Orem's Model Research Articles

THE EFFECT OF THE OREM MODEL APPROACH ON KNOWLEDGE AND ATTITUDE OF PREGNANT WOMEN IN REDUCING THE INCIDENCE OF SEVERE PREECLAMPSIA (PEB) DURING THE PANDEMIC AT THE NORTH CIMAHI HEALTH CENTER

Background : One of the causes of maternal death is preeclampsia, the high incidence of preeclampsia in Indonesia cannot be separated by several factors such as low education and lack of health awareness. The role of nurses in this case: is to carry out promotive efforts by carrying out health promotions to pregnant women about preeclampsia, Self Care Orem theory with the main focus on seeing how a person maintains his health and welfare can be applied through health education as an effort to increase knowledge and attitudes of pregnant women. Objectives : This study aims to determine the effect of the Orem model approach on the knowledge and attitudes of pregnant women about preeclampsia at the North Cimahi Health Center. Methods : This research method is quasi-experimental quantitative research with a one-group pretest-posttest design. The sample is 55 respondents using the purposive sampling technique. The instrument is a knowledge and attitude questionnaire about preeclampsia. Result : The results of this study indicate that half of them, 30 respondents (54.4%) have good knowledge and almost all 46 respondents (83.6%) have a positive attitude. Based on the analysis of the Marginal Homogeniety and Mcnemar test, the value of p = 0.000 < (0.05). Conclusions : Concluded that there is an effect of the Orem model approach on the knowledge and attitudes of pregnant women regarding preeclampsia. The results of this study are expected to be used as a reference and basis for improving the health status of pregnant women, especially in preventing preeclampsia.

FAMILY-BASED CARE USING THE OREM SELF-CARE MODEL IN FAMILIES WITH HYPERTENSION: A CASE STUDY

Introduction: Uncontrolled hypertension can negatively affect a person's physical well-being and quality of life. The implementation of family-based care helps families to achieve independence in maintaining family health. The Orem model approach can explain how the family's role in caring for family health independently. Objectives: This study aims to describe the application of family-based care with the Orem model approach in hypertensive families. Methods: This research was conducted with a case study approach, using a nursing process consisting of assessment with the Orem model, namely assessment of basic conditional factor data, strength components, universal self care, developmental self care, and health deviation and Hypertension Self Management Behavior (HSMB), formulation of nursing diagnoses using SDKI, nursing plans using SIKI, implementation and evaluation. Results: Intervention and implementation were carried out for four meetings including providing family-based health education using leaflet media, foot massage modality therapy and self-management monitoring sheets. The results obtained by both families experienced an increase in behavioral self-management scores and controlled blood pressure. Conclusions: Family-based care can improve behavioral self-management in compliant families.

Effect of Orem's Management Model on Patients Undergoing Percutaneous Nephrolithotomy for Kidney Calculi: A Multicenter Retrospective Trial.

Percutaneous nephrolithotomy (PCNL) is the standard procedure for treating upper urinary tract calculi and complex kidney calculi >2 cm in diameter, though it has a high incidence of postoperative complications. This study aimed to investigate the effect of Orem's management model on patients undergoing PCNL. This retrospective study included 465 patients who underwent PCNL from February 2022 to February 2023 from two tertiary hospitals. After excluding 16 patients based on exclusion criteria, 449 patients remained. The observation group (n = 227) received Orem's management model, while the control group (n = 222) underwent conventional surgical management. Primary outcomes included postoperative recovery time and the incidence of postoperative complications, while secondary outcomes such as postoperative pain levels (measured via a numerical rating scale) and self-care ability assessed through the exercise of self-care agency were obtained through medical records and physical examinations. Compared to the control group, the observation group achieved faster outcomes for the first anal exsufflation, first ambulation, and discharge, and a lower incidence of postoperative complications (p < 0.05). Post-management, the observation group had lower numerical rating scale scores and higher exercise of self-care agency scores (p < 0.001). Orem's management model accelerates postoperative recovery, alleviates pain, and reduces postoperative complications in patients undergoing PCNL. Moreover, this model enhances self-care ability, though its effectiveness is limited to patients with non-recurrent renal calculi and normal renal function. Further exploration of its broader application is needed.

