The Application Of Continuing Care Based On Omaha System In Discharged Patients With Aortic Dissection

Objectives:To evaluate the status quo of quality of life and existing nursing problems of patients after aortic dissection by investigating the quality of life and self-care ability in patients with aortic dissection in three years,and to construct a continuing nursing mode based on Omaha system for the patients with aortic dissection and analyze the nursing outcome and the improvement effect of quality of life after intervention for providing basic reference in clinical application.Methods:(1)A total of 186 patients with aortic dissection,who were from a comprehensive tertiary hospital in Hengyang,from January 1,2015 to November 30,2017,were investigated their quality of life and self-care ability in three years by random sampling using general information questionnaire,short scale of quality of life(SF-8),and self-care ability scale(ESCA).(2)On the basis of previous research and literature review,combined with expert consultation,“a continuing nursing model for patients discharged after aortic endovascular isolation(trial)”was established.(3)Seventy-two patients,who were from a comprehensive tertiary hospital in Hengyang and were undergone endovascular aortic isolation from January 1,2018 to October 31,2018,were randomly evenly divided into the control group(N=36)and the intervention group(N=36).The patients in the control group were given routine discharge guidance,and the patients in the intervention group were given continuing nursing model based on Omaha system.At the end of the twelfth week,SF-8 scale and Omaha outcome evaluation system were used to evaluate the quality of life and cognitive(K),behavioral(B)and state(S)of the patients.There were 34 patients in the control group and 35 patients in the intervention group who finished the test.(4)SPSS20.0 software was used to analyze the data.The composition ratio or percentage was used to describe the data.The results were evaluated by repeated variance analysis,independent sample t test and Wilcoxon rank sum test.The admission criteria were alpha=0.05,P<0.05,and the difference was statistically significant.Results:(1)The total average score of the quality of life in the patients after aortic dissection was(74.40±15.28).The results showed that there were significant differences in gender,age,education level,operation method,time after operation,complications and hospitalization time(P<0.05).Multiple stepwise regression analysis showed that the factors influencing the quality of life in the patients after operation included self-care ability,hospitalization days and age(P<0.05).(2)The expert authority coefficient of“the Continuous Nursing Record Form after Endovascular Aortic Isolation(trial)”was 0.791.The first and the second Kendall's W were 0.687 and 0.746,respectively.(3)The results of repeated variance analysis for the patients in the intervention group showed that there were no significant differences for their sexual behavior,pain status,and substance abuse(P>0.05);there were significant differences in other nursing problems in the cognitive,behavioral and state of other nursing problems(P<0.05).(4)At the end of the 12~thh week,there were significant differences compared the total score of SF-8,general self-assessment of health,physical activity function,vitality,social function,psychological function,and effect of emotion on the role function between two groups(P<0.05);there were no significant differences compared effect of physical activity function on the role function and pain status between two groups(P>0.05).Conclusions:(1)The quality of life in the patients with aortic dissection in three years was at a moderate level.(2)Continuous nursing based on Omaha system for the patients after endovascular aortic isolation may improve their nursing outcome.(3)Continuous nursing based on Omaha system may enhance the quality of life in the patients after endovascular aortic isolation.