Orem自护理论对恶性梗阻性黄疸行经皮肝穿刺胆道引流术患者的影响分析

李灵艳; 王红雨; 刘双池; 许文青; 张艳芳; 谈燚

doi:10.16766/j.cnki.issn.1674-4152.002390

Orem自护理论对恶性梗阻性黄疸行经皮肝穿刺胆道引流术患者的影响分析

doi: 10.16766/j.cnki.issn.1674-4152.002390

1.
蚌埠医学院第一附属医院肝胆外科，安徽蚌埠 233004
2.
蚌埠医学院体适能研究中心，安徽蚌埠 233030

基金项目:

安徽省高校人文社科重大研究项目 SK2020ZD32

安徽省高校自然科学重大研究项目 BYTM2019023

蚌埠医学院“512计划”骨干教师项目 by51201208

蚌埠医学院自然重点项目 2020byzd100

详细信息

通讯作者:
王红雨，E-mail: wanghongyu81920@163.com

中图分类号: R473.6 R575
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- PDF下载量: 7
- 被引次数: 0
出版历程
- 收稿日期: 2021-09-08
- 网络出版日期: 2022-08-13

Analysis of the influence of Orem's self-nursing theory on patients with malignant obstructive jaundice undergoing percutaneous transhepatic cholangial drainage

1.
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探讨Orem自护理论的护理方法对经皮肝穿刺胆道引流术(percutaneoustransh epatic cholangial drainage, PTCD)患者自护能力、护理满意率、疾病相关知识掌握程度的影响。方法选取2020年5月—2021年3月在某市三甲医院因恶性梗阻性黄疸行PTCD治疗的93例患者，按随机数字表法分为实验组(47例)和对照组(46例)。对照组实施常规护理，实验组实施基于自护理论的护理干预，干预周期为1个月，比较2组患者自我护理能力、护理满意率及疾病知识的掌握程度。结果干预1个月后实验组自我护理能力4个维度评分依次为(25.71±2.38)分、(16.29±2.87)分、(35.79±3.84)分、(47.45±4.76)分，均高于对照组的(23.06±3.42)分、(13.75±3.11)分、(32.68±4.12)分、(38.26±3.49)分，差异有统计学意义(均P＜0.05)；实验组护理满意率为95.7%，对照组为77.3%，差异有统计学意义(χ²=6.574，P=0.010)；2组对伤口观察、PTCD管护理、并发症的观察及护理、饮食知识、活动知识的评分比较差异有统计学意义(均P＜0.05)。结论将自护理论应用到PTCD术患者中可以提高患者自我护理能力及护理满意率，促进患者更好地掌握疾病知识。
- 自护理论 /
- 恶性梗阻性黄疸 /
- 经皮肝穿刺胆道引流术
Abstract: Objective To explore the effect of the nursing method of Orem's self-care theory on the self-care ability, nursing satisfaction rate and disease-related knowledge of patients with percutaneous transhepatic cholangial drainage (PTCD). Methods Ninety-three patients who underwent PTCD treatment for malignant obstructive jaundice in a third-class hospital in a city from May 2020 to March 2021 were divided into the experimental group (47 cases) and control group (46 cases) according to the random number table. The observation group was given routine nursing care, and the experimental group was given nursing intervention based on self-care theory. The intervention period was one month. The two groups of patients were compared for their self-care ability, nursing satisfaction rate and disease knowledge mastery. Results After one month of intervention, the four dimensions of self-care ability in the experimental group were (25.71±2.38) points, (16.29±2.87) points, (35.79±3.84) points and (47.45±4.76) points, and those in the control group were (23.06±3.42) points, (13.75±3.11) points, (32.68±4.12) points and (38.26±3.49) points. The difference was statistically significant (all P < 0.05). The nursing satisfaction rate of the experimental group was 95.7%, and that of the control group was 77.3%. The difference was statistically significant (χ²=6.574, P=0.010). There were statistically significant differences in the scores of wound observation, PTCD tube nursing, complication observation and nursing, diet knowledge and activity knowledge between the two groups (all P > 0.05). Conclusion The application of self-care theory to patients undergoing PTCD can improve patients' self-care ability and nursing satisfaction rate, and promote patients to better grasp disease knowledge.
- Self-care theory /
- Malignant obstructive jaundice /
- Percutaneous transhepatic cholangial drainage

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表 1 2组恶性梗阻性黄疸患者一般资料比较

Table 1. Comparison of general data between two groups of malignant obstructive jaundice patients

组别	例数	年龄(x±s，岁)	性别(例，男/女)	文化程度(小学及以下/ 初中及以上, 例)	住院天数(x±s，d)	高血压(无/有, 例)	糖尿病(无/有, 例)	参保类型(城乡居民医保/职工医保, 例)	疾病类型(胰腺癌/肝癌/ 胆管或胆囊癌, 例)
实验组	46	67.7±10.8	27/19	33/13	13.9±6.1	24/22	37/9	23/23	10/8/28
对照组	44	69.7±8.8	28/16	30/14	14.7±5.4	29/15	35/9	19/25	7/6/31
统计量		-0.923^a	0.231^b	0.136^b	-0.578^a	1.752^b	0.011^b	0.420^b	0.924^b
P值		0.358	0.631	0.713	0.565	0.186	0.916	0.517	0.630
注：^a为t值，^b为χ²值。

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表 2 2组患者自我护理能力评分比较(x±s，分)

Table 2. Comparison of self-care ability between two groups (x±s, points)

组别	例数	自我概念		自我责任感		自我护理技能		健康知识水平
组别	例数	干预前	干预1个月	干预前	干预1个月	干预前	干预1个月	干预前	干预1个月
实验组	46	20.86±3.53	25.71±2.38	13.43±2.05	16.29±2.87	26.57±3.15	35.79±3.84	36.82±10.76	47.45±4.76
对照组	44	20.25±2.25	23.06±3.42	12.97±2.56	13.75±3.11	27.25±2.68	32.68±4.12	34.97±9.54	38.26±3.49
t值		0.982	4.249	0.938	4.307	-1.105	2.511	0.864	10.47
P值		0.329	＜0.001	0.351	＜0.001	0.272	＜0.001	0.390	＜0.001

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表 3 2组患者护理满意度比较

Table 3. Comparison of nursing satisfaction between two groups

组别	例数	非常满意(例)	基本满意(例)	不满意(例)	满意度(%)
实验组	46	36	8	2	95.7 (44/46)
对照组	44	27	7	10	77.3 (34/44)
注：2组满意度比较，χ²=6.574，P=0.010。

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表 4 2组患者对术后疾病知识的掌握程度(x±s，分)

Table 4. The degree of knowledge of postoperative disease in two groups (x±s, ponits)

组别	例数	伤口观察	PTCD管护理	并发症的观察及护理	饮食知识	活动知识
实验组	46	14.28±2.37	16.36±1.88	22.57±3.56	15.47±2.08	8.13±1.62
对照组	44	11.67±3.28	14.87±2.49	20.85±3.73	12.15±2.76	7.06±1.83
t值		4.311	3.193	2.236	6.423	2.932
P值		0.001	0.002	0.028	＜0.001	0.004

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