摘要
目的评价Orem自理模式在老年髋部骨折患者中的应用效果。方法网络检索Medline、Embase、Web of Science、Cochrane图书馆资料库、万方、知网、维普、中国生物医学文献服务系统共8个数据库,搜集关于运用Orem自理模式用于老年髋部骨折患者的随机对照试验,检索时间从建库至2020年9月。由2名评价人员按照标准独立进行文献检索筛选、资料提取和文献质量评价后,采用RevMan 5.3软件对纳入文献进行Meta分析。结果共纳入11项随机对照研究,包括1088例研究对象。Meta分析结果显示,与常规护理模式相比,Orem自理模式能有效地降低住院期间并发症发生率(RR=0.26,95%CI 0.18~0.39,P<0.001)和提高患者髋关节功能评分(MD=13.33,95%CI 11.09~15.57,P<0.001);然而自理模式对于降低患者术后疼痛方面尚缺乏有力证据。此外,自理模式能缩短老年髋部骨折患者的住院时间,但由于相关研究间存在高度异质性,本研究尚无法对该效应量进行合并。结论与常规护理模式相比,Orem自理模式在缩短老年髋部骨折患者住院时间、降低并发症发生率和促进髋关节功能恢复方面具有更好的效果,但在患者疼痛管理方面并无显著优势,未来还有待多中心、大样本和高质量的随机对照试验对该指标予以进一步论证。
Objective To evaluate the effectiveness of Orem self-care model for elderly patients with hip fracture.Methods The databases including Medline,Embase,Web of Science,Cochrane Library Database,Wanfang,CNKI,VIP,and CMB were searched from inception to September 2020.All randomized controlled trials(RCTs)of the Orem self-care model applied in elderly patients with hip fracture were included.Two investigators independently screened research,extracted data and assessed the quality of literature based on standard methods.RevMan 5.3 software was performed to conduct the Meta-analysis.Results A total of 11 RCTs were included,involving 1088 patients.Compared with conventional nursing model,self-care model could effectively reduce the incidence of complications during hospitalization(RR=0.26,95%CI 0.18-0.39,P<0.001)and improve the Harris scores(MD=13.33,95%CI 11.09-15.57,P<0.001)of elderly patients with hip fracture.However,the impacts of self-care model on alleviating postoperative pain was still uncertain.Additionally,the self-care model could shorten hospital stay,but the combined effect size was unavailable due to the high heterogeneity between related studies.Conclusions In comparison with conventional nursing model,the Orem self-care model was more beneficial to shorten the hospitalization stay,reduce the incidence of postoperative complications and promote hip joint function of elderly patients with hip fractures.To confirm the effectiveness of self-care models in pain management for elderly patients with hip fractures,multicenter RCTs with high quality and large samples are needed.
作者
付丽萍
范俊瑶
赵慧敏
孔令璘
李节
王荃
Fu Liping;Fan Junyao;Zhao Huimin;Kong Linglin;Li Jie;Wang Quan(Orthopedics Department,Zhengzhou Orthopaedic Hospital,Henan Province,Zhengzhou 450052,China;School of Nursing,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《中国实用护理杂志》
2021年第29期2313-2320,F0003,共9页
Chinese Journal of Practical Nursing
