Application And Evaluation Of Care Mode Based On Omaha System In Stroke Patients

Objectives:Based on Omaha System, the care mode was established according to nursing theoriesand expert consultation. In order to provide references for clinical care, we analyzed mainnursing problems and effectiveness of improvement. Effect of care mode based on OmahaSystem on life quality of stroke patients were studied.Methods:(1) A total of153clinical nursing records were selected from one three-A grade hospital byconvenient sampling method from in2010to in2013. The nursing records wereretrospectively classified and statistically analyzed by extracting the description of thepatients’ nursing problems, clinical signs and symptoms, and nursing cares. They were asitems analyzed.(2) The care mode was developed according to the results of the secondary analysis data,the concept and framework of the Omaha System, and the patients’ care needs and nursingpractice contents. Then care intervention mode was constructed after consulting thesuggestions proposed by experts.(3) A total of100stroke patients were selected from one three-A grade hospital byconvenient sampling method. The patients were randomly evenly divided into theintervention group and the control group, but there were47patients who finished the studyin the control group and48patients in the intervention group. The control group onlyreceived routine care, while the intervention group received the care mode based onOmaha System. The knowledge, behavior and status of nursing problems of the patients inthe intervention group were evaluated and scored before and after intervention. And thequality of life were evaluated using Stroke-Specific Quality of Life Scale at times ofadmission and the day before discharge.(4) All data were analyzed by SPSS13.0involving Descriptive Analysis, t test, χ2test andWilcoxon Rank Sum test. Results:(1)Among153stroke patients, there were1515nursing problems.The percentage ofpatients’ problems in the physiological domain were76%, the percentage of patientproblems in the health-related behaviors domain were20.2%, the percentage of patientproblems in the psychosocial domain were3.8%. The most frequent nursing interventioncategories were treatments and procedures, surveillance, which were according to nursingintervention targets were laboratory findings, medicalcare, medication administration,signs/symptoms-physical and specimen collection. There were15problems and27intervention targets which were not described in the records.(2) The Assessment scale based on the Omaha System was developed by Delphi Methodand detected the validity. The intervention program based on the Omaha System includingintervention targets and measures were constructed. Meanwhile, the evaluation example ofnursing outcomes was developed which by5-point Likert score from knowledge, behavior,status, and scores based on a simple example.(3) The most common problems of the patients in the intervention group were related withthe physiological domain, followed by the health-related behaviors domain, psychosocialdomain and environmental domain.(4) Twenty-seven nursing problems which occurred more than10%of the interventiongroup during hospitalization were analyzed. There were significant differences in allnursing outcomes(knowledge, behavior, status)(P<0.05) except of status of space in theenvironment domain; behavior and status of social contact and caretaking in thepsychosocial domain; status of cognition and behavior, status of hearing in thephysiological domain; status of substance use in the health-related behaviors domain.(5)In the intervention group, the total score of life quality of the patients and its otherdimensions including energy, family role, language, mobility, mood, self-care, thinking,upper extremity function were higher than the day of admission(P<0.05). Among them, thetotal score and scores of energy, family role, mobility, mood, self-care, upper extremityfunction were higher than the control group(P<0.05).Conclusions:(1) The care mode based on Omaha System could be used in clinical care for strokepatients.(2) The care mode based on Omaha System could improve the quality of life for strokepatients (3) The care mode based on Omaha System could improve the effect of evaluation onknowlwdge, behavior and status by nurses.