| 吴虹,葛兆霞,邓小岚.基于奥马哈框架的营养不良COPD患者干预模式临床应用[J].上海护理,2018,18(11): |
| 基于奥马哈框架的营养不良COPD患者干预模式临床应用 |
| Omaha system used in malnourished COPD patients |
| DOI： |
| 中文关键词: 奥马哈系统 营养不良 慢性阻塞性肺疾病 护理干预 微型营养评估量表 |
| 英文关键词:Omaha system Malnutrition COPD Nursing intervention The Mini Nutritional Assessment |
| 基金项目:南京市鼓楼医院院级课题 |
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| 中文摘要: |
| 目的：探讨奥马哈系统护理模式对营养不良慢性阻塞性肺疾病（chronic obstructive pulmonary diseases，COPD）患者营养状况的干预情况，观察营养状况对低体重COPD患者病情的影响。
方法：应用奥马哈系统回顾性分析COPD患者临床护理记录，采用Delphi专家咨询法构建COPD患者的奥马哈系统护理的问题体系及干预体系。选取2016年6月至2017年6月在某三甲医院就诊的营养不良COPD患者60例，同意加入研究后采用抽签法随机将60例患者分成实验组和对照组，每组各30例。对照组患者给予常规护理，实验组患者按照奥马哈系统护理模式进行营养干预。以微型营养评估量表(The Mini Nutritional Assessment,MNA)、慢性阻塞性肺疾病评估测试(COPD Assessment Test,CAT)、英国医学研究会呼吸困难量表(Modified Medical Research Councildyspneascale,MMRC)为奥马哈系统护理模式评价体系，记录两组患者入院时、出院后1个月、3个月、6个月MNA、CAT、MMRC评分变化情况，分析实验组和对照组各指标随时间变化情况，两组患者指标在不同时间点的差异性以及MNA评分与CAT、MMRC评分的相关关系。
结果：对两组患者年龄、性别、病程长短、一秒率差异无统计学意义(P>0.05)。实验组患者主要健康问题在环境领域、社会心理领域、生理领域、健康相关行为领域均有分布，其中以健康相关行为领域居多。对实验结果进行简单效应分析，两组患者CAT、MMRC、MNA量表评分在入院时与出院后1个月、出院后3个月、6个月差异均有统计学意义(P<0.05),干预方法和时间存在交互效应(P<0.05)，实验组与对照组之间各量表差异在入院时无统计学意义，在出院1个月、3个月、6个月相比有统计学意义(P<0.05)。pearson相关关系分析提示MNA评分与CAT、MMRC评分呈显著负相关（r=-0.493,r=-0.594；P<0.05）。结论：1、采用奥马哈系统护理模式对营养不良COPD患者进行营养干预，可以明显改善患者的营养情况，随着时间的进行营养改善更明显；2、MNA评分与CAT、MMRC评分呈负相关，提示奥马哈系统护理模式可以提高营养不良COPD患者生活质量及改善疾病病情。 |
| 英文摘要: |
| 【Abstract】 Objective: To investiage the effect of Omaha system used in malnourished COPD patients and the effect of nutritional status on tmalnourished COPD patients. Metods: Used Omaha system to analyse the clinical nursing records of patients with COPD and constructe the issue system and intervention system with Delphi expert consultation methods. From June 2016 to June 2017 in a third grade hospital , we randonly selected 30 malnourished COPD patients in research group and 30 malnourished COPD patients in control group with the method of lottery after they agreed to join the study. Patients in the control group were given routine nursing, and the research group were given nutritional intervention according to the mode of Omaha system. The Mini Nutritional Assessment,COPD Assessment Test,Modified Medical Research Councildyspneascale were considered to be evaluation system and they were recorded four times(on admission, 1 months after discharge, 3 months after discharge, 6 months after discharge).Analysing indexes of two groups were to investiage the difference with the change of time, the difference between the two groups of MNA,MMRC,CAT score at each time as well as the correlation between MNA score and cat, MMRC score.Results: Age, gender, duration of disease, FEV1/FVC was not difference in two groups. The major health problems of the patients in research group were in the field of environment, social psychology,the physiological field and the health related behaviors field,and most of the problem were in the field of health related behaviors. The CAT、MMRC、MNA scores on admission were different compared with the time of 1 months after discharge, 3 months after discharge, 6 months after discharge both in research group and control group(P<0.05).There existed interaction effect between intervention methods and time(P<0.05).Between two groups, the CAT、MMRC、MNA scores were no different on admission(P＞0.05),but the CAT、MMRC、MNA scores were different at the time of 1 months after discharge, 3 months after discharge, 6 months after discharge(P<0.05).Pearson correlation analysis showed that MNA score was significantly negatively correlated with CAT score and MMRC score（r=-0.493,r=-0.594；P<0.05）.Conclusion: 1,Omaha system nursing mode used in malnourished COPD patients can significantly improve their nutritional status and the nutritional status of them is better as time going on. 2,MNA score was significantly negatively correlated with CAT score and MMRC score, which means that Omaha system nursing model can improve the quality of life and the condition of disease in malnourished COPD patients. |
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