Orem自护模式在老年髋部骨折围手术期中的应用

黄伟琼 蓝海瑜

【摘要】 目的：探讨Orem自护模式在老年髋部骨折围手术期的应用效果。方法：选取2016年5月-2019年5月于罗定市红十字会医院和罗定市中医院接受髋部骨折手术治疗的老年患者136例为研究对象，按照随机数字表法分成对照组和观察组，各68例。对照组给予传统常规护理指导，观察组采用Orem自护模式，比较两组患者术前和术后6个月的自护能力评分、生活质量评分及护理服务满意度。结果：术后6个月，观察组自护知识、自护技能、自护概念、自护责任感评分、生理健康和心理健康方面评分均高于对照组，差异均有统计学意义（P<0.05）。术后6个月，观察组护理服务总满意率为89.71%，显著高于对照组的66.18%，差异有统计学意义（P<0.05）。结论：基于Orem自护模式下，不仅有效增强老年患者自护能力，还较大地改善其生活质量，提高了护理服务满意度。

【关键词】 Orem自护模式 老年髋部骨折 生活质量 自护能力

[Abstract] Objective： To explore the application effect of Orem self-care mode in the perioperative period of geriatric hip fracture. Method： A total of 136 elderly patients receiving surgical treatment for hip fracture in Luoding Red Cross Hospital and Luoding Hospital of Traditional Chinese Medicine from May 2016 to May 2019 were selected as the research subjects， they were divided into control group and observation group according to random number table method， 68 cases in each group. The control group was given traditional routine nursing guidance， while the observation group adopted Orem self-care mode. The self-care ability score， quality of life score and nursing service satisfaction of two groups were compared before and 6 months after operation. Result： 6 months after operation， the observation group were higher than the control group in self-care knowledge， self-care skills， self-care concept， self-care responsibility scores， physical health and mental health scores， the differences were statistical significance （P<0.05）. 6 months after operation， the total satisfaction rate of nursing service in the observation group was 89.71%， which was significantly higher than 66.18% in the control group， the difference was statistical significance （P<0.05）. Conclusion： Based on Orem self-care model， it not only effectively enhances the elderly patients self-care ability， but also greatly improves their quality of life， to improve the nursing service satisfaction.

[Key words] Orem self-care mode Geriatric hip fracture Quality of life Self-care ability

First-authors address： Luoding Red Cross Hospital， Luoding 527200， China

doi：10.3969/j.issn.1674-4985.2021.09.026

老年髖部骨折是一个复杂多变的过程，在围手术期间，由于老年生理机能已逐渐退化，与中青年人群相比其身心健康承受能力也发生较大变化，对护理需求产生更明显的依赖性。而传统骨科护理多限于饮食指导、健康教育、心理安抚及康复锻炼等干预措施，在一定程度上忽视患者的自我护理能力存在，未能及时挖掘和发挥其自理能力。Orem自护模式作为一种改善和修正患者自理缺陷的新护理理论，近年来已广泛应用于乳腺癌改良根治术、股骨骨折及股骨头置换术等外科术后患者[1-3]，取得很好的护理效果。鉴于老年群体容易受各种外在因素影响，且诱发并发症较多，本研究在参考文献[4-8]基础上，探讨Orem自护模式在本院围手术期老年髋部骨折患者的护理应用效果，现报道如下。……