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目的探讨基于Orem理论的自我护理干预对恶性肿瘤患者自我护理能力的影响。方法选取2014年4月至2015年10月间华中科技大学同济医学院附属同济医院收治的148例接受化疗治疗的恶性肿瘤患者,采用随机数字表法分为试验组和对照组,每组74例。对照组患者采用常规护理,试验组患者在对照组基础上以Orem理论为框架进行自我护理干预。于干预前后采用自我管理效能感量表(C-SUPPH)和自我护理能力量表(ESCA)评价两组患者自我效能水平和自我护理能力,并调查两组患者的护理服务满意度。结果干预后,试验组患者C-SUPPH量表的自我减压、自我决策、正性态度得分及总得分均明显高于对照组患者,差异均有统计学意义(均P<0.05)。试验组患者ESCA量表的自我概念、自护责任感、自我护理技能得分及总得分均明显高于对照组患者,差异均有统计学意义(均P<0.05);健康知识水平得分组间比较,差异无统计学意义(P>0.05)。试验组患者护理满意度为94.6%(70/74),对照组患者为83.8%(62/74),组间比较,差异有统计学意义(P<0.05)。结论以Orem理论为框架进行自我护理干预,可显著提高恶性肿瘤化疗患者的自我效能水平和自我护理能力,利于提高护理满意度,值得临床推广。
Objective To investigate the effect of self-care intervention on self-care ability of patients with malignant tumor based on Orem theory. Methods From April 2014 to October 2015, 148 patients with malignant tumor treated with chemotherapy in Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology were divided into experimental group and control group by random number table method, with 74 cases in each group . Patients in the control group were treated with routine care. Patients in the test group were self-nursing interventions based on the Orem theory based on the control group. Before and after intervention, the self-efficacy and self-care ability of both groups were evaluated by C-SUPPH and ESCA, and the satisfaction of nursing service in both groups was investigated. Results After intervention, the C-SUPPH scale in the test group had significantly lower self-depressive, self-decision-making, positive attitude scores and total score than those in the control group (all P <0.05). The self-concept, self-care responsibility, self-care skills score and total score of ESCA in test group patients were significantly higher than those in control group (all P <0.05). Compared with the scores of health knowledge, The difference was not statistically significant (P> 0.05). The satisfaction rate of nursing in trial group was 94.6% (70/74), while that in control group was 83.8% (62/74). The difference between the two groups was statistically significant (P <0.05). Conclusion Orem theory as a framework for self-care intervention can significantly improve the patients with malignant tumor chemotherapy self-efficacy and self-care ability, which will help to improve nursing satisfaction, worthy of clinical promotion.