| Objective:Applying Omaha System to implementing extending nursing on patients undergoing anterior cruciate ligament reconstruction, in order to summarize nursing problems and interventions during the rehabilitation period,providing scientific theoretical and practical guidance for the rehabilitation of anterior cruciate ligament reconstruction.Methods:A total of 118 cases of patients undergoing anterior cruciate ligament reconstruction were randomly divided into the intervention group and the control group, 56 cases the intervention group and 62 cases in the control group. The control group received routine discharge guidance and follow-up, while the intervention group implement extending nursing based on Omaha System. According to the reference of the theoretical framework of the Omaha system, we establish the nursing assessment table about the patient undergoing anterior cruciate ligament reconstruction, the nursing problems and psychological needs were evaluated and analyzed in different stages from the day before discharge to 12 weeks after the surgery,then according to the reference of intervention direction in Omaha system,aiming at various problems of rehabilitation nursing intervention plan, Finally, we use Likert5 scale score to compare the effect of problems at different time points,and the differences of knowledge,behavior,status between the two groups. The rate of reaching the standard about range of motion(ROM) were recorded on the 2nd、4th、8th、12thweek after the surgery; the quadriceps atrophy index were calculated preoperatively and on the 4th、8th、12thweek postoperatively; the Lysholm scale and complications were used to measure the rehabilitation outcome preoperatively and on the 12 thweek postoperatively. All data were processed by SPSS 20.0 software and differences in measurement were compared with t-test data, Chi-Square test, The results from different times were analyzed with repeated measures analysis of variance.Results:(1) The problems were distributed mainly in the health-related behavior(44.13%) item and the physiological item(41.59%), and then were the social psychological item(8.89%)and environmental item(3.49%).(2) We analyze the 6 nursing problems occurred more than 30% of the ACLR patients in 12 w after surgery. There were significant differences in the score of knowledge, behavior,status, about problems of pain, neuro-musculo-skeletal function, personal care, and physical activity the intervention group(P<0.05).(3) There were significant differences in the score of knowledge, behavior, status, about the problems of pain, neuro-musculo-skeletal function, personal care, physical activity, sleep and rest patters(P<0.05) between the two groups.(4) There was significant statistical difference about the rate of reaching the standard of range of motion(ROM) between the two group at 8 and 12 weeks after surgery(P<0.05).(5) There was significant statistical difference about the quadriceps atrophy index at8and12 weeks after surgery, the intervention group were lower than the control group,(P<0.05).(6) The Lysholm score of the intervention group were significantly higher than the control group at 12 weeks postoperatively, there was statistically significant between the two groups(P<0.05).(7) There was no significant statistical difference between the two groups on postoperative complications.Conclusion:(1) Omaha System-based extending nursing can analyze the main nursing problems and provide standard guidance about recovery of ACLR patients in 12 weeks after surgery.(2) Omaha System-based extending nursing can raise the score of knowledge, behavior,status about the main nursing problems.(3) Omaha System-based extending nursing can improve the reaching standard rate of ROM and the Lysholm score, reduce the quadriceps atrophy index. |
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