梁艳芳

[摘要] 目的 分析Orem自理理论对胃溃疡患者心理状态与预后的影响。 方法 选择2015年10月～2017年10月南方医科大学附属小榄人民医院收治的120例胃溃疡患者，采用随机信封法分为观察组及对照组，每组各60例。对照组采用常规护理方案进行干预，观察组采用Orem自理理论指导的护理方案进行干预。护理后对患者的护理满意度进行评估，在护理前后使用自我护理能测量量表对患者自我护理能力进行评估；采用焦虑自评量表（SAS）及抑郁自评量表（SDS）对患者的焦虑及抑郁心理进行评估，比较两组的评估结果。 结果 护理后两组患者健康知识、自我概念、自护能力及自护责任感评分显著升高，且观察组各指标显著高于对照组，差异有统计学意义（P < 0.05）。护理后两组SAS及SDS评分均显著降低，且观察组明显低于对照组，差异有统计学意义（P < 0.05）。观察组满意度明显高于对照组，差异有统计学意义（P < 0.05）。 结论 胃溃疡患者采用Orem自理理论指导的护理模式干预下，可显著提高患者心理状态并改善预后质量，具有较广的临床应用价值。

[关键词] Orem自理理论；胃溃疡；心理状态；预后

[中图分类号] R473.5 [文献标识码] A [文章编号] 1673-7210（2018）04（a）-0174-04

[Abstracts] Objective To analyze the influence of psychological status and self-care ability after gastric ulcer patients treated with Orem self-care theory. Methods From October 2015 to October 2017， in Xiaolan People′s Hospital Affiliated to Southern Medical University， 120 gastric ulcer patients were selected， they were divided into observation group and control group by random envelope method， with 60 cases in each group. The control group was given routine nursing intervention program， the observation group was given Orem intervention programme self-care theory. The nursing satisfaction of patients was assessed before and after nursing， patients′ self-care ability was assessed by andusing self-nursing can scale； anxiety and depression of patients were assessed by the self-rating anxiety scale （SAS） and self-rating depression scale （SDS）. Results After the treatment， the health knowledge， self-concept， self-care ability and self-care responsibility score increased significantly in two groups， and the indexs in observation group were significantly higher than the control group， the differences were statistically significant （P < 0.05）. The SAS and SDS scores in two groups reduced after nursing， and the observation group was significantly lower than the control group， the differences were statistically significant （P < 0.05）. The satisfaction degree of the observation group was significantly higher than the control group， the differences were statistically significant （P < 0.05）. Conclusion Under the intervention of Orem self-care theory， the patients with gastric ulcer can significantly improve the psychological status and improve the quality of prognosis， it has a wide range of clinical application value.

[Key words] Orem self-care theory； Gastric ulcer； Psychological status； Prognosis

隨着社会的发展，人们的工作及生活压力也随之增加，且受不健康生活方式影响，导致胃溃疡的临床发病率逐年升高，逐渐呈现明显的低龄化趋势[1]。胃溃疡是临床中较为常见的消化道疾病，有研究指出，胃黏膜受胃部消化液侵蚀时导致胃溃疡发生的重要机制[2]。若胃溃疡患者不进行早期有效的治疗与干预致病情恶化，可能导致患者病情加剧，造成胃穿孔等严重不良后果[3]。有学者指出，胃部、食管及十二指肠是胃溃疡发生的主要部分，此外包括胃-空肠吻合口及Meckel憩室等含胃黏膜的部位也可能病发胃溃疡[4]。此外，药物、饮食、幽门螺杆菌感染、胃酸、应激精神因素、胃蛋白酶、胃运动异常、遗传因素等均为导致胃溃疡发生及发展的主要危险性因素[5]。……