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Objective:To study the application effect of progressive case teaching based on Omaha system in practical teaching of geriatric nursing.Methods:A total of 84 college students nursing students of Beijing Chaoyang Hospital (West Branch) from June 2019 to October 2020 were selected as the research objects, and they were randomly divided into an observation group (conventional teaching) and a control group (progressive case teaching based on the Omaha system) in average. The clinical thinking ability of the two groups before and after teaching were compared, and the satisfaction of the two groups' teaching effect was compared. SPSS 22.0 was performed for chi-square test and independent sample t test. Results:After teaching, the critical thinking ability, systematic thinking ability, and evidence-based thinking ability of the observation group were significantly higher than those of the control group before and during the same period ( P<0.05). The teaching satisfaction of the observation group was significantly higher than that of the control group ( P<0.05). Conclusion:The progressive case teaching based on the Omaha system has a good application effect on the practical teaching of geriatric nursing, which can improve students' clinical thinking ability and increase teaching satisfaction.
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Objective:To explore the application of Omaha system-based specialized precise nursing intervention in patients with acute coronary syndrome (ACS).Methods:This study recruited 120 hospitalized patients with ACS in the Department of Cardiology, the First Affiliated Hospital of Xi′an Jiaotong University from June 2019 to December 2019. These patients were randomly allocated into the experimental ( n=60) or control group ( n=60) by using a random number table. Patients in the control group received routine care only, while those in the experimental group also received the Omaha system-based specialized precise nursing intervention. Results:After the intervention, compared with the control group, the score of cognitive and behavioral status in the experimental was significantly improved. In particular, the cognitive scores of pain, chest tightness, arrhythmia, hypertension, edema, dizziness, constipation, wound bleeding, swelling, fatigue, insomnia, diet, medication, smoking, drinking, overweight, exercise, mental stress, social regression, and awareness were significantly improved ( t values were 1.39-5.06, P<0.05). The behavioral scores of pain, chest tightness, arrhythmia, hypertension, edema, dizziness, constipation, wound bleeding, swelling, fatigue, diet, medication, overweight, exercise, mental stress, and social regression were significantly improved ( t values were 1.41-4.80, P<0.05). The fatigue, insomnia, exercise compliance, mental stress, and social regression were significantly improved ( t values were 1.44-4.27, P<0.05). Conclusions:Omaha system-based specialized precise nursing intervention can comprehensively evaluate the nursing problems of patients with ACS, can implement precision specialized nursing, can effectively solve the nursing problems of patients, and can promote the recovery of heart function and rehabilitation of patients with ACS.
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Objective@#To construct a nursing care service index system for postoperative ostomy patients with colorectal cancer based on Omaha system, which is used to guide nursing practice.@*Methods@#Using the Omaha system as the conceptual framework, using literature search method, expert group discussion, Delphi expert correspondence method, screening indicators to establish a system of postoperative care services for patients with colorectal cancer.@*Results@#The two rounds of expert letters asked that the effective recovery rate of the volume was 100%(28/28). The coefficient of expert authority of the two rounds of letters was 0.88 and 0.89 respectively, and the coordination coefficients of the expert opinions were 0.476 and 0.501 respectively. The finalized indicator system for care services includes 4 first-level indicators, 13 secondary indicators, and 61 third-level indicators.@*Conclusion@#The results of this study are scientific and reliable, and the formation of postoperative ostomy patients with colorectal cancerThe indicator system can provide a reference for clinical practice.
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Objective@#To construct a nursing intervention program for patients with coronary heart disease based on the theory of Omaha intervention system, and to provide evidence for the specialist nursing of patients with coronary heart disease.@*Methods@#Based on the Omaha intervention system, the specialist nursing intervention plan for patients with coronary heart disease was preliminarily established on the basis of reviewing the medical records, and was modified by the Delphi method.@*Results@#Reviewing the medical records combined with the Omaha intervention system, preliminary development of nursing intervention programs for patients with coronary heart disease. The expert inquiry letter of the intervention program was 2 rounds, and the expert positive coefficients of the 2 rounds of inquiry letters were 91.67% and 93.94%, the authoritative coefficient was 0.92, and the Kendall Harmony Coefficient was 0.34 and 0.47 respectively. The specialist nursing intervention for patients with coronary heart disease was finally determined.@*Conclusion@#The nursing intervention plan for patients with coronary heart disease based on Omaha theory has a good theoretical basis and has been unanimously recognized by experts.
