,enhancing patients’self-care abilities,and reducing psychological symp-toms.AIM To evaluate the effect of nursing interventions in the emergency department on these indicators in an emergency department.METHODS A retrospective analysis was conducted on 120 patients admitted to the emergency department between January 2022 and May 2023.The patients were divided into two groups:The control group(conventional nursing intervention)and the observation group(conventional nursing intervention+emergency department nursing intervention).The two groups were compared regarding continuity of care,self-care ability,psychological symptoms,and satisfaction with care.RESULTS The emergency department nursing interventions significantly improved the continuity of care,enhanced patients’self-care abilities,and reduced psycho-logical symptoms such as anxiety and depression.CONCLUSION Nursing interventions in the emergency department positively impact continuity of care,self-care,and psychological symptoms.However,it is important to acknowledge the limitations of this study,including the small number of studies,variable methodological quality,and the heterogeneity of the study population.Future research should address these limitations and further explore the effects of different types of nursing interventions in the emergency department.Additionally,efforts should be made to enhance the application and evaluation of these interventions in clinical practice.

Analysis of the Effect of Comfort Care in The Perioperative Care of Patients with Hysteromyomectomy and its Influence on Self-Care Ability

Objective:To analyze the effect of perioperative comfort care for patients with hysteromyomectomy(HYS).Methods:Seventy cases of HYS patients admitted to our hospital from October 2022 to October 2023 were randomly selected and divided into Group A(control group,35 cases,conventional care)and Group B(observation group 35 cases,comfort care).The effects of the two groups before and after nursing care were compared.Results:The self-rating anxiety(SAS)scores,exercise of self-care agency(ESCA)scores,and nursing satisfaction scores at the time of discharge of Group B were better than in Group A after nursing care(P<0.05).Conclusion:Perioperative comfort care for HYS patients improved the patient’s adverse emotions,self-care ability,and nursing satisfaction.

Self-Care Practice of Patients with Mechanical Heart Valve Prosthesis Accompanied in Nursing Consultation

The objective was to evaluate the practice of self-care of patients with mechanical heart valve prosthesis. A descriptive, cross-sectional study developed in two outpatient valvopathies of teaching hospitals of Fortaleza/CE, from October 2013 to January 2014. The sample consisted of 127 patients with mechanical heart valve prosthesis. It was held an interview using instrument based on the Theory of Orem’s Self-Care and Brazilian Guidelines for Valvular Heart Diseases. The data were presented in tables and charts. Results: Universal self-care practices of larger adhesion: body hygiene (97.6% washed-haired, daily-bath 92.1%);oral hygiene (brushing teeth before sleeping, 87.4%);fluid intake (drinking-water 95.2%);food intake (salt intake ≤ 2 g/day, 92.1%, fruit and vegetable consumption 79.5%);intestinal eliminations (without blood or mucus—96%, non-parasitic 94.4%);urinary elimination (no blood nor pus-96.8%, urination 4 to 6 times a day, 96%). As self-care developmental requirements predominated: never used illegal drugs, tobacco, alcohol, or stopped at the discovery of the disease (70%). As self-care health deviation requirements we have: making use of certain medication at the right dose (95.2%);attending medical appointments (cardiologist—92.1%;nursing—84.2%);INR control (identifies signs of bleeding— 85.8%). We conclude that patients did not perform all recommended self-care practices, being necessary to establish strategies to reduce the self-care deficit.

Effect of continuing nursing on self-care ability of diabetic patients:A meta-analysis

Objective:To evaluate the effect of continuing nursing on self-care ability of diabetic patients.Methods:Meta-analysis was used to search multiple Chinese and English databases,and relevant randomized controlled trials were collected.After reviewing the literature quality,RevMan 5.2 software was used for data analysis.Results:A total of 8 randomized controlled trials(RCTs)were included.The results showed that the self-care ability of the continuing care observation group was significantly higher than that of the control group [WMD = 17.88,95%CI(17.30,18.47),P<0.001].Conclusion:Continuing nursing shows superiority in improving self-care ability of diabetic patients.

