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Amaç: Bu çalışmada, kuadriplejik tipte Serebral Palsi (SP) tanısı olan bir çocuk hastanın Orem Öz-bakım Eksikliği Kuramı'na göre hemşirelik girişimlerinin planlanması amaçlanmıştır. Yöntem: Pediatri servisinde on gündür yatmakta olan SP, epilepsi ve hidrosefali tanılı hastada gözlem, fizik muayene ve iletişim tekniği kullanılarak Orem Öz-Bakım Eksikliği Kuramı’nda yer alan temel durumsal faktörler değerlendirildi. Kuramın her basamağı Orem’in oluşturduğu hemşirelik sistemi, öz-bakım ve öz-bakım yetersizlik modelinin verilerinin yer aldığı bakım planı üzerinden özetlendi ve örümcek kavram haritası ile sunuldu. Bulgular: SP, epilepsi ve hidrosefalisi olan 8 yaşında kız hastanın öz-bakım gereksinimlerini etkileyen faktörler arasında hastalığın şiddetine bağlı sekonder sorunlarının fazla, destek mekanizmalarının ve bakım vericilerin bilgi düzeyinin yetersiz olduğu saptandı. Hastanın öz-bakım gücünün, algısal, bilişsel ve duyusal yeterliliğinin oldukça zayıf olduğu görüldü. Orem’e göre hastanın en önemli sağlıktan sapma gereksinimleri solunum, görme, diş, üriner, oral motor ve uyku problemleri, beslenme bozukluğu, mental retardasyon, epileptik nöbetler ve sosyal izolasyon olarak belirlendi. Sonuç: Bu çalışmada, kuadriplejik tipte SP’li bir çocuk hastanın, Orem’in Öz-bakım Eksikliği Kuramı'na göre temel öz-bakım becerilerini karşılamakta oldukça yetersiz olduğu saptandı. Bu nedenle hemşirenin “Tümüyle Eksiklik Giderici” rolü kapsamında hastanın öz-bakımını sağlayıcı hemşirelik girişimleri planlandı. Ayrıca hastanın öz-bakımını karşılayan annesinin ve diğer aile üyelerinin gereksinimleri, hemşirenin “Destekleyici ve Eğitsel” rolü kapsamında ele alınarak eğitim ve danışmanlık planlandı. Pediatri hemşireleri, SP’li çocukların öz-bakımlarını gerçekleştirme durumlarını ve öz-bakım gereksinimlerini belirlemeli, öz-bakımını gerçekleştirmede çocuk ve ebeveynlerini desteklemelidirler.
Purpose: In this study, a child with a quadriplegic type of brain palsy (SP) diagnosis is aimed at planning nursing initiatives according to the Orem Self-care Deficiency Theory of a child. Method: The patient with SP, epilepsy and hydrosphaly diagnosed in the pediatric service for ten days, using observation, physical examination and communication techniques, the basic state-of-the-art factors included in the Orem Self-Conservation Disability Theory were evaluated. Each stage of the theory was summarized through the care plan in which the data of the Orem’s nursing system, self-care and self-care insufficiency model were included and presented with the Spider concept map. The findings: among the factors affecting the needs of self-care of a 8-year-old girl with SP, epilepsy and hydrosphaly, the severity of the disease has been found to have excessive secondary problems, support mechanisms and the level of knowledge of the care providers. The patient’s self-care capacity, perceptive, cognitive and sensual capacity, was found to be quite weak. According to Orem, the patient’s demands for deviation from the important health were determined as: respiratory, visual, tooth, urine, oral motor and sleep problems, eating disorders, mental retardation, epileptic attacks and social isolation. Result: In this study, a child with quadriplegic type SP was found to be quite insufficient in meeting Orem’s basic self-care skills according to the Self-care Deficiency Theory. Therefore, in the framework of the nursing's role "Total Disadvantaged" the patient's self-care initiatives were planned. In addition, the needs of the mother and other family members that meet the patient's self-care were planned by training and consultancy, addressing the nursing's "supporting and educational" role. Pediatric nurses should determine the conditions of self-care and self-care needs of children with SP, and support their children and parents in their self-care.
Objective: The aim of this study was to plan nursing interventions according to Orem Self-care Deficiency Theory in a pediatric patient with quadriplegic type Cerebral Palsy (CP). Methods: The basic situational factors in Orem Self-Care Deficiency Theory were evaluated by using observation, physical examination and communication technique in a patient with CP, epilepsy and hydrocephalus who had been hospitalized in the pediatric ward for ten days. Each step of the theory is summarized through the care plan which includes the data of the nursing system, self-care and self-care disability model formed by Orem and presented with a spider concept map. Results: Among the factors affecting the self-care needs of an 8-year-old female patient with CP, epilepsy and hydrocephalus, secondary problems related to the severity of the disease were high, support mechanisms and knowledge of caregivers were insufficient. The patient's self-care power, perceptual, cognitive and sensory competence were found to be poor. According to Orem, the most important health deviation requirements of the patient are; respiratory, visual, dental, urinary, oral motor and sleep problems, malnutrition, mental retardation, epileptic seizures and social isolation. Conclusion: In this study, a child with quadriplegic type CP was found to be inadequate to meet basic self-care skills according to Orem's Self-Care Deficiency Theory. For this reason, nursing interventions that provide self-care of the patient were planned within the scope of “Completely Deficient” role of the nurse. In addition, the needs of the mother and other family members who meet the patient's self-care were discussed within the scope of the “Supportive and Educational” role of the nurse and training and counseling were planned. Pediatric nurses should determine the status and self-care needs of children with CP and support their child and parents in performing self-care.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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