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Objective To explore the effect of Omaha system nursing model on nutritional status and disease condition of patients with low body mass and chronic obstructive pulmonary disease (COPD). Methods Sixty COPD patients with low body mass who were admitted to the First Affiliated Hospital of Huzhou University from January 2015 to November 2016 were enrolled, and they were randomly divided into an Omaha system nursing model group and a routine care intervention group, with 30 cases in each group. The Delphi expert consultation method was used to construct the Omaha nursing problem system and intervention system for COPD patients with low body mass. The patients in the routine care intervention group were given routine care intervention; the patients in the Omaha system nursing model group underwent nutritional intervention according to the Omaha system nursing model. The Mini Nutritional Assessment (MNA), COPD Assessment Test (CAT) and the modified Medical Research Council Dyspnea Scale (mMRC) were used to be the evaluation system of the Omaha system nursing model, the changes of MNA, CAT and mMRC evaluation scores on admission and in 1, 3, and 6 months after discharge in the two groups were recorded, and the correlations between MNA score and CAT, mMRC scores were analyzed. Results Omaha system analysis showed that the main health problems of the Omaha system nursing model group were distributed in the environmental (17.86%), social psychological (8.93%), physiological (19.64%), and health-related behavioral (53.57%) aspects, among which health-related behaviors were mostly common. There were no statistical significant differences in the scores of CAT, mMRC, and MNA between the two groups on admission (all P > 0.05). The CAT and mMRC scores of the Omaha system nursing model group in 1, 3, and 6 months after discharge were significantly lower than those on admission (CAT score: 16.98±2.39, 16.67±2.55, 15.36±2.17 vs. 25.76±3.67; mMRC score: 2.35±0.57, 1.97±0.52, 1.49±0.51 vs. 3.07±0.55, all P < 0.05), MNA scores were significantly higher than those on admission (11.89±3.57, 13.97±3.52, 15.49±3.51 vs. 10.33±3.02, all P < 0.05), and along with the prolongation of time the decrease and increase in scores were more significant. The scores of the Omaha system nursing model group were improved more significantly in 1, 3 and 6 months after discharge than those of the routine care intervention group (CAT score: 16.98±2.39, 16.67±2.55, 15.36±2.17 vs. 23.01±2.67, 21.15±2.79, 19.06±2.61; mMRC score: 2.35±0.57, 1.97±0.52, 1.49±0.51 vs. 3.06±0.65, 3.06±0.61, 2.65±0.67;MNA score: 11.89±3.57, 13.97±3.52, 15.49±3.51 vs. 9.96±3.15, 10.06±3.09, 8.55±3.17, all P < 0.05]. Pearson correlation analyses showed that MNA score was significantly negatively correlated with CAT score (r = -0.493, P = 0.001) and with mMRC score (r = -0.594, P = 0.001) respectively. Conclusion Using the Omaha system nursing model for nutrition intervention in COPD patients with low body mass can significantly improve their nutritional status and disease condition as well as quality of life.
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Objective To explore the feasibility of applying Omaha system theory to patients with coronary heart disease (CHD) through comparative analysis of nursing description. Methods Using content extraction analysis method, the nursing records, nursing plans and nursing measures of discharged patients with CHD were retrieved from the medical records, and then the conceptual consistency of the extracted records and the problem classification system and intervention measures in the Omaha system were evaluated by cross mapping method. Results A total of 2 609 nursing problems and intervention measures were extracted from the medical records of 68 patients with CHD. Among them, 1 844 (70.68%) records were labeled as "perfect fit", 608 records (23.30% ) as "partial fit", and 157 (6.02% ) recordsas"not fit at all". The total fit rate was 93.98% (perfect fit and partial fit). The most frequently reported problems were in physiological domain, followed by health-related behaviors domain, psychosocial domain and environmental domain. The nursing interventions extracted accounted for 26.67% (1 968 sentences) of directions and l00.00% (4 kinds) of categories in the intervention scheme of Omaha system. Conclusions The conceptual congruence between the medical records of patients with CHD and the Omaha System is quite high. It can help to improve nursing problems of patients of CHD in health-related behavioral domain, psychosocial domain and environmental domain, and can be applied to such patients after appropriate adjustment, so as to help clinical nursing staff to provide specialized and all-round guidance for patients with CHD.
