以奥马哈系统为框架的延续护理在永久性结肠造口病人中的应用评价

目的:探讨应用奥马哈系统对永久性结肠造口病人实施延续护理的效果。方法:选取44例永久性结肠造口病人为研究对象，评估病人存在的护理问题，对病人给予常规出院指导和随访的基础上实施以奥马哈系统为框架的延续护理。观察病人出院当天、出院第7天、出院第2周、出院1个月及出院3个月延续护理问题的改善成效，从认知、行为、状况三个方面进行评价。结果:出院第7天与出院当天比较，病人除在心理社会领域中社交方面行为指标和角色改变方面行为、状态方面的差异，在健康相关行为领域中个人照顾和营养方面状态指标差异均无统计学意义（P>0.05）外，其他比较差异均有统计学意义（P<0.05~P<0.01）。出院第2周与出院第7天比较，病人在心理社会领域中社交方面知识、行为和状况三个指标比较差异均无统计学意义（P>0.05），在健康相关行为领域中睡眠和休息型态方面行为、状况和营养方面状况比较差异均无统计学意义（P>0.05），其他领域方面比较差异均有统计学意义（P<0.05~P<0.01）。出院1个月与出院第2周比较，在健康相关行为领域个人照顾行为指标和营养状态指标及生理领域行为和状况指标比较差异均无统计学意义（P>0.05）；出院3个月与出院1个月比较，在健康相关行为领域中睡眠和休息型态方面行为和营养方面状态及生理领域消化-水合行为指标差异均无统计学意义（P>0.05），其他领域方面比较差异均有统计学意义（P<0.05~P<0.01）。结论:奥马哈系统能够对永久性结肠造口病人延续护理问题提供全面评估，且能够对其延续护理问题提供全面的干预指引，同时以奥马哈系统为框架的延续护理能够改善永久性结肠造口病人主要护理结局。

The application value of the continuous care based on Omaha system in patients with permanent colostomy

Objective:To investigate the application value of continuous care based on Omaha system in patients with permanent colostomy.Methods:The nursing problems of 44 patients with permanent colostomy were evaluated,and the patients were continuously nursed with Omaha system on the basis of conventional discharge guidance and following up.The cognition,behavior and status at discharge,after 7 days,2 weeks,1 month and 3 months of discharge were evaluated.Results: Among the patients after 7 days of discharge,the differences in the psychological society field(including social behavior indicators,role transform and state aspect)and health-related behavior field(including personal care and nutrition)were not statistically significant(P>0.05),and the differences of other fields were statistically significant compared with discharge(P <0.05 to P <0.01).Among the patients after 2 weeks of discharge,the difference in the psychological society field(including knowledge,behavior and condition)was not statistically significant compared after 7 days of discharge(P>0.05),the difference in the health related field(including sleep and rest behavior,condition and nutrition)was not statistically significant(P>0.05),and the differences of other fields were statistically significant compared with after 2 weeks of discharge(P<0.05 to P<0.01).Among the patients after 1 month of discharge,the differences in the health related field(including personal care and nutrition)and physiological field(including behavior and condition)were not statistically significant compared with after 2 weeks of discharge(P>0.05).Among the patients after 3 months of discharge,the differences in health related field(including sleep and rest behavior and nutrition)and physiological field(digestion-hydratation)were notstatistically significant(P>0.05),and the differences of other fields were statistically significant compared with after 1 month of discharge(P<0.05 to P<0.01).Conclusions:The Omaha system can evaluate the continuous nursing problem,provide the comprehensive intervention guideline,and improve the main nursing outcomein patients with permanent colostomy.