Application And Effect Evaluation Of Omaha System In Continuous Nursing Of Children's Primary Nephrotic Syndrome

Objective:To construct a continuing care model for children with primary nephrotic syndrome with the framework of Omaha system,analyze the nursing problems of PNS children at different stages after discharge,provide corresponding nursing interventions for different nursing problems,and evaluate the application effect of children with primary nephrotic syndrome after applying this mode.Meanwhile,a randomized controlled trial was conducted to explore the effect of continuous nursing mode based on the Omaha system for the recurrence rate and quality of life of PNS children at different stages after discharge.To demonstrate the effectiveness of the application of Omaha system in the continuous nursing of children with primary nephrotic syndrome.Method:80 cases of children with primary nephrotic syndrome treated from March2017 to December 2017 in Department of Pediatrics of the first hospital of Shanxi Medical University were selected by convenience sampling.It was divided into the control group(40 cases)and the intervention group(40 cases)by using the random digital table method.The normal health education before discharge and regular telephone follow-up after discharge were carried out in the control group.The intervention group was treated by the continuous nursing mode of children with primary nephrotic syndrome based on the Omaha system,and the nursing problems were evaluated,intervened and evaluated.The children were followed up at the end of 1 weeks,1 months and 3 months after discharge.The recurrence rate of children with primary nephrotic syndrome was evaluated by two groups of children with primary nephrotic syndrome at the 1 months,2 months and 3 months after discharge.The subjective quality of life of two groups of PNS children wasevaluated using the inventory of subjective life quality at 1 days before discharge and at the end of 3 months after discharge.Results:1.a total of 80 children with PNS were enrolled in the study,and 5 were withdrawn from the study for other reasons such as medical treatment in the field,and the loss rate was 6.25%.There were 37 children in the intervention group and38 in the control group.There was no statistically significant difference in baseline data between two groups of children in terms of sex,age,area,duration,family income,and only child(P>0.05).2.There were 215 nursing problems in the first stage(from the discharge to one week after discharge)of the children in the intervention group,of which the most common problem was in the psychosocial field(51.63%);there are 174 problems in the second stage(one week after discharge from discharge to one month after discharge),of which the most common problem was in the psychosocial field(43.10%);in third stages(one month to three months after discharg),there were181 nursing problems,of which the most common problem was in the physiological field(37.02%).3.There were 8 high-frequency nursing problems in children with PNS in the intervention group:care/parenting,social,mental health,urinary system,infection or infection,physical activity,nutrition,and drug treatment.The improvement of cognition,behavior,and status of the eight high-frequency nursing intervention outcomes were statistically significant(P<0.05);Compared with repeated measurements,there was a statistically significant difference in infection/infection between one week,one month and three months after discharge,compared with 1days before discharge(P<0.01),that was,the cognition,behavior,and status of infection/infection have been significantly improved.4.The recurrence rate of children with PNS in the intervention group within one month,one to two months,and two to three months after discharge was lower than that in the control group.At the same time,the total recurrence rate in the threemonths of the intervention group was 5.41%,which was significantly lower than the control group(26.32%).There was a statistically significant difference in the recurrence rate between the two groups of children after discharge for three months(P<0.05).5.The scores of each dimensionand total scores of subjective quality of life of the two groups of PNS children before the intervention were statistically analyzed and there was no statistically significant difference(P>0.05);the cognitive component score,emotional component score and total score of subjective quality of life of interventional group PNS children after 3 months of intervention were significantly higher than those of the control group,and the difference was statistically significant(P<0.01);there were statistically significant differences in family life,peer interaction,school life,self-knowledge,depression experience and body emotion scores in the 8 dimensions of the two groups of children(P<0.05);there was no significant difference in scores of living environment and anxiety experience(P>0.05).Conclusion:The use of the Omaha Problem Classification System to assess the nursing problem of children with PNS was more comprehensive,enable nurses to master the occurrence rules of nursing problems in all stages after discharge of PNS children,and make clear the direction and content of continuing nursing after discharge,which was helpful to make the continuous nursing scientific and accurate;using the Omaha Outcome Evaluation System to evaluate the effectiveness of nursing interventions could ensure the quality and effectiveness of continuous nursing in children with PNS;the adoption of PNS continuous nursing based on the Omaha system could effectively reduce the recurrence rate of children with PNS after discharge,and confirm that the PNS continuous nursing model based on the Omaha system could improve the subjective quality of life of children with PNS.It proved that the Omaha system was worthy of promotion in the clinical work of continuous nursing for children with PNS.