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Objective To develop a comprehensive services system of integrated home care for the elderly based on Omaha System. Methods The Omaha system was used to determine relevant indicators of the content of integrated home care services for the elderly, and identified through the Delphi expert consultation. Results After two rounds of expert correspondence consultation, the effective recovery rate of the questionnaire was 100.00%, the authoritative coefficient of the experts was 0.872 and 0.851, the variation coefficient of the first and second indexes in the second round of expert correspondence consultation was 0.00 to 0.28, The mean importance ratings ranged from 3.80 to 5.00 on a 5_point scale, and the full score was 33.33% to 100.00%. Finally, four first_level indicators including physiological field, social_psychological field, health_related behavior field, environmental field and other fields were established, as well as 43 second_level indicators. Conclusions The indicators related to the services system of integrated home care services for the elderly based on Omaha system are reliable and scientific, which can provide reference basis for further understanding the needs of the elderly of integrated home care services, improving the quality of medical care and old_age care services for the elderly.
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Objective To explore the effect of Omaha system combined with voice training in the treatment of patients with functional vocal dyspraxia caused by incomplete glottic closure. Methods From January 2017 to December 2017,eighty-eight patients with vocal dystonia due to glottic insufficiency who were treated in the Second Hospital of Shaoxing were randomly divided into control group and observation group by random number table method, with 44 cases in each group.The control group was treated with voice training.The observation group was given Omaha system measures on the basis of treatment in the control group.After 8 weeks,the therapeutic effects,GRBAS index scores,VHI scores,changes in acoustic parameters,and laryngoscope scores were compared between the two groups. Results After treatment,the total effective rate of the observation group (90.91% ) was significantly higher than that of the control group(59.09% ) (χ2 =9.317,P<0.05).After treatment,the scores of total deafness,roughness and other indicators were significantly reduced in both two groups,and the scores of GRBAS in the observation group were significantly lower than those in the control group(t=8.674,P<0.001;t=2.169,P=0.032;t=2.489,P=0.014;t=32.832,P<0.001;t=9.381,P<0.001).After treatment,the index scores and total VHI scores of both two groups were significantly decreased,and the scores of the observation group were significantly lower than those of the control group(t=2.222,P =0.028;t =3.144,P =0.002;t =2.003,P =0.048;t =5.763,P <0.001). After treatment,the maximum phonation time(MPT),basic frequency( Jitter),and lowest sound intensity( I-Low) were significantly reduced in the two groups, which in the observation group were significantly lower than those in the control group( t =4.037,P <0.001;t =4.789,P <0.001; t =4.717,P <0.001). The highest basic frequency (F0-High) and DSI index significantly increased in both two groups,which in the observation group were signifi-cantly higher than those in the control group(t=4.497,P<0.001;t=4.794,P<0.001).Conclusion The combi-nation of Omaha system measures and voice training can significantly improve functional vocal disturbances caused by glottic insufficiency,significantly improve the quality of patients＇voices,improve glottic closure,and contribute to the recovery of patients＇voices.It is worthy of promotion in clinical practice.
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Objective@#To explore the feasibility of applying Omaha system theory to patients with coronary heart disease (CHD) through comparative analysis of nursing description.@*Methods@#Using content extraction analysis method, the nursing records, nursing plans and nursing measures of discharged patients with CHD were retrieved from the medical records, and then the conceptual consistency of the extracted records and the problem classification system and intervention measures in the Omaha system were evaluated by cross mapping method.@*Results@#A total of 2 609 nursing problems and intervention measures were extracted from the medical records of 68 patients with CHD. Among them, 1 844 (70.68%) records were labeled as "perfect fit", 608 records (23.30%) as "partial fit", and 157 (6.02%) recordsas "not fit at all". The total fit rate was 93.98% (perfect fit and partial fit). The most frequently reported problems were in physiological domain, followed by health-related behaviors domain, psychosocial domain and environmental domain. The nursing interventions extracted accounted for 26.67% (1 968 sentences) of directions and l00.00% (4 kinds) of categories in the intervention scheme of Omaha system.@*Conclusions@#The conceptual congruence between the medical records of patients with CHD and the Omaha System is quite high. It can help to improve nursing problems of patients of CHD in health-related behavioral domain, psychosocial domain and environmental domain, and can be applied to such patients after appropriate adjustment, so as to help clinical nursing staff to provide specialized and all-round guidance for patients with CHD.
