| ObjectiveIn the guidance of the Omaha system,with the reference to literature reviews,case reviews as well as the suggestions of specialists,the tumor patient PICC extended nursing mode has been constructed,and the main nursing problems during tumor patients indwelling PICC were analyzed and nursing intervention measures were given to improve the situation.During the process of tumor patients continuing care,the conditions are evaluated.This essay discussed the influence of Omaha system nursing outcomes of the knowledge,behavior,status of the tumor patientswith PICC and its influence to the self management ability.Methods(1)The writer had referred to literature reviews and case reviews in order to have a general understanding of the nursing problems,clinical symptom and nursing measures.With the suggestions of specialists,the author used the methods classification,intervention and outcome evaluation in Omaha system as the guidance of tumor patients PICC continuing nursing mode.(2)The research volunteers were selected from a general hospital Oncology department between February to December in 2017 and all conform to the experimentstandard and volunteered.The volunteers were divided into the experimental group(54 volunteers)and control group(53 volunteers).The Experimental group used the nursing mode guided by the Omaha system for continuous assessment and intervention research,collection and evaluation of knowledge,behavior and conditions of patients with PICC in different time.At the same time,the self-management capability of PICC in the experimental group and control group was investigated and analyzed.The evaluation times were the first day put in the indwelling needle,the first time of chemotherapy,the second time of chemotherapy,and the time.the third chemotherapy ends.(3)All data using SPSS 17.0 software to analysis and processing of the baseline data of patients with the composition ratio of statistical index system,using the chi-square test or Fisher's exact probability method for statistical analysis.The evaluation index of nursing outcome,patient self-nursing ability use mean standard deviation(X±s),evaluation index to compare different time using repetitive measure analysis of variance,selecting inspection level a = 0.05,P<0.05 for to guarantee the statistically significant.ResultsDue to the unplanned tube drawing,hospital transfer,death,etc.,the experimental group had 50 patients while 46 in the control group.(1)There are total 1060 nursing problems during the four evaluation times in the experimental group,in which social psychological problems contains most(39.15%),followed by health related behavior,physiology,environment,accounted for 36.13%,18.21%and 6.51%respectively:(2)Among the patients in the experimental group,health problems occurred in the environmental field was the most,with 26 cases and incidence of 52%,and the specific performance was poor personal hygiene.In the psychosocial areas,the mental health problems and its ignorance became the most frequent cases,48 cases accordingly,with the rate of 96%,and the specific performance were lethargy,emotional indifference,lack of necessary supervision and lack of care,etc;In the physiological field,the cases of infectioninfection was the most,with 49 cases and incidence of 98%,and the specific performance were low immunity and non-compliance with infection control scheme.In the health related behavior field,the problem of physical restriction was the most,with 50 cases,and incidence of 100%,and the specific performance were the reduce of self-control ability in daily life,lack of physical exercise with remaining needle as required,the lack of physical exercise plan and fixed position.(3)The health problems related of experimental group have improved accordingly to different degree in the field of knowledge,behavior,status during the.four evaluation times,which had a significant difference(P<0.05).The cognition and behavior of income problem were significantly improved(P<0.05).While statushad changed,there was no statistical difference(P>0.05).The knowledge,behavior and status in the field of community resources,social,role change,mental health and neglect in psychological society during the four evaluation times were improved significantly,the difference was statistically significant(P<0.05).The knowledge in physical field,the knowledge,behavior and status in the field of skin,nerve muscle,circulation and infection have been improved significantly,which was statistically significant(P<0.05).while the knowledge,behavior and status in pain problem have improved to some extent,there was no statistical difference(P>0.05).The knowledge,behavior and status have been improved greatly in the health-related field of physical activity,personal care,health care supervision,medical practice during the four evaluation times,which was statistically significant(P<0.05).(4)The experimental group was carried through the Omaha system while the control group was carried through the usual care.The ability of daily life and exercises with the indwelling needle,the daily catheter observation,catheter maintenance compliance,access of information of catheter,catheter exception handling,catheter management confidence,self-nursing scores grow with the time growth.The difference between time effect was statistically significant(P<0.05).In the end,the score of patients in the experimental group was higher than that in thecontrol group,and the difference between the groups was statistically significant(P<0.05).Conclusion(1)The Omaha system can be applied to the tumor patients with PICC continuing care.(2)The nursing mode based on Omaha system can improve the knowledge,behavior and status of nursing of the tumor patients in environmental domain.(3)The nursing mode based on Omaha system can improve the knowledge,behavior and status of nursing of the tumor patients in psychosocial domain.(4)The nursing mode based on Omaha system can improve the knowledge,behavior and status of nursing of the tumor patients in physiological domain..(5)The nursing mode based on Omaha system can improve the knowledge,behavior and status of the tumor patients in health-related domain.(6)The nursing mode based on Omaha system can improve the self-nursing ability of tumor patients with PICC. |
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