|
|
|
| Effectiveness of comprehensive nursing care based on Omaha theory for traumatic paraplegic patients |
| XIANG Rui1 XU Fengqin2 JI Lili1 YIN Zhaoyang3 XU Qin4▲ |
1.Spine Surgery, Lianyungang Clinical Medical College, Nanjing Medical University, Jiangsu Province, Lianyungang 222000, China;
2.Department of Nursing, Lianyungang Clinical Medical College, Nanjing Medical University, Jiangsu Province, Lianyungang 222000, China;
3.Department of Traumatology, Lianyungang Clinical Medical College, Nanjing Medical University, Jiangsu Province, Lianyungang 222000, China;
4.College of Nursing, Nanjing Medical University, Jiangsu Province, Nanjing 211166, China |
|
|
|
Abstract Objective To explore the analysis of the effectiveness of comprehensive care based on the Omaha system for patients with traumatic paraplegia. Methods Eighty-four patients with traumatic paraplegia treated at Lianyungang Clinical Medical College, Nanjing Medical University from January 2020 to June 2021 were selected and divided into basic group and combined group by the random number table method, with 42 cases in each group. The basic group was given conventional care, while the combined group was given comprehensive care under the guidance of Omaha system theory during hospitalization and after discharge, and negative emotions, sleep quality and recovery of limb function were assessed before and after care in both groups. The adverse reactions were recorded. Results After comprehensive care, the independence rating scale and Fugl-Meyer scores were higher in both groups than before care, while those of the combined group were higher than those of the control group, with statistically significant differences (P ＜ 0.05). After care, the dimensions of Nottingham health questionnaire scores were lower in both groups than before care, while the combined group had lower energy, pain, sleep, social, and physical scores than the base group, with statistically significant differences (P ＜ 0.05). After care, the scores on the self-rating sleep status scale, the self-rating anxiety scale, and the self-rating depression scale in both groups were lower than before care, while in those the combined group were lower than those in the basic group, with statistically significant differences (P ＜ 0.05). The incidences of muscle atrophy and joint stiffness during care were lower in the combined group than in the basic group, and the differences were statistically significant (P ＜ 0.05). Conclusion Comprehensive care based on the Omaha system can significantly improve somatic and motor functions, increase quality of life, and reduce psychological stress in patients with traumatic paraplegia.
|
|
|
|
|
|
[1] 池红万.川芎嗪联合rTMS治疗外伤性截瘫的效果及对神经电生理和骨代谢的影响[J].实用中西医结合临床，2021，21（14）：39-40.
[2] Kalidindi KKV，Gupta M，Chhabra HS. A rare cause of neurological deterioration to complete paraplegia after surgery for thoracic myelopathy：a case report [J]. Spinal Cord Series Cases，2019，5（1）：55-58.
[3] Rachel C，Kellyn M，Daniel T，et al. Effect of Comprehensive Care Coordination on Medicaid Expenditures Compared With Usual Care Among Children and Youth With Chronic Disease：A Randomized Clinical Trial [J]. JAMA Network Open，2019，2（10）：2755-2759.
[4] 包永兰，胡佳成，林琳，等.综合护理干预对外伤性截瘫患者负性情绪及生活质量的影响[J].护士进修杂志，2017， 7（26）：1260-1263.
[5] Holt JM，Brooke KL，Pryor N，et al. Using the Omaha System to Evaluate the Integration of Behavioral Health Services into Nurse-Led Primary Health Care [J]. J Community Health Nurs，2020，37（1）：35-46.
[6] 朱侥侥，涂俊玲，闵燕.奥马哈系统在外伤性截瘫患者延续护理中的应用研究进展[J].齐鲁护理杂志，2018，24（8）：99-101.
[7] 李维国，王向东.新版《临床疾病诊断依据治愈好转标准》简介[J].解放军医院管理杂志，1998（3）：299.
[8] 美国脊髓损伤协会，国际脊髓损伤学会，李建军，等.脊髓损伤神经学分类国际标准（2011年修订）[J].中国康复理论与实践，2011，17（10）：963-971.
[9] 李勇.鼠神经生长因子联合甲泼尼龙治疗外伤性马尾神经损伤临床疗效及安全性研究[J].中国临床药理学杂志，2016，32（15）：1381-1383.
[10] Lesley CJ，Gert K，Bussmann JBJ，et al. Are the hierarchical properties of the Fugl-Meyer assessment scale the same in acute stroke and chronic stroke? [J]. Phys Ther，2018，94（7）：977-986.
[11] Wapenaar M，Twiss J，Wagenaar M，et al. Adaptation and validation of the Cambridge Pulmonary Hypertension Outcome Review （CAMPHOR） for the Netherlands [J]. Neth Heart J，2016，24（6）：417-424.
[12] 李建明.睡眠状况自评量表（SRSS）简介[J].中国健康心理学杂志，2012，20（12）：1851.
[13] 刘宏炜，刘璐，李军，等.创伤性截瘫患者康复早期下肢深静脉血栓形成特点及影响因素[J].中国康复理论与实践，2018，24（2）：191-195.
[14] 胡彩霞，吴霞，张利敏，等.综合护理干预在肺栓塞患者康复治疗中的应用研究[J].实用临床医药杂志，2017， 21（14）：154-155.
[15] 曹烈虎，牛丰，张文财，等.创伤性脊柱脊髓损伤康复治疗专家共识（202版）[J].中华创伤杂志，2020，36（5）：385- 392.
[16] 张婷宇.综合阶段性护理干预联合药物治疗对外伤性下肢截肢术后病人短期临床结局的影响[J].蚌埠医学院学报，2018，43（11）：120-123，128.
[17] 刘晓华，李泽辉，赵世芬.延续护理对截瘫患者生活质量[J].护理质量管理，2015，15（12）：896-898.
[18] 赵静，薛淑枝，罗红梅，等.基于奥马哈系统的延续护理对维持性血液透析患者自我管理能力与生存质量的影响[J].中国血液净化，2019，18（4）：281-283.
[19] 朱壮丽.基于奥马哈系统的延续性护理对PCI术后患者自我管理能力的影响[D].海口：海南医学院，2018.
[20] 刘晓华，李泽辉，赵世芬，等.延续护理对截瘫患者生活质量及心理状态的影响[J].护理管理杂志，2015，15（12）：896-898.
[21] Niitsu K，Watanabe-Galloway S，Sayles H，et al. A Pilot Study of the Psychological Impact of the Great East Japan Earthquake and Tsunami [J]. J Am Psychiatr Nurses Assoc，2014，20（3）：194-202.
[22] Rohr MK，Mikuls TR，Cohen SB，et al. Underuse of Methotrexate in the Treatment of Rheumatoid Arthritis：A National Analysis of Prescribing Practices in the US [J]. Arthritis Care Res （Hoboken），2017，69（6）：794-800.
[23] 罗静文，林海英，黄小舟，等.脊髓损伤患者主要照顾者照顾负担与积极感受的相关性研究[J].护士进修杂志，2016，31（24）：2216-2218.
[24] Sezgin D，Esin MN. Use of the Omaha System to identify musculoskeletal problems in intensive care unit nurses：A case study [J]. Br J Nurs，2019，28（5）：300-306.
[25] Liu ZC，Gao L，Zhang WH，et al. Effects of a 4-week Omaha System transitional care programme on rheumatoid arthritis patients’ self-efficacy，health status，and readmission in mainland China：A randomized controlled trial [J]. Int J Nurs Pract，2020，26（4）：77-81. |
|
|
|