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Objective@#To develop a comprehensive services system of integrated home care for the elderly based on Omaha System.@*Methods@#The Omaha system was used to determine relevant indicators of the content of integrated home care services for the elderly, and identified through the Delphi expert consultation.@*Results@#After two rounds of expert correspondence consultation, the effective recovery rate of the questionnaire was 100.00%, the authoritative coefficient of the experts was 0.872 and 0.851, the variation coefficient of the first and second indexes in the second round of expert correspondence consultation was 0.00 to 0.28, The mean importance ratings ranged from 3.80 to 5.00 on a 5-point scale, and the full score was 33.33% to 100.00%. Finally, four first-level indicators including physiological field, social-psychological field, health-related behavior field, environmental field and other fields were established, as well as 43 second-level indicators.@*Conclusions@#The indicators related to the services system of integrated home care services for the elderly based on Omaha system are reliable and scientific, which can provide reference basis for further understanding the needs of the elderly of integrated home care services, improving the quality of medical care and old-age care services for the elderly.
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Objective Using Omaha system to construct continuing nursing assessment system in patients with cancer at the intermission of chemotherapy.Methods Based on the Omaha system as the theoretical basis,combined with literature review and semi structural interview,a preliminary construction of sensitive index system for continuous nursing of cancer patients was constructed,and the index system was deleted and supplemented through Delphi 2 rounds of expert consultation.Results The expert's positive coefficients of 2 rounds were 90.91%(20/22)and 16/18 respectively,authority coefficient were 0.839 and 0.853,generally coordination coefficients were 0.213 and 0.606 respectively.The continuing nursing assessment system in patients with cancer at intermission of chemotherapy was constructed containing 4 one-level indicators,24 secondary indicators and 71 third indicators.Conclusions The continuing nursing assessment system in patients with cancer at intermission of chemotherapy is analyzed by Delphi could comprehensively reflect characteristic of cancer patients'continue nursing demand.
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Objective To study the effect of application of continued nursing based on Omaha system to the patients with urinary artificial orifice. Methods Review 80 cases of patient who was performed with total cystectomy and permanent urinary artificial orifice at abdominal wall in our hospital from Jun,2015 to Nov,2016 were selected as object of study,they were divided into observation group and control group according to different nursing methods with 40 cases for each group.The control group was administrated with conventional nursing, the observation group was additionally administrated with continued nursing theoretically based on Omaha system.The quality of life,the nursing evaluation of the Omaha system and the satisfaction score of the 2 groups were compared. Results The patients in observation group evidently had higher scores 88.4±4.4,91.2±2.8,89.7±3.6,87.1±4.4,87.3±3.4 in terms of social function, cognitive function, emotional function, role function, physical function and overall health,than 81.3±2.5,81.2±3.4,80.1±4.1,81.2±3.5,80.2±2.6 in the control group,the differences were statistically significant (t=8.378 0-15.028 2, P<0.01); the patients in observation group had evidently a higher autonomous nursing score 92.11±4.64 and patient satisfaction 97.50%(39/40)than 75.09±6.93 and 82.50%(33/40)in control group did,the differences were statistically significant(t=7.281,χ2=6.504,P<0.01). Conclusion The nursing program theoretically based on Omaha system and designed for the patients with urinary artificial orifice can effectively improve the patient′s life quality and autonomous nursing ability,and the patients are highly satisfied by the nursing,which has a clinical significance.