The effect of training based on Orem self-care model on burden in patients with multiple sclerosis

Background. Multiple sclerosis is a chronic disease of the central nervous system and most often occurs in people between the ages of 20 to 50 years. Orem's self-care model is one of the models that have had a special approach to human and health care issues. The aim of this study was to review the effect of self-care training based on the Orem model on the burden on caregivers of patients.. Methods. The present quasi-experimental study was performed on 76 main members of the family caring for patients with multiple sclerosis in Bandar Abbas with a pre-test, post-test design and a control group. The study units were randomly selected and divided into two groups of control and intervention. The intervention group was trained according to the Orem training program in patients with amnesia during 6-8 sessions of 40 minutes. In order to assess the burden on caregivers, a 22-item "Zarit" questionnaire was used and a questionnaire was completed before and after the intervention in both groups. The results were analyzed with SPSS software version 26. Results. The difference between the mean of burden before the intervention (44.6 13 13) and after the intervention (33.7 10 10) in the intervention group was significant (P&lt;0.05), which indicated the positive effect of training on decrease in the burden. The increase in the age of the intervention group was associated with an increase in the burden on the caregivers (P&lt;0.05). There was a significant relationship between the burden on caregivers and the amount of income in the intervention group (P&lt;0.05). Conclusion. Educating the caregiver of these patients can play an important role in reducing the burden on the caregiver during the long period of care. Applying Orem self-care model enables people to play a more active role in their care and treatment, thereby improving self-care, reducing fear and dependence, increasing motivation and self-confidence, and a sense of independence. Practical Implications. Application of research findings in nursing practice, nursing service management and nursing training.

Effect of Implementing Orem Self-Care Model on Health-Promoting Behaviors of Mothers having Children with Leukemia Referring to the Pediatric Ward of Seyed Al-Shohada Hospital in Isfahan City (Iran) in 2021

Background and Objective: Leukemia refers to one of the most prevailed childhood malignancies. Mothers are the first caregivers of children with leukemia, experiencing a bunch of challenges in dealing with the numerous problems and duties caused by their children’s illness. This study aimed to determine the effect of implementing the Orem self-care model on health-promoting behaviors of mothers having children with leukemia referring to the pediatric ward of Seyed Al-Shohada Hospital in Isfahan city, Iran, in 2021. Materials and Methods: This quasi-experimental study investigated 32 mothers having children with leukemia referring to the pediatric ward of Seyed Al-Shohada Hospital, who were selected by the available sampling method according to the study’s inclusion criteria. The tools employed to collect the required data were a demographic information form, Walker’s Health-Promoting Lifestyle Profile, and a needs assessment based on the Orem model, measured at two stages of before and after the implementation of the Orem self-care model. In accordance with the mothers’ needs, a supportive training program was designed and implemented in-person and individually for a total of 8 h in 4 sessions held once a week. Furthermore, an educational pamphlet was designed and they were provided to the participants. During the intervention, the research samples were communicated by telephone and in-person and were checked about the way of performing and applying the given pieces of training. Any problem in any of the units was solved in case of presence. In the next step, after 1 month of self-care training, the researcher completed the standard Health-Promoting Lifestyle Profile again after 1 week. In the end, the collected data were analyzed in SPSS20 statistical software using both descriptive and inferential levels. Results: The results revealed that in the dimensions of self-fulfillment, accountability, interpersonal support, stress management, exercise, nutrition, and health-promoting index, the mean scores of maternal health-promoting behaviors were significantly higher after implementing the Orem self-care model, compared to the score before implementing the model (P&lt;0.001). Conclusion: According to the findings, it may be claimed that the implementation of the Orem self-care model affected the health-promoting behaviors of mothers having children with leukemia. Consequently, it is necessary to adopt supportive-educational measures based on the Orem model in the relevant centers according to the mothers’ needs.

Comparison of two nursing theories orem's theory of self-care deficit &amp; kolcaba's comfort theory

This article is focused on the major features of Orem's self-care theory, grand theory, and Katharine Kolcaba's comfort theory, a middle-range theory Kolcaba developed in the 1990s. It is a middle-range nursing theory designed for nursing practice, research, and education. According to her theory, patient comfort exists in three forms, relief, ease, and transcendence. These comforts can occur in four contexts: physical, psycho-spiritual, environmental, and sociocultural. Dorothea Orem established the Self-Care Nursing Theory, often known as the Orem Model of Nursing, between 1959 and 2001. Orem's theory comprises three theories, the theory of self-care, the theory of self-care deficit, and the theory of the nursing process. The article is based on a real-life scenario. The aim of this paper is to compare the mentioned theorists, their impacts on the outcomes, and their relationships with the clinical scenario in their own approaches.