The development and implementation of a model to facilitate self-care of the professional nurses caring for critically ill patients

Objectives This article aimed to describe the development,implementation,and evaluation of the model’s effectiveness to facilitate self-care of professional nurses caring for critically ill patients in ICUs.Methods The methods of Chinn and Kramer,Walker and Avant were utilized to generate this model.The study included four steps to develop,implement and evaluate the model:Step 1-concept analysis;Step 2-placing the concept in relationship statements;Step 3-description and evaluation of the model;and Step 4-implementation and evaluation of the model.The implementation and evaluation of the model included two phases:a one-day workshop to present the model,and three months of model implementation.The study was conducted in a specific tertiary hospital in Gauteng Province,South Africa.Twenty-five participants were identified amongst the five ICUs,and only eight participants accepted the invitation.Out of the eight participants,only six professional nurses working in different ICUs in the public sector were interviewed.Results The model was divided into three stages:relationship,working,and termination;it comprised the primary and secondary contexts in which the facilitation of self-care occurs.The model process occurred in a spiral form.The registered nurses benefitted holistically from the three presenters at the workshop,and the social worker contributed to their emotional self-care activities.Three themes emerged:The model brought positive experiences,change,and self-awareness;the model benefitted the registered nurses holistically;role modeling self-care practices motivated and benefitted others.Conclusion The model implementation assisted the registered nurses’in developing self-awareness and resilience.They gained more knowledge regarding self-care,and the model encouraged them to implement improved self-care practices.They became role models of self-care and motivated their friends and families.

行为分阶段改变理论协同护理模式联合Orem护理在肝动脉化疗栓塞术患者中的应用

目的探讨行为分阶段改变理论(TTM)协同护理模式联合Orem护理在肝动脉化疗栓塞术(TACE)患者中的应用效果。方法选取2020年2月至2022年9月赣州市第五人民医院收治的96例行TACE化疗患者作为研究对象,按照随机数字表法分为对照组和观察组,各48例。对照组患者予以常规护理,观察组患者予以TTM协同护理模式联合Orem护理。比较两组患者自护能力水平、生活质量、不良反应发生率、护理满意度以及心理状态。结果两组患者护理前自护能力、心理状态、生活质量水平比较,差异无统计学意义(P>0.05);观察组护理后自护能力分数高于对照组,差异有统计学意义(P<0.05);观察组护理后心理状态评分高于对照组,差异有统计学意义(P<0.05);观察组护理后生活质量水平高于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。观察组满意度高于对照组,差异有统计学意义(P<0.05)。结论TTM协同护理模式联合Orem护理应用于原发性肝癌TACE患者,可以帮助患者保持良好心理状态,改善患者生活质量,提高患者自我护理能力及满意度,减少不良反应发生。

Bibliometric analysis of researches of Orem self-care model in China based on BICOMB

Objective:To analyze the hotspots of the Orem self-care model research from the construction of CNKI database to May 2019,and to understand the research status in this field and to explore its development trend.Methods:"Orem self-care model"was used as the search term to search CNKI database,and the Bibliographic Items Co-occurrence Matrix Builder(BICOMB)was used to perform bibliometric analysis on the annual distribution,authors,keywords,etc.in related articles,and SPSS 23.0 was utilized to cluster analysis of high-frequency keywords.Results:A total of 1845 associated articles were included.The annual change of Orem self-care model literatures showed an increasing trend and a total of 1604 first authors were extracted.Today Nurse published the most relevant literatures.The research extracted 56 high-frequency keywords,accounting for 50.88%of the total frequency.Co-word cluster analysis obtained five research hotspots:clinical application effect and patient satisfaction of Orem self-care model;self-care ability and quality of life of breast cancer patients;self-care behaviors for the elderly and community care;rehabilitation nursing of stroke and spinal cord injury;Orem self-care model,nursing theory.Conclusion:Analyzing the research hotspots of Orem self-care model in recent years is helpful to understand the current status in this field and future development trends,and provide references for future nursing clinical practice work and education and scientific research.