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Objective To explore the clinical intervention effect of Omaha on chronic obstructive pulmonary disease(COPD)patients by comparing the routine nursing measures of COPD and the nursing measures under the Omaha management mode. Methods Using experimental design method research in Omaha based management system, according to the inclusion and exclusion criteria, 70 patients with COPD were collected, and they were divided into observation group and control group of 35 cases by random digits table method. The control group was received routine nursing measures of COPD and the observation group was accepted nursing measures under the Omaha management mode.The incidence rate of nursing problems before and after hospitalization was observed. The chronic obstructive pulmonary disease assessment(CAT)was used to evaluate the patient's disease status at admission,discharge and 1 month after discharge. Results The problems with the incidence rate of not less than 20% were analyzed statistically.Except the role change,mental status,social status,skin,eyesight,substance abuse have no significant difference (P>0.05), the others were statistically significant (t =4.158-55.940, P <0.05).There was no significant difference in CAT score at admission,discharge between two groups(P>0.05). CAT score was (18.14 ± 1.01) points at 1 month after discharge in observation group and (20.17 ± 1.41) points in control group, the difference was statistically significant(t =6.890, P<0.05). Conclusions The application of nursing intervention in patients with COPD of the Omaha system, can achieve improving disease in patients with COPD,and make it easier for the patient's disease level of long-term stability,to provide new ideas and directions for further adjuvant therapy COPD.
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Objective To discuss the clinical application value of Omaha system-based targeting nursing care for patients with hepatocellular carcinoma (HCC) who were treated with transcatheter arterial chemoembolization (TACE).Methods A total of 60 advanced HCC patients,who were planned to receive TACE,were prospectively and randomly divided into the control group (n=30) and the observation group (n=30).Routine nursing mode was adopted for the patients in the control group,while Omaha system nursing model was employed for the patients in the observation group.The patients of the observation group were evaluated with Omaha system at the time of admission,the key common problems were screened out and targeted nursing measures were employed.Meanwhile,on the days of admission and discharge all the patients of both groups were asked to fill in the forms of Hamilton depression scale (HAMD-17),Hamilton anxiety scale (HAMA),social support rating scale (SSQ) and numerical pain rating scale (NRS);and the degrees of depression,anxiety,social support and pain were respectively assessed.Results Both nursing modes could improve the degrees of depression and anxiety as well as the social support system of HCC patients,but the curative effect of these two aspects in the observation group were obviously better than those in the control group (P＜0.05).No statistically significant difference in the improvement of pain degree existed between the two nursing models,but Omaha system-based targeting nursing mode could alleviate the patient's pain to a certain extent.Conclusion For patients with advanced HCC,Omaha system-based targeting nursing care can alleviate the patient's negative emotion and promote the patients to establish effective social support system,this nursing mode is superior to conventional nursing mode.Therefore,Omaha system-based targeting nursing has great application potential in clinical practice.
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Objective To investigate the effect of Omaha system on the self-management ability of patients with glaucoma after discharge, so as to provide evidence for the further development of glaucoma. Methods A total of 86 cases of glaucoma patients were divided into control group and observation group, each group of 43 cases, the control group was given routine discharge guidance and follow-up,the observation group was given continuous nursing care based on the Omaha system.The two groups of patients before and after the discharge of the last 3 days and the end of the 2 months of self-management ability score. Results There was no statistical significance in the life adjustment, functional health care,medical management of diseases level of 3 d before discharge from the hospital(P>0.05).The life adjustment,medical management of diseases level was(8.73±2.51),(20.86±1.55)points at 2 months after discharge in control group,which was higher than that at 3 d before discharge(6.07±1.62), (16.11 ± 3.35) points,there was significant difference(t=2.127, 2.867,P<0.05). The life adjustment, functional health care,medical management of diseases level was(11.25±1.48),(20.78±2.61),(26.74±1.26) points at 2 months after discharge in observation group,which was higher than that at 3 d before discharge (6.12±1.71),(13.62±3.22),(16.04±2.78)points,there was significant difference(t=4.215,3.544,5.328,P<0.05).There was significant difference in the life adjustment,functional health care,medical management of diseases level of 2 months after discharge between two groups (t=2.074, 4.064, 4.878, P<0.05). Conclusions Continuous care based on the Omaha system can improve the life management,functional health care,medical management and general self-management ability of patients with glaucoma.