The Effect of Orem Self-Care Program on Sleep Quality, Daily Activities, and Lower Extremity Edema in Patients Undergoing Coronary Artery Bypass Graft Surgery.

Background:Postoperative complications of open heart surgery require extensive care, especially by the patient. One of the important strategies in this regard is self-care education and one of the well-known patterns is Orem self-care model. This study aimed to investigating the effect of Orem-based self-care program on sleep quality, daily activities, and lower extremity edema in patients undergoing coronary artery bypass graft surgery.Materials and Methods:This clinical trial study was performed on 74 patients with coronary artery bypass graft surgery in Kashani Hospital in Shahrekord. The patients were randomly assigned to intervention and control groups. Data were collected using need assessment form according to the Orem model, quality of life and activity daily living questionnaire and measurement of edema by the meters. Data were analyzed using descriptive and analytical statistics with SPSS software.Results:The sleep quality score in the intervention group immediately after the intervention and 2 months after, was significantly lower in the intervention group than in the control group (P = 0.001). In the intervention group immediately after the intervention and 2 months after, the daily activity score was significantly higher than the control group (P < 0.05) 2 months after intervention, edema score in intervention group was significantly lower than the control group (P = 0.006).Conclusions:Results of the recent study showed that the implementation of the Orem-based self-care program can reduce the postoperative complications and the use of nursing patterns, such as Orem, to enhance self-care ability in patients who require long-term care can be very effective.

The Impact of Self-care Education Based on Orem's Model on Self-care Behaviors of Patients with β-Thalassemia Major: A Clinical Trial

Background: Thalassemia negatively affects key aspects of life and self-care behaviors. It is essential to promote self-care behaviors in patients with thalassemia in order to improve their functions and mitigate adverse effects. Objectives: In this context, the present study aimed to investigate the effects of self-care education on self-care behaviors of patients with major β-thalassemia based on Orem’s model. Methods: This clinical trial investigated 60 patients with major β-thalassemia who had been admitted to Razi Hospital in Saravan, southeast of Iran, in 2017. The subjects were selected and randomly allocated to the control and experimental groups. A demographic questionnaire and a researcher-made self-care scale were used to gather data. The experimental group received individual- and group-training for 5 sessions of 30 to 45 minutes, while the control group was presented with routine instructions. After one month, the questionnaires were completed again and the data were analyzed in SPSS 23 using chi-square test and independent t-test. Results: The results of this study showed that administering the self-care program enhanced three aspects of self-care, including mental health, physical activities, and therapeutic measures in patients with major β-thalassemia, but no improvement was observed in terms of nutrition after the intervention (P = 0.28). Conclusions: It is promising to undertake self-care interventions to improve self-care behaviors of patients with major β-thalassemia.

Effect of Orem's Self-Care Model Training Program on Anxiety of Women with Breast Cancer: A Clinical Trial Study

Background: Breast cancer is the most common type of cancer and the second leading cause of death after lung cancer and is associated with numerous complications, including anxiety. It seems that organized educational interventions, such as Orem's self-care model, decrease the incidence of complications, such as anxiety. Objectives: Therefore, the aim of the present study was to determine the effect of the self-care training program based on Orem's model on anxiety of women with cancer undergoing chemotherapy. Methods: The present research was a clinical trial study conducted on 70 women with breast cancer, who had referred to educational hospitals of Zahedan, during year 2017. The convenience sampling method was used and data was collected using a demographic questionnaire, the Orem's need assessment form, and the Spielberger State-Trait Anxiety Inventory (STAI). Data were collected at baseline and four weeks after the end of the last intervention session. The intervention group received training sessions (three 25- to 30-minute sessions) based on the Orem's model, on a weekly basis, yet the control group did not receive any intervention except routine care. Results: The results of statistical tests showed no significant difference between the two groups in terms of distribution of demographic variables, such as age, marital status, level of education, number of children, and occupation. The results of statistical tests also showed a significant difference between pre- and post-anxiety levels in the intervention group and there was no such significant difference in the control group (P < 0.001). Moreover, the results showed a significant difference between the two groups in terms of pre- and post-anxiety changes (P < 0.001). The results of comparing the two groups showed a lower post-intervention anxiety level in the intervention as compared to the control group, although this difference was not significant regarding trait anxiety (P: 0.62) and state anxiety (P: 0.017). Conclusions: Orem's self-care model-based training program can reduce anxiety among patients with breast cancer and can serve as a self-care model for nursing care interventions in these patients.