以Orem自理模式为指导的延续性护理对2型糖尿病病人自我管理行为及血糖控制的影响

目的:探究在2型糖尿病病人中实施以Orem自理模式为指导的延续性护理对自我管理行为、血糖控制及生活质量的影响。方法:选取思南县人民医院2022年2月—2023年10月收治的100例2型糖尿病病人,按随机数字表法分两组,各50例。对照组给予常规延续性护理,观察组实施以Orem自理模式为指导的延续性护理,均护理2个月。比较两组自我管理行为、血糖控制情况、生活质量。结果:两组护理前自我管理行为、血糖控制情况、生活质量比较,差异无统计学意义(P>0.05);护理后观察组2型糖尿病自我管理行为量表中各维度评分均高于对照组,空腹血糖、餐后2 h血糖、糖化血红蛋白均低于对照组,糖尿病特异性生活质量量表(DSQL)中各维度评分均低于对照组,差异有统计学意义(P<0.05)。结论:在2型糖尿病病人中实施以Orem自理模式为指导的延续性护理可提高自我管理能力、血糖控制效果,改善生活质量。

Orem自理模式护理在结直肠癌术后患者中的应用效果

目的:观察Orem自理模式护理在结直肠癌术后患者中的应用效果。方法:选取2020年11月至2022年9月该院收治的83例结直肠癌术后患者进行前瞻性研究,按照随机数字表法将其分为观察组42例和对照组41例。对照组术后实施常规护理,观察组在对照组基础上实施Orem自理模式护理,两组均护理至出院后2个月。比较两组临床指标(首次排气时间、首次下床活动时间、住院时间)水平,护理前后负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、自护能力[自我护理能力测定量表(ESCA)]、生命质量[造口患者生活质量问卷(COH-QOL-OQ)]评分,以及护理满意度。结果:观察组首次排气时间、首次下床活动时间、住院时间均短于对照组,差异有统计学意义(P<0.05);护理后,观察组SAS、SDS评分均低于对照组,差异有统计学意义(P<0.05);护理后,观察组ESCA、COH-QOL-OQ评分均高于对照组,差异有统计学意义(P<0.05);观察组护理满意度为97.62%(41/42),高于对照组的80.49%(33/41),差异有统计学意义(P<0.05)。结论:Orem自理模式护理应用于结直肠癌术后患者可改善临床指标水平,降低负性情绪评分,提高自护能力、生命质量评分和护理满意度,效果优于单纯常规护理。

Orem护理模式在初发2型糖尿病患者中的实施效果评估

目的探究初发2型糖尿病患者应用Orem护理模式的价值。方法选取2020年6月-2023年6月江苏省盐城市第一人民医院收治的150例初发2型糖尿病患者为研究对象。按随机数表法分成常规护理的对照组(n=75)、Orem护理模式的观察组(n=75)。比较两组患者自我管理能力、血糖指标和护理满意度。结果护理后,观察组自我管理能力评分更高,差异有统计学意义(P<0.05)。观察组空腹血糖(5.42±0.89)mmol/L与餐后2 h血糖(7.78±1.56)mmol/L均显著低于对照组,差异有统计学意义(t=4.802、5.241,P均<0.05)。观察组护理总满意度高于对照组,差异有统计学意义(P<0.05)。结论对于初发2型糖尿病患者施以Orem护理模式可以促进提高其自我管理能力,更好的控制血糖指标结果,提高其护理满意度。

积极心理学理论联合Orem自理理论护理对精神分裂症合并高血压患者血压及睡眠质量的影响

目的:观察积极心理学理论联合Orem自理理论护理对精神分裂症合并高血压患者血压水平和睡眠质量的影响。方法:选取2022年4月至2023年3月福建省泉州市第三医院精神科收治的精神分裂症合并高血压患者94例作为研究对象,按照随机数字表法分为对照组和观察组,每组47例。对照组开展常规护理,观察组开展积极心理学理论联合Orem自理理论护理干预。评估2组护理前后血压水平、睡眠质量的改善情况。结果:干预后观察组舒张压、收缩压均显著低于对照组(均P<0.01),干预后观察组的幸福感水平评分显著高于对照组(P<0.01),护理后观察组的匹兹堡睡眠质量指数(PSQI)评分显著低于对照组(P<0.01)。结论:对精神分裂症合并高血压患者护理时开展积极心理学理论联合Orem自理理论护理,可以降低患者血压水平,改善患者睡眠质量,提升患者幸福感,有助于患者恢复。

