Orem自护理论在老年消化道肿瘤化疗病人中的应用

doi:10.3969/j.issn.1003-9198.2025.03.022

摘要/Abstract

摘要： 目的探讨Orem自护理论对老年消化道肿瘤化疗病人的自护能力、治疗依从性、心理状态、生活质量的影响。方法研究对象为住院化疗的老年消化道肿瘤病人,选取2023年1—8月收治的35例病人为对照组,2023年9月至2024年3月收治的35例病人为观察组。对照组接受常规护理干预,观察组在常规护理干预基础上接受Orem自护理论护理干预。比较2组间自护能力、治疗依从性、心理状态、生活质量的差异。结果干预后,2组自我护理能力测量量表评分、Frankl依从性量表评分、简明健康状况调查问卷评分均高于干预前,且观察组高于对照组(P＜0.05);2组抑郁自评量表评分和焦虑自评量表评分均低于干预前(P＜0.05),且观察组低于对照组(P＜0.05)。结论住院期间给予老年消化道肿瘤化疗的病人Orem自护理论护理干预,可提高病人的自护能力和治疗依从性,改善心理状态,提升生活质量。

关键词: Orem自护理论, 消化道肿瘤, 化疗, 自护能力, 治疗依从性, 心理状态, 生活质量

Abstract: Objective To explore the effects of Orem self-care theory on self-care ability, treatment compliance, mental state and quality of life in elderly patients with gastrointestinal cancer undergoing chemotherapy. Methods The elderly patients with gastrointestinal cancer who were hospitalized for chemotherapy were enrolled in this study. A total of 35 patients admitted from January to August 2023 were selected as the control group, and 35 patients admitted from September 2023 to March 2024 were selected as the observation group. The control group was given routine care, and the observation group was given Orem self-care theory on the basis of the control group. The self-care ability(exercise of self-care agency scale, ESCA), treatment compliance(Frankl compliance scale), mental state(self-rating anxiety scale, SAS; self-rating depression scale, SDS) and quality of life(short form heath survey, SF-36) of the two groups were compared. Results After intervention, the scores of ESCA, Frankl compliance scale and SF-36 in the two groups were higher than those before intervention, and the scores in the observation group were higher than those in the control group(P<0.05). The SAS and SDS scores in the two groups were lower than those before intervention(P<0.05), and those in the observation group were lower than those in the control group(P<0.05). Conclusions Orem self-care theory nursing intervention for elderly patients with gastrointestinal cancer undergoing chemotherapy during hospitalization may improve the self-care ability, treatment compliance, mental state and quality of the life of patients.

Key words: Orem self-care theory, gastrointestinal cancer, chemotherapy, self-care ability, treatment compliance, mental state, quality of life

中图分类号:

R 473.73

王蕾, 李晨, 管友文, 李雁飞. Orem自护理论在老年消化道肿瘤化疗病人中的应用[J]. 实用老年医学, 2025, 39(3): 312-316.

WANG Lei, LI Chen, GUAN Youwen, LI Yanfei. Application of Orem self-care theory in elderly patients with gastrointestinal cancer undergoing chemotherapy[J]. Practical Geriatrics, 2025, 39(3): 312-316.

参考文献

[1] 郑荣寿, 孙可欣, 张思维, 等. 2015年中国恶性肿瘤流行情况分析[J]. 中华肿瘤杂志, 2019, 41(1): 19-28.
[2] 张小敏, 程洁莲, 谭仕红, 等. Orem自护模式对慢性胃溃疡患者自护能力和生活质量的影响[J]. 中国医药导报, 2021, 18(8): 169-172.
[3] 吕春子, 朱丽瑜, 陈会容, 等. Orem自我护理模型在颈脊髓损伤截瘫患者术后康复中的应用[J]. 实用医学杂志, 2019, 35(11): 1841-1845.
[4] 骆东妹, 杨丹, 徐丽. Orem自理模式在肿瘤化疗患者中的应用[J]. 齐鲁护理杂志, 2019, 25(21): 10-12.
[5] 俞乐春, 唐仁兄. 基于叙事故事理论家属支持干预对老年胃癌化疗病人癌因性疲乏及生命质量的影响[J]. 实用老年医学, 2023, 37(10): 1072-1075.
[6] WONGC L, IPW Y, SHIUT Y. Translation and validation of the Chinese-Cantonese version of the exercise of self-care agency scale[J]. Int J Nurs Stud, 2012, 49(9): 1122-1137.
[7] 徐兴娜, 冯莉霞, 张蕾. Orem自理理论人文关怀的护理在胃癌化疗患者中的应用[J]. 护理实践与研究, 2023, 20(4): 579-583.
[8] 刘建敏, 苟瑞晨, 郭静, 等. 多样化护理模式在老年消化道肿瘤合并抑郁症患者中的应用[J]. 齐鲁护理杂志, 2021,27(15): 1-3.
[9] 董爱淑, 朱莲莲, 石博文, 等. 中文版SF-36 v2量表评价住院心房颤动患者生命质量的适用性研究[J]. 中国全科医学, 2015, 18(26): 3211-3215.
[10] 许焱, 李琳. 老年肿瘤患者化疗与营养状态的关系探讨[J]. 中华老年医学杂志, 2019, 38(10): 1185-1188.
[11] 魏柏, 陈景三, 张书勤, 等. 老年消化道恶性肿瘤患者心理障碍及相关因素Logistic分析[J]. 中国老年学杂志, 2012,32(7): 1466-1467.
[12] 杨利, 孔羽, 崔嬿嬿, 等. Orem自理模式对晚期肝癌患者心理负担、负性情绪、自理能力及生活质量的影响[J]. 癌症进展, 2021, 19(13): 1394-1398.
[13] 张丽, 王晓春. Orem自理护理模式对老年脑梗死患者认知功能及康复效果的影响[J]. 中华现代护理杂志, 2014, 49(3): 312-314.
[14] 邵冬梅, 于晓吉, 康春梅, 等. Orem自理理论在宫颈癌术后化疗患者护理中的应用[J]. 中国实用护理杂志, 2012, 28(6): 1-4.
[15] 常娜娜, 李金娣. Orem自理理论对胃癌化疗患者心理状况及生存质量的影响[J]. 山西医药杂志, 2020, 49(8): 1041-1044.