The application of clinical effects of empowerment education based on Omaha system on the self-management behaviors of cirrhosis patients
基于奥马哈系统的赋能教育对肝硬化患者自我管理行为的临床效果研究

摘要

目的 探讨基于奥马哈系统构建的全面评价表与赋能教育记录表对提升肝硬化患者自我管理行为及自我效能的有效性。方法 采用前瞻性随机对照试验设计，于2024年1月至12月便利选取我院120例肝硬化患者，采用随机数字表法分为干预组与对照组，每组60例。对照组接受常规健康教育，干预组在常规基础上，实施基于奥马哈系统的赋能教育，该干预贯穿入院至出院后随访。分别于干预前、出院时、出院后1个月和3个月，采用肝硬化患者自我管理行为量表和慢性病管理自我效能量表进行评价。结果 重复测量方差分析显示，组别与时间交互作用显著（P<0.01）。干预后，干预组自我管理行为总分在出院时、出院后1个月和3个月均显著高于对照组（分别为78.9±9.2 vs 68.5±8.4; 85.3±8.1 vs 70.1±9.3 ; 87.6±7.5 vs 66.8±8.9，P<0.001）。出院后3个月，干预组症状管理自我效能（7.8±1.2 vs 5.9±1.5, P<0.001）与疾病共性管理自我效能（8.2±1.1 vs 6.1±1.4, P<0.001）亦显著优于对照组。结论 基于奥马哈系统的赋能教育能有效且持续地改善肝硬化患者的自我管理行为并提升其自我效能感，是一种科学、有效的临床护理干预模式，值得推广。

Abstract

Objective To explore the effectiveness of a comprehensive evaluation form and empowerment education record form based on the Omaha System in improving self-management behaviors and self-efficacy among patients with liver cirrhosis.
Methods A prospective randomized controlled trial was conducted from January to December 2024. A total of 120 patients with liver cirrhosis were conveniently selected from our hospital and randomly divided into an intervention group and a control group using a random number table, with 60 patients in each group. The control group received routine health education, while the intervention group received empowerment education based on the Omaha System in addition to routine care, which was implemented from admission to post-discharge follow-up. The Self-Management Behavior Scale for Liver Cirrhosis Patients and the Chronic Disease Management Self-Efficacy Scale were used for evaluation before the intervention, at discharge, and 1 and 3 months after discharge.
Results Repeated measures ANOVA showed a significant interaction between group and time (P < 0.01). After the intervention, the total score of self-management behavior in the intervention group was significantly higher than that in the control group at discharge, 1 month after discharge, and 3 months after discharge (78.9 ± 9.2 vs 68.5 ± 8.4; 85.3 ± 8.1 vs 70.1 ± 9.3; 87.6 ± 7.5 vs 66.8 ± 8.9, P < 0.001). At 3 months after discharge, the intervention group also had significantly higher self-efficacy in symptom management (7.8 ± 1.2 vs 5.9 ± 1.5, P < 0.001) and common disease management (8.2 ± 1.1 vs 6.1 ± 1.4, P < 0.001) than the control group.
Conclusion   Empowerment education based on the Omaha System can effectively and sustainably improve self-management behaviors and self-efficacy among patients with liver cirrhosis, and it is a scientific and effective clinical nursing intervention model worthy of promotion.