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Orem自理模式在造血干细胞移植极期护理的应用

来源:《中国医学创新》 编辑:高珠玲 方文添  时间:2018-12-22

【摘要】 目的:探讨在护理造血干细胞移植极期患者过程中运用Orem自理模式的临床分析及效果。方法:选取2017年1-12月某三级甲等医院血液科移植仓内的成人白血病患者68例作为研究对象,按照随机数字表法将其分为观察组(n=34)和对照组(n=34)。在实施干预过程中,对研究对象采取单盲法,观察组运用Orem自理模式进行自我护理,对照组则采用常规分级护理。比较两组出仓时生活质量评分以及移植仓内感染发生情况。结果:观察组各项生活质量评分及总分均明显高于对照组,差异均有统计学意义(P<0.05)。觀察组出院前感染发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:应用Orem自理模式可以降低造血干细胞移植极期患者的感染率,同时提高生存质量。

【关键词】 Orem自理模式; 造血干细胞移植; 极期; 护理

Application of Orem Self-care Mode in Nursing of Patients with Hematopoietic Stem Cell Transplantation during Extreme Period/GAO Zhuling,FANG Wentian,WENG Yimei,et al.//Medical Innovation of China,2018,15(27):0-075

【Abstract】 Objective:To explore the clinical analysis and effect of Orem self-care mode in patients with hematopoietic stem cell transplantation during the extreme period.Method:A total of 68 adults patients with leukemia in hematology department transplantation warehouse of a tertiary hospital from January to December 2017 were selected as the study objects.According to the random number table method,they were divided into observation group (n=34) and control group (n=34).In the intervention process,the study objects were given single blind method,the observation group was received Orem self-care mode,the control group was treated with routine grading nursing mode.The quality of life score and the incidence of infection in ward and transplanted warehouse between the two groups were compared.Result:The scores of life quality and total scores in the observation group were significantly higher than those in the control group,the differences were statistically significant (P<0.05).The incidence of infection in the observation group before discharge was significantly lower than that in the control group, the difference was statistically significant (P<0.05).Conclusion:Orem self-care mode can reduce the infection rate and improve the quality of life of patients with hematopoietic stem cell transplantation during extreme period.

【Key words】 Orem self-care mode; Hematopoietic stem cell transplantation; Extreme period; Nursing

First-author’s address:Fujian Institute of Hematological Diseases/Key Laboratory of Hematology in Fujian/Union Hospital Affiliated to Fujian Medical University,Fuzhou 350001,China

doi:10.3969/j.issn.1674-4985.2018.27.019

Orem提出了全补偿护理系统、部分补偿护理系统、支持-教育补偿护理系统的理论[1-3]。完全补偿系统是指患者自身没有能力进行活动,需要护士给予帮助;部分补偿系统是指护士和患者一起参与自理活动;支持-教育补偿护理系统是指患者自身可以完成全部活动,护士在其中起教育支持和指导作用。造血干细胞移植技术是目前治疗恶性血液病以及难治性血液病的一种方法[4]。在移植前需要进行预处理,就是进行大剂量的放疗和化疗,进而清除体内异常增生的细胞、抑制机体的免疫功能,从而保证造血干细胞移植成功的主要手段[5]。预处理阶段会导致细胞降低,造血细胞重建一般需要30~40 d[6]。移植极期是整个移植过程中的关键时期,移植极期一般是指移植后7~28 d[7]。此期患者全血细胞降低,患者免疫力低下,易发生感染、出血等并发症[8]。就此问题,对某三级甲等医院血液科2017年1-12月准备异基因造血干细胞移植急性白血病成人患者进行研究,按照随机数字表法将其分为观察组(n=34)和对照组(n=34),在实施干预过程中,对研究对象采取单盲法,观察组运用Orem自理模式进行自我护理,对照组则采用分级护理标准进行护理。现将造血干细胞移植极期不同护理方式的具体报道如下。

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