基于Orem自理模式的运动康复护理在慢性心力衰竭患者中的应用效果

目的分析基于奥瑞姆(Orem)自理模式的运动康复护理在慢性心力衰竭患者中的应用效果。方法选取2017年1月至2021年12月就诊于郑州大学第一附属医院的72例慢性心力衰竭患者,依照随机数字表法划分成常规组(n=36)和研究组(n=36),常规组接受常规干预,研究组在常规组的基础上接受基于Orem自理运动康复干预。比较两组希望水平、生化指标[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)]、运动耐力变化。结果与常规组相比,研究组干预后积极态度、与他人亲密关系、行为得分提高(P<0.05),LVEDD降低,LVEF升高(P<0.05),6 min步行距离延长(P<0.05)。结论Orem自理模式运动康复干预对于慢性心力衰竭患者可以提高希望水平,改善心功能,加强运动耐力。

以Orem自护模式为基础的综合性护理在精神分裂症患者中的应用效果

目的:探究以Orem自护模式为基础的综合性护理在精神分裂症患者中的应用效果。方法:前瞻性选取在上海交通大学医学院附属精神卫生中心住院治疗的127例慢性精神分裂症患者,采用随机数表法分为观察组(n=63)与对照组(n=64)。其中观察组患者行以Orem自护模式为基础的综合性护理,对照组患者采用常规护理。比较2组干预前后阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、失言识别任务(Faux Pas Recognition Task,FPRT)、自知力问卷(Self-Awareness Inventory,SAI)-治疗依从性量表评分变化。同时,对所有的患者进行为期1年的跟踪随访调查,记录其复发、再入院情况。结果:干预后,观察组患者的PANSS子量表得分以及总得分均低于对照组,FPRT、SAI-治疗依从性得分均高于对照组,差异均有统计学意义(均P<0.05)。干预后1年,观察组的复发率、再入院率均低于对照组(均P<0.05)。结论:以Orem自护模式为基础的综合性护理可以有效改善慢性精神分裂症患者的精神症状,提高其用药依从性和认知理解能力,降低1年内复发和再入院率。

Motivational interviewing to improve the self-care behaviors for patients with chronic heart failure: A randomized controlled trial

Objectives:This study aimed to investigate the effect of motivational interviewing on the self-care behaviours in patients with chronic heart failure.Methods:Sixty-two hospitalized patients with chronic heart failure were recruited in this study from April 2014 to April 2015 from a hospital.Twenty-nine patients were in the intervention group,and 33 patients were in the control group.Patients in the intervention group received four sessions of motivational interviewing,whereas those in the control group received traditional health education.At 2,4,and 8 weeks post-discharge,the intervention group underwent telephone follow-up based on motivational interviewing,whereas the control group underwent routine telephone follow-up.Primary outcome was measured using the Self-care of Heart Failure Index at baseline and at 2 months postdischarge.Results:Before intervention,the self-care behaviours scores were 79.00±48.80 in the intervention group and 88.68±29.26in the control group.No statistically significant differences were found between two groups in scores for each subscale and total scale(P>0.05).After intervention,the scores of self-care behaviours in the two groups were both improved at 155.13±35.65 for the intervention group and 115.44±22.82 for the control group with statistically significance(P<0.01).The score of self-care behaviours increased by 76.13 point in the intervention group on average,whereas 26.76 point in the control group.There was significant difference between increases in scores of self-care behaviours in two groups(P<0.01).Conclusions:The self-care behaviours of patients with chronic heart failure could be improved effectively through motivational interviewing.

