Orem自理模式在首次脑梗死后认知功能障碍患者中的应用.docVIP

文章编号：w1107146（重修稿） Orem自理模式在首次脑梗死后认知功能障碍患者中的应用 陆兰芳 江苏省张家港市中医医院 215600 摘要 目的 探讨Orem自理模式在首次脑梗死后认知功能障碍患者中的应用。 方法 将64例首次脑梗死后发生认知功能障碍的患者随机分为观察组34例和对照组30例，对照组采用传统的脑梗死常规护理措施，观察组应用 Orem自理模式贯穿于常规护理全过程。用蒙特利尔认知评估量表（Montreal Cognitive Assessment, MOCA）对两组患者在入院时和护理实施后30天各评估一次认知功能。结果 护理实施30天后两组患者的认知功能均有提高，但试验组的改善程度明显高于对照组，差异具有统计学意义 (P 0.05)。结论 Orem自理模式对首次脑梗死后发生认知功能障碍的患者的认知能力的恢复起到了积极的作用，值得在临床护理工作中广泛开展。 关键词 Orem自理模式；脑梗死；认知功能障碍；护理 Application of Orem Self-care Model for the Cognitive Impairment Patients Secondary to First Cerebral Infarction Lu Lanfang Zhangjiagang Traditional Chinese Medicine Hospital JiangSu 215600 Abstract: Objective　To study the application of Orem Self-care Model for the cognitive impairment patients secondary to first cerebral infarction. Methods 64 cognitive impairment patients secondary to first cerebral infarction were randomly divided into experiment group (34) and control group(30), the former were cared by Orem Self-care Model nursing, and the latter by conventional nursing. Montreal Cognitive Assessment(MOCA) score of patients in two groups were respectively evaluated in hospitalization and 30 days after nursing. Results Both groups showed improvement in MCOA score 30 days after nursing, but the score of experiment group increased higher than that of the control group, and the difference had the statistical significance(P0.05). Conclusion　Application of Orem Self-care Model in cognitive impairment patients secondary to first cerebral infarction can obviously improve their cognitive function,and was worth carrying out in clinical nursing work extensively. Key words Orem Self-care Model; Cognitive Impairment; Cerebral Infarction; Nursing 有研究[1]显示，高达64﹪的脑卒中患者存在某种程度的认知障碍，约有1/3的患者会发展成明确的痴呆。但大多数患者确诊为痴呆时认知障碍已很严重，失去了二级预防和治疗的最佳时期。因此，重视首次脑卒中后患者的认知功能受损情况，早期行有效的治疗和康复，对防止认知功能进一步下降有着重要的临床意义。Orem 自理理论是由美国护理学家Dorothea．E．Orem 于 1971 年首次提出，并由此产生了3 种护理系统：完全补偿系统、部分补偿系统、支持教育系统[2,3]，这为临床护理提供了良好的理论依据。我们对2008年1月~2011年6月在我院住院的首次脑梗死后认知障碍患者34例应用Orem自理模式，结果该组患者认知能力较