基于奥瑞姆自护理论的干预模式对食管裂孔疝（HH）患者术后自我效能、疼痛及心理状态的影响。

本研究采取回顾性队列设计，选取2024年7月至2025年6月新疆维吾尔自治区人民医院及白鸟湖医院收治的96例HH患者为研究对象，依据干预方法的不同分为对照组和试验组各48例，对照组实施常规护理方法，试验组采用基于奥瑞姆自护理论的干预模式，为期1周。采用配对、独立样本t检验比较两组患者干预前后组内、组间自我效能水平、疼痛程度、心理状态、自我护理能力。

干预1周后，试验组一般自我效能感量表（GSES）评分（28.48±4.14）分、自我护理能力实施量表（ESCA）评分（102.54±13.07）分，高于对照组的（25.38±3.87）分、（95.21±11.36）分（t=3.790、2.933，P均<0.05）；试验组与对照组GSES、ESCA评分干预前后差值比较[（5.02±3.02）分比（9.06±4.42）分、（7.67±5.78）分比（16.04±13.85）分]，差异有统计学意义（t=5.229、3.864，P均<0.001，Cohen's d≈1.07、0.80）。试验组抑郁-焦虑-压力量表（DASS-21）中抑郁评分（8.98±0.67）分、焦虑评分（9.85±0.95）分、压力评分（10.75±1.39）分，低于对照组的（9.44±0.77）分、（11.85±1.38）分、（12.58±1.47）分（t=3.082、8.229、6.233，P均<0.05）。试验组术后12、24、48 h疼痛视觉模拟评分法（VAS）评分分别为（4.96±0.68）分、（3.92±0.58）分、（2.73±0.45）分，低于对照组的（5.38±0.76）分、（4.54±0.62）分、（3.63±0.53）分（t=2.853、5.059、8.968，P均<0.05）。重复测量方差分析显示两组患者VAS评分的时间、组间、交互主效应，差异均有统计学意义（F_时间=254.171，P_时间<0.001；F_组间=80.352，P_组间=0.026；F_交互=3.702，P_交互=0.026）。试验组疼痛持续时间短于对照组（t=7.093，P<0.001）。

基于奥瑞姆自护理论的护理干预可明显改善HH术后患者的自我效能感、自我护理能力、负性情绪状态及疼痛控制效果，为患者提供科学优质的心理护理支持。

To investigate the influence of an intervention model based on Orem's self-care theory on postoperative self-efficacy, pain, and psychological status in patients with hiatal hernia (HH).

This study adopted a retrospective cohort design to select 96 HH patients who were admitted to Bainiaohu Hospital and Xinjiang Uygur Autonomous Region People's Hospital from July 2024 to June 2025 as the research subjects. These patients were divided into the control group and the experimental group, with 48 cases in each group, based on the different intervention methods. The control group received routine nursing care, while the experimental group was given an intervention model based on Orem's self-care theory for 1 week. Paired-sample and independent-sample t-tests were used to compare self-efficacy, pain intensity, psychological status, and self-care ability within and between the two groups before and after the intervention.

After 1 week of intervention, the experimental group had significantly higher general self-efficacy scale (GSES) score (28.48±4.14) points and exercise of self-care agency (ESCA) score (102.54±13.07) points than the control group GSES score (25.38±3.87) points, ESCA score (95.21±11.36) points (t=3.790, 2.933, both P<0.05). The changes in GSES and ESCA scores from baseline to post-intervention were compared between the two groups. The corresponding values were (5.02±3.02) vs (9.06±4.42) points and (7.67±5.78) vs (16.04±13.85) points, with statistically significant differences (t=5.229, 3.864; all P<0.001; Cohen's d≈1.07, 0.80). The scores of depression (8.98±0.67) points, anxiety (9.85±0.95) points, and stress (10.75±1.39) points in the depression-anxiety-stress scale (DASS-21) in the experimental group were significantly lower than those in the control group depression (9.44±0.77) points, anxiety (11.85±1.38) points, stress (12.58±1.47) points (t=3.082, 8.229, 6.233, all P<0.05). The visual analog scale (VAS) scores at 12 h (4.96±0.68) points, 24 h (3.92±0.58) points, and 48 h (2.73±0.45) points after operation in the experimental group were significantly lower than those in the control group at 12 h (5.38±0.76) points, 24 h (4.54±0.62) points, and 48 h (3.63±0.53) points after operation (t=2.853、5.059、8.968, P<0.05). Repeated-measures ANOVA revealed significant main effects of time, group, and time-group interaction on VAS scores (F_time=254.171, P_time<0.001; F_group=80.352, P_group=0.026; F_interaction=3.702, P_interaction= 0.026). In addition, the duration of pain in the experimental group was significantly shorter than that in the control group (t=7.093, P<0.001).

The nursing intervention based on Orem's self-care theory significantly enhances self-efficacy, strengthens self-care ability, alleviates negative emotional states, and improves pain control in postoperative HH patients, thereby providing scientific and high-quality psychological nursing support.