Orem自我护理模型在脊柱骨折合并脊髓损伤高位截瘫患者中的应用

目的 分析Orem自我护理模型在脊柱骨折合并脊髓损伤高位截瘫患者的应用。方法 选取2016年1月至2021年7月收治的脊柱骨折合并脊髓损伤高位截瘫患者96例随机分为对照组和观察组,每组48例。对照组术后进行常规护理,观察组进行Orem自我护理模型护理,2组均干预至术后3个月。比较2组术后1周和术后3个月自我护理行为、心理状态和睡眠质量、生活质量,统计2组术后3个月功能锻炼依从性及干预期间并发症发生情况。结果 术后3个月与术后1周比较,2组日常行为、处理行为、控制行为、检测行为评分及独立性、生理、心理、环境、社会关系、精神支持评分均升高(P<0.05),且观察组高于对照组(P<0.05)。术后3个月与术后1周比较,2组SAS、SDS、PSQI评分降低(P<0.05),且观察组低于对照组(P<0.05)。术后3个月,观察组功能锻炼总依从率(93.75%)显著高于对照组(79.17%,P<0.05)。干预期间,对照组总并发症发生率高于观察组(P<0.05)。结论 Orem自我护理模型护理可有效提高脊柱骨折合并脊髓损伤高位截瘫患者自我护理行为、生活质量、功能锻炼依从性,改善患者心理状态和睡眠质量,降低并发症的发生,具有较好的干预效果。

Systematic nursing interventions in gastric cancer:A randomized controlled study

BACKGROUND Scientific and effective nursing methods can effectively mitigate negative emotions in patients.Related studies have shown that systematic nursing interventions are beneficial in enhancing the self-efficacy and self-care abilities of patients and improving their physical and mental state,thereby alleviating their fatigue and improving their quality of life.AIM To explore the effects of systematic nursing intervention on cancer-related fatigue,self-efficacy,self-nursing ability,and quality of life in gastric cancer(GC)patients during the perioperative period.METHODS In this study,sample size was based on the multivariable scale.The sample size was 10 times the acceptable variable,with an additional 20% added to account for an expected loss of patients in follow-up for a final sample size of 168 patients.Conventional nursing measures were used in the control group,while the systematic nursing intervention Adopted Cancer Fatigue Scale(CFS),General Self-Efficacy Scale-Schwarzer(GSES),Self-Care Agency Scale(ESCA),and simple health scale(SF-36)were used in the observation group.The questionnaires were administered on admission and discharge.RESULTS At admission,there was no statistically significant difference in the scores on each scale between the groups.At discharge,the CFS and GSES scores in the observation group were 21.56±2.24 and 51.16±11.71,while those in the control group were 29.61±3.48 and 41.58±8.54,respectively,with statistically significant differences.The ESCA score in the observation and control groups was 112.09±11.72 and 97.87±9.26,respectively.Moreover,the scores in all dimensions(self-concept,selfresponsibility,health knowledge level,and self-care skills)in the observation group were higher than those in the control group,with statistically significant differences.The SF-36 score in the observation and control groups was 75.51±3.63 and 63.24±3.41,respectively,with statistically significant differences.The scores in all dimensions(mental health,vitality,physical function,physical pain,social function,emotional function,and overall health level)in the observation group were higher than those in the control group,with statistically significant differences.CONCLUSION Systemic nursing intervention for GC patients during the perioperative period could alleviate cancer-related fatigue,improve self-efficacy and self-nursing ability,and improve quality of life,which all have clinical value.

Orem理论联合循证护理干预对精神分裂症患者作用价值分析

目的探讨Orem理论联合循证护理干预在精神分裂症患者中的应用价值。方法选取2020年3月至2022年5月抚州市第三医院收治的62例精神分裂症患者作为研究对象,采用随机数字表法将其分为对照组(31例)和观察组(31例)。对照组采用循证护理方法,观察组在对照组的基础上采用以Orem理论指导的循证护理干预,持续护理3个月。比较两组自我护理能力、日常生活能力、康复情况和护理满意度。结果观察组护理后自我护理能力测定量表(ESCA)各维度评分高于对照组,差异有统计学意义(P<0.05)。观察组护理后Barthel指数评定量表(BI)评分高于对照组,精神患者康复疗效评定量表评分低于对照组,差异有统计学意义(P<0.05)。观察组护理满意度(100.00%)高于对照组(80.65%),差异有统计学意义(P<0.05)。结论精神分裂症患者接受Orem理论联合循证护理能够增强自我护理能力,促进患者日常生活能力提升,降低患者社会功能损害,患者满意度更高。

The Effect of Anemia on Quality of Life and Self-Care Agency in Turkey Hemodialysis Patients

