奥马哈系统在结直肠癌患者延续性护理中的应用

杨佳艺　全大祥　王万里　邹剑

[摘要] 目的 评价奥马哈系统在结直肠癌患者延续性护理中的应用效果。 方法 选取2015年1月～2016年6月成都市第五人民医院行结直肠癌根治术的患者62例，采用随机数字法分为观察组和对照组，每组各31例。对照组实施常规出院指导和随访，观察组实施以奥马哈系统为理论依据构建的延续性护理干预。比较出院前后两组患者护理结局各领域认知、行为和状况评分情况。 结果 干预后3、6个月，观察组患者的社交、精神健康、消化、异位排便、造口周围皮肤、感染、营养、自我照护能力和居住环境的认知、行为、状况评分均明显高于出院前及对照组，差异有统计学意义（P < 0.05）。 结论 基于奥马哈系统理论制订的结直肠癌患者延续性护理随访干预模式可以明显改善患者的护理结局。

[关键词] 奥马哈系统；结直肠癌；延续性护理

[中图分类号] R473.5 [文献标识码] A [文章编号] 1673-7210（2018）09（b）-0137-05

[Abstract] Objective To evaluate the effects of continuity nursing intervention based on Omaha system in patients with colorectal cancer. Methods From January 2015 to June 2016， in Chengdu Fifth People′s Hospital， 62 patients with colorectal cancer underwent surgery were enrolled， and they were divided into observation group and control group by random number table method， with 31 cases in each group. The control group was given routine discharge instruction and follow-up， the observation group was given continuity nursing intervention based on Omaha system. The knowledge-behavior-status scores in two groups were compared. Results The knowledge-behavior-status scores of social and mental health， digestive， ectopic defecation， skin， infection， self-care and living condition 3， 6 months after the intervention in observation group were significantly higher than before discharge and control group， the differences were statistically significant （P < 0.05）. Conclusion The application of continuity nursing intervention based on Omaha system can significantly strengthen the rehabilitation prognosis of patients with colorectal cancer.

[Key words] Omaha system； Colorectal cancer； Continuity nursing intervention

结直肠癌是消化道常见的恶性肿瘤之一，据统计，仅2012年全球新发结直肠癌患者达136万，位列肺癌和乳腺癌之后，居恶性肿瘤第3位，当年有69万结直肠癌患者死亡[1-2]。近年来，随着国民生活水平的提高，结直肠癌的发病率逐年升高，已成为国内最常见的恶性肿瘤之一[3-4]。目前，手术切除仍是治疗结直肠癌的首选方式，但手术也易引起术后出血、肠梗阻、吻合口相关并发症等[5-8]。疾病的打击、生活方式的改变以及经济负担的加重，给患者身心造成了极大的打击和伤害，严重影响了患者的生活质量[9-11]。

奥马哈系统是美国护士协会认可的一种护理标准化语言，用于评价医疗服务的影响[12-13]。奥马哈系统由问题分类系统、干预系统和效果评价系统组成，实质上是一种以问题为导向解决问题的方法[14]。……