Study On Care Guidance Based On Omaha System In Discharged Patients With Cardiac Valve Replacement

Objectives:Based on nursing theories,the care mode was established according to Omaha System.In order to provide references for nursing care of patients with cardiac valve replacement after discharge,we analyzed main nursing problems and effectiveness of improvement.To explore the effect of improving quality of life after intervention,the Omaha system was used as the framework of the nursing model to guide cardiac valve replacement patients after discharge for 4 weeks.Methods:1.60 nurse visiting records of patients with cardiac valve replacement in 2016 were analyzed retrospectively to find out the conceptual congruence between it and the Omaha System.The data was chosen from a Third Grade Class A Hospital in Ji'nan.2.The care mode was developed according to the results of the secondary analysis data,the concept and framework of the Omaha System.Then the nursing assessment checklist of patients with cardiac valve replacement was made and constructed after consulting the suggestions proposed by experts.A total of 100 patients were selected from a Third Grade Class A Hospital in Ji'nan by convenient sampling method.The patients were randomly evenly divided into the intervention group and the control group,but there were 47 patients who finished the study in the intervention group and 48 patients in the control group.The intervention group were evaluated by the nursing assessment checklist before discharge.By analyzing the nursing problems of improvement results of patients' nursing problems were evaluated by applying the outcome evaluation guide.The quality of life of the two groups was evaluated before discharge and after the intervention using SF-36 V2 scale.3.All data were analyzed by SPSS 22.0 involving Descriptive Analysis,t-test,x2 test and Wilcoxon Rank Sum test.Results:1.Totally 105 sentences describing the patients' nursing problems,signs or symptoms in nurse visiting records match descriptions in the problem classification scheme of Omaha System,and is 91.4%of nurse visiting records.Totally 120 nursing interventions in nurse visiting records match those in the intervention scheme of Omaha System,and is 96.7%of nurse visiting records.The most common problems of the patients in the intervention group were related with the physiological domain,followed by the health-related behaviors domain and psychological domain.2.In the nursing assessment of patients with cardiac valve replacement in the intervention group,there were significant differences in all nursing outcomes(knowledge,behavior,status)(P<0.05).3.The score of quality of life and each dimension of patients with cardiac valve replacement in two groups after the intervention were significantly higher than before discharge(P<0.05).In addition to the two dimensions of general health and mental health,the scores of quality of life and each dimension of the intervention group were higher than that of the control group(P<0.05).Conclusions:1.The care model based on Omaha system can be applied to patients with cardiac valve replacement after discharge.2.The care mode based on Omaha System could improve the quality of life for patients with cardiac valve replacement.3.The care mode based on Omaha System could improve the effect of evaluation on knowledge,behavior and status by nurses.