Objective: Anemia is an important complication which affects quality of life and self-care agency in hemodialysis patients. The aim of this study was to determine the effects of anemia on quality of life and self-care agency in adult patients who receive chronic hemodialysis treatment. Methods: In this cross-sectional study, the Quality of Life Scale, the Self Care Agency Scale, and a data form were administered to 136 hemodialysis patients who were receiving treatment three hospital-based dialysis units in Istanbul. Results: The health perception of cases whose hemoglobin level was 12 mg/dl and above was significantly better than those whose hemoglobin level was lower than 12 mg/dl. Hemoglobin levels were significantly and positively correlated to physical role function, general health, and health from the previous year (p < 0.05). As the hemoglobin levels of the cases increased, quality of life pertaining to the mentioned domains increased. Conclusion: It was concluded that the quality of life in chronic dialysis patients was affected by anemia.

Effect of Activities of Daily Living on Self-Care Agency in Individuals with Type 2 Diabetes

Diabetes mellitus continues to be a global health problem with increasing importance across the world by affecting the activities of daily living and self-care ability of patients due to its incidence and troubles caused by it. The present study aims at determining the effect of activities of daily living of patients with type 2 diabetes mellitus on their self-care agency. Methods: The population of this descriptive study consisted of patients with type 2 diabetes mellitus who were being treated at the internal medicine clinic of a provincial state hospital between July 2014 and November 2015 and its sample consisted of 150 diabetic patients who volunteered to take part in the study and who were open to communication. A personal information form, the Activities of Daily Living (ADL) Scale, the Instrumental Activities of Daily Living (IADL) Scale and the Self-Care Ability Scale (CAS) were used as data collecting tools. The data were analyzed using descriptive statistics (numbers, percentages, mean, standard deviation, mean rank and frequencies), the Shapiro-Wilk, Kruskal-Wallis Variance Analysis, Mann-Whitney U test and Cronbach’s alpha formula and correlation analysis. Results: Approximately 97.3% of the patients with type 2 diabetes stated that they were independent in ADL and 75.3% of them in IADL. The patients’ mean self-care ability score was found to be 83.85 ± 17.87 ADL and IADL were found to be affected by age, marital status, education, duration of disease, willingness to receive further education, and presence of another disease besides diabetes. There was a significant correlation between the self-care agency score and marital status, education, duration of disease, willingness to receive further education, presence of another disease besides diabetes, regular checking of blood sugar and compliance with diet. A significant positive correlation was found between the patients’ activities of daily living and their self-care agency. Conclusion: The patients’ activities of daily living were found to affect their self-care agency. The personal and disease-related characteristics of patients should be identified so that their self-care behaviors can be increased.

Knowledge about Diabetes Mellitus and Self-Care Activities before and after an Educational Program: A Pilot Study

Background: Health education has proven to be an effective strategy to enable people with diabetes mellitus to manage this condition. However, few studies in Brazilian population samples have been conducted to evaluate the effects of educational programs on diabetes knowledge and self-care. Aim: To evaluate the knowledge about diabetes mellitus and the performance of self-care activities, before and after participation in an educational program. Methods: This is an intervention study, with a quantitative approach, in a single comparison group, for the analysis of “before and after” results related to an educational program focused on self-care and concurrent physical training. The study interventions consisted of 42 exercise sessions, as well as individual educational meetings, according to the needs of each participant and through nursing consultations, using educational material prepared from the literature. The sample was initially composed of 33 adults with diabetes mellitus, but 18 completed the study. For the assessment of knowledge and self-care activities, the revised Brazilian versions of the Diabetes Knowledge Scale and the Diabetes Self-Care Activity Questionnaire were used, respectively, in the two moments of the study, that is, prior to the first educational meeting and immediately before the first physical training session, and after the last educational meeting, which ran parallel to the 42nd physical training session, making a six-month interval between the two assessment moments for each participant. Results: The analysis of knowledge about diabetes showed significant improvement after the educational program and, as for self-care, there was clinical improvement in all dimensions, but only the dimension “general diet” obtained statistically significant improvement. Conclusion: The educational program has been shown to be beneficial for improving knowledge and self-care of the disease, which reiterates the need to maintain interventions of this nature for people with diabetes mellitus.