邹艳辉 段红梅 陈芳 董晓燕

【摘要】 目的：探究采用Orem自理理论的康复护理指导对脑梗死偏瘫患者日常自理能力和焦虑情绪的影响。方法：选取2017年9月-2018年9月笔者所在科室收治的464例脑梗死偏瘫患者，随机分为观察组和对照组，分别为233例和231例。对照组予以常规护理，观察组在常规护理基础上予以基于Orem自理理论的康复护理，对两组肌力、失语功能进行评定，采用焦虑自评量表（SAS）、日常生活指数（ADL）评定脑梗死偏瘫患者的焦虑程度、自理能力并进行比较。结果：护理后，观察组肌力和失语功能恢复情况均优于对照组，SAS评分显著低于对照组，ADL评分显著高于对照组，差异均有统计学意义（P<0.05）。结论：将Orem自理理论的康复护理应用于脑梗死偏瘫患者的护理中，能明显提高患者的日常自理能力，并使焦虑情绪显著缓解，从而使生活质量得到提高。

【关键词】 Orem自理理论 脑梗死 偏瘫 日常自理能力 焦虑情绪

doi：10.14033/j.cnki.cfmr.2019.30.050 文献标识码 B 文章编号 1674-6805（2019）30-0-03

[Abstract] Objective： To explore the effect of rehabilitation nursing guidance based on Orem self-care theory on daily self-care ability and anxiety of hemiplegic patients with cerebral infarction. Method： A total of 464 hemiplegic patients with cerebral infarction admitted to our department from September 2017 to September 2018 were randomly divided into the observation group and the control group， 233 cases and 231 cases respectively. The control group was given routine nursing， while the observation group was given rehabilitation nursing guidance based on Orem self-care theory on the basis of routine nursing. The muscle strength and aphasia function of the two groups were evaluated. Self-rating anxiety scale （SAS） and activities of daily living （ADL） were used to assess the anxiety degree and self-care ability of hemiplegic patients with cerebral infarction. Result： After nursing， the recovery of muscle strength and aphasia function in the observation group were better than those of the control group， and the SAS score was significantly lower than that of the control group， and the ADL score was significantly higher than that of the control group， and the differences were statistically significant （P<0.05）. Conclusion： Rehabilitation nursing guidance based on Orem self-care theory applied to hemiplegic patients with cerebral infarction can significantly improve the daily self-care ability of patients， and make the anxiety significantly relieved， thereby improving quality of life.

[Key words] Orem self-care theory Cerebral infarction Hemiplegia Daily self-care ability Anxiety

First-authors address： Shenzhen Nanshan Peoples Hospital， Shenzhen 518052， China

腦梗死是严重的脑血管疾病，受我国人口老龄化加剧等多种因素影响，发病率明显上升。我国脑卒中致残率高达83%，其中15%的患者日常生活不能自理，造成不同程度的焦虑状态，日常生活活动能力显著降低[1]。传统的脑梗死护理为单纯为患者提供最基础的护理[2-3]，不能够使患者的日常生活能力提高及焦虑心态改善。因此，本文旨在探究采用Orem自理理论的康复护理指导对脑梗死偏瘫患者日常自理能力和焦虑情绪的影响。

1 资料与方法

1.1 一般资料

选取笔者所在医院2017年9月-2018年9月脑梗死偏瘫患者464例。纳入标准：（1）符合脑梗死临床诊断标准，并经MRI等影像学检查确诊，且存在肢体功能障碍;（2）格拉斯哥昏迷评分法（GCS）评分≥9分;（3）家住市区，能随访。……