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Objective To construct clinical nursing pathway for patients with laparoscopic cholecystectomy surgery in acute cholecystitis stage, and to provide standardized nursing service. Methods With case record and literature review as theoretical basis, Omaha System as frame, clinical nursing pathway with patient centered was developed through analysis of main nursing problem and intervention. Results Omaha System oriented clinical nursing pathway was constructed in different stages of Laparoscopic cholecystectomy surgery with acute calculous cholecystitis. Conclusions Combined standardized nursing language and nursing process, clinical nursing pathway based on Omaha system provide practicability nursing plan in different stage regarding time as the coordinate axle. It contains assessment, problem, intervention and outcome evaluation indexed, which is beneficial to improve nursing quality.
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Objective To explore the assessment and intervention categorized for patients with permanent colostomy′s continue nursing problem based on the Omaha system. Methods Developing permanent colostomy′s continue nursing problem assessment form in the framework of Omaha system, using this assessment form to evaluate 46 patients′continue nursing problem and choose appropriate interventions. Results A total of 46 patients on the day of discharge had a total of 260 continue nursing problems. There were 5.7 nursing problems averagely for every patient. Incidence of more than 50%of the nursing problems had personal care, role change, mental health, sleep and rest, digestion- hydration and social; potential continue nursing problems was 90. There were 1.97 nursing problems averagely for every patient. The main potential continue nursing problems were two, respectively was colostomy complications and colostomy surrounding skin complications. Continue nursing intervention had a total of 727. There were 15.8 continue nursing interventions averagely for every patient. The most frequent interventions were for physiological and psychosocial domain. Conclusions Omaha Question Classification System can fully assess permanent colostomy′s continue nursing problem andset corresponding nursing intervention strategiesaccording to Omaha intervention system. More attention should be paid to psychosocial and health-related behavior problem. The most frequent interventions were health education, guidance, counseling and monitoring.
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Objective To explore the construction and application effects of extended care form for children with epilepsy based on Omaha System.Methods Based on Omaha System,the form was established by referring medical records,literature review and three rounds of focus group discussion.From February to June,2016,48 children with epilepsy were selected as the observation group and received routine care as well as management using the form based on Omaha System;from August to December,2015,48 children with epilepsy were selected as the control group and received routine care and follow-up.The effects of intervention and scores of Family Management Measure were compared between two groups.Results Nursing issues in all domains for the observation group 3 months after intervention were lower than those during hospitalization except financial situation (P＜0.05);there was statistically significant difference in scores of knowledge-behavior-status of main nursing issues before and after intervention except cognition and mental health items (P＜0.05).Duration of hospitalization,expenditure,readmission rate,EEG results and scores of FAMM in the observation group were better than those in the control group (P＜0.05).Conclusion The construction and application of the form based on Omaha System can provide references for longterm management for children.
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Objective To evaluate the effect about medication compliance for patients with chronic heart failure in outpatients using nursing intervention model based on Omaha system.Methods 100 patients were randomly divided into observation group(50 patients)and control group(50 patients).The two groups of patients were given routine nursing intervention,the observation group also used the Omaha system to develop care programs on this basis, and was given the implementation about continuity of care.Results On the point of the two or three months after the patients were discharged,the AHFKT -V2 questionnaire scores in the observation group[(17.690 ±1.892)points, (20.900 ±2.052)points]were significantly higher than the control group[(14.080 ±2.374)points,(18.450 ± 1.781)points],the differences were statistically significant (t =-8.488,-6.442,all P <0.05).However,the same as the points after the patients were discharged,Morisky questionnaire scores in the observation group[(1.036 ± 0.780)points,(0.487 ±0.260)points]were significantly lower than the control group[(1.54 ±1.182)points, (0.920 ±0.804)points],the differences were statistically significant(t =3.420,4.965,all P <0.05).Conclusion The use of Omaha system to develop the targeted continuity of care,can improve the patients medication compliance.
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Objective To investigate the current situation of nursing research based on Omaha system in China. Methods All the nursing research based on Omaha System were retrieved and collected by using China National Knowledge Infrastructure, Wanfang database and VIP database, NoteExpress software for the management of documents was used. Based on the classification of nursing research literature, a content analysis of system analysis model analyzed the documents had been retrieved. Results Sixty-four pieces of literature were included, and thirteen categories system were formed. The transverse reliability coefficient of all kinds of system were 0.940-1.000, the longitudinal reliability coefficient were 0.658-1.000. Conclusions The study of nursing research based on Omaha system in China is booming, which is also facing challenges, and has a broad space for exploration.