| Objective:Using the nursing language Omaha system as a framework,the concept of medical records of patients with Omaha system and salivary gland tumor surgery was explored.The main nursing problems in the records of surgical records of patients with salivary gland tumors were sorted out,and the nursing intervention model for patients with salivary gland tumor surgery was designed.This intervention model was applied to the nursing of patients with salivary gland tumor surgery,and the nursing effect of this model in clinical practice was analyzed.Methods:(1)Facilitating the extraction of the maxillofacial surgery of the Affiliated Hospital of Guizhou Medical University and the maxillofacial surgery of the Guiyang Stomatological Hospital.From August 2015 to August 2016,medical records of patients with salivary gland tumors were collected.A total of 118 medical records were collected and analyzed by the content method.The cross-mapping method was used to analyze the symptoms,interventions and nursing records of the Omaha system,and the similarities between the perioperative care contents of the patients with Omaha and salivary gland tumors were obtained;(2)The research team used Delphi method to establish interventions.Evaluation form:E-mail-based,telephone-assisted form of the questionnaire sent to the experts,issued at the same time to tell the experts the background and purpose of the study,experts asked to judge the initial intervention content,if not agree Write the reason,the supplementary content is written in the supplementary column,in this way after repeated consultation,consultation,induction,modification;(3)Omaha system in salivary gland tumor surgery patient care empirical research:(1)randomly selected Guizhou medical science University Hospital Affiliated Hospital of Maxillofacial Surgery November 2016-November 2017 98 patients with salivary gland tumor surgery,using a random number table Methods were divided into control group and intervention group;(2)The control group was given routine nursing care.Baseline data were collected at admission,preoperative and postoperative anxiety questionnaires(SAI),postoperative day 1 and day 3 pain scales,and a care satisfaction survey was completed at discharge.Baseline data of patients in the intervention group were collected at the time of admission.The contents of the intervention model scales were used to evaluate nursing.Preoperative and postoperative anxiety questionnaires(SAI)were filled in.Pain scales were filled on the first and third postoperative days.Nursing satisfaction survey was conducted to assess the cognitive KBS of the Omaha system on the day before and after discharge.(3)Analyzed and compared the differences in scores between the two groups;(4)Using SPSS22.0 software,measurement data for the mean,standard deviation,and normality test and homogeneity of variance test,two independent samples with t Before and after the intervention,a paired t-test was used.The count data were compared with thex~2 test,frequency,and percentage to compare the differences between the intervention group and the control group(the test significance level was P<0.05).RESULTS:(1)After repeated comparisons and classifications,the study members discussed that the perioperative medical history of surgical patients with salivary gland tumors was consistent with the Omaha problem system and the intervention system,and the researchers'consistency of the results of the study was the kappa coefficient.The value,the problem system is:0.712,the intervention system is:0.765.A total of 2,546 nursing records were collected,1,220 were in the problem classification section,and there were 1,326 interventions,of which 89(7.3%)and 146(non-compliance)Omaha problem classification systems and intervention systems were 11.01%).In the records of 118 cases of salivary gland tumors,64.43%were completely consistent with the Omaha problem system,some of which were 28.28%,and 7.3%were unsatisfactory;71.07%were completely consistent with the intervention system.17.92%partially matched,accounting for 11.01%;(2)After two rounds of expert interrogation,the questionnaires for patients undergoing surgery for salivary gland tumors were designed using the Omaha system problem classification section and intervention measures.For 15,the query volume recovery rate was 100.0%and 100.0%,respectively,and the authority coefficients of experts were 0.853 and 0.871,respectively.The degree of expert coordination was 0.382 and0.414,respectively,all with statistical significance(P<0.05);A guidance intervention program based on the Omaha system.Through clinical empirical studies,the use of Omaha evaluation system to evaluate the KBS score before and after intervention intervention group was statistically significant(P<0.05),the preoperative anxiety scale(SAI)score between the two groups was not statistically significant(t=2.675,P>0.05),Postoperative Anxiety Scale(SAI)scores were statistically significant(t=-12.896,P<0.05),postoperative pain scale was statistically significant on the first day(t=-3.765,P<0.05),there was a statistically significant difference between the groups on the third day(t=-6.045,P<0.05).There was a statistically significant difference in nursing satisfaction when discharged(x~2=16.92,P<0.05).Conclusions:(1)In this study,the Omaha system problems and the two parts of the intervention are in good agreement with the nursing records of salivary gland tumor surgery patients.It can be used as the standard nursing language for patients with salivary gland tumors during perioperative period,and is used for clinical nursing work.(2)The assessment table for patients undergoing salivary gland tumor surgery made by the Delphi method can be used as a reference for clinical practice work,to guide the nursing work,and to comprehensively evaluate patients from the aspects of environment,physiology,psychosocial and health behaviors.The existing problems,then improve the quality of care,and promote the recovery of patients;(3)Through clinical practice research,Omaha system as a standard care language,suitable for clinical care of patients with salivary gland tumor surgery. |
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