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.