The Effect of Self-Care Education Based on Orem's Model on Self- Efficacy of Patients with Beta Thalassemia Major

Background: self-efficacy is the main factor in human behavior showing the extent of an individual's efforts in performing an activity. Strengthening self-efficacy empowers the person to follow and adhere to treatment. Improving selfcare behaviors is of the requirements of strengthening selfefficacy behaviors. Thus, the present study was conducted to determine the effect of self-care education based on Orem's model on self-efficacy in patients with beta thalassemia major. Methods: In this clinical trial, 60 patients with thalassemia who were admitted to Razi Hospital of Saravan were randomly divided into control and intervention groups. Demographic and Sherer's self-efficacy questionnaires were used to collect data. The intervention group was educated for 5 sessions. The control group received routine interventions. The questionnaires were completed again after a month, and data were analyzed using SPSS23. Results: The mean and standard deviation of self-efficacy scores before intervention in intervention and control groups were 42.86 ± 3.24 and 42.80 ± 3.86, respectively, and after intervention 49.16 ± 8.17 and 43.20 ± 4.84, respectively. Statistical variance test with repeated measures showed significant statistical differences between the two groups before and after intervention (p=0.01). Conclusion: The results showed that the use of Orem's selfcare model increased the level of self-care behaviors in these patients. Thus, using Orem's model is recommended as an effective way to promote self-efficacy of patients.

Prevention of osteoporosis in female students based on the Orem self-care model.

BackgroundThe World Health Organization has introduced osteoporosis as the fourth main enemy of mankind. Self care has served as a new trend in health care.ObjectiveEducational intervention for osteoporosis related preventive self care in female university students using the Orem model.MethodsThis study is a controlled filed trial, carried out with female students of Islamic Azad University, Shahrekord Branch, Iran, from October 28, 2014 to November 15, 2016. Two-stage random stratified sampling was performed and the data were collected through a validated questionnaire developed by the researcher for osteoporosis preventive self-care based on the Orem model. The intervention group received education about osteoporosis preventive self-care through two months training, as per the dimensions in the Orem model. For statistical analysis, independent-samples t-test and paired t-test were used in SPSS version 23.ResultsAs revealed, mean scores for self-care agency, self-care demand, self-care operation structures and total self-care in the intervention group were significantly different before and after the intervention (p=0.014, p<0.001, p=0.002, and p<0.001, respectively). Accordingly, educational intervention seems to be effective in promoting self-care for the prevention of osteoporosis. While the control group, showed no significant difference in any of the above-mentioned aspects before and after intervention (p=0.90, p=0.53, p=0.51, and p= 0.97, respectively).ConclusionThe results are in favor of the effects of educational intervention on osteoporosis preventive self-care among female students. It can be suggested that education during a woman’s young age, can be very beneficial for the prevention of osteoporosis in the future.Trial registrationThe trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT201510028742N8.FundingThe authors received no financial support for the research, authorship, and/or publication of this article.

Preventing and managing diabetic foot ulcers: application of Orem’s self-care model

One of the most common complications of diabetes mellitus is a diabetic foot ulcer. Thus, managing and preventing this complication is a main priority for health professionals, especially for nurses. This study was designed to investigate the application of Orem’s self-care deficit theory on prevention and management of diabetic foot ulcer. This quasi-experimental study was conducted in Urmia, Iran. Purposive sampling was used to select 60 patients and they were allocated into two groups. Two patients in the intervention group were excluded due to amputation and four patients from each group left the study because of unwillingness to complete the study. The intervention group received two self-care training sessions and home visits for 12 weeks, but the control group received the routine care. Data were collected using a questionnaire which consisted of four parts (demographic data, self- care status, need assessments based on Orem model, and Saint Elian Wound Score System). Data were analyzed by SPSS software (ver. 16). A significant difference was found between two groups regarding self-care mean scores, number of affected zones, ischemia, infection, and wound healing phase (p < 0.05). Application of Orem’s self-care model could be helpful for the management of diabetic foot ulcers and could change patients’ lives by lowering the risk of amputation and medical costs.

The Effect of a Self-care Training Program based on Orem Model on Anxiety in Patients with Multiple Sclerosis (MS)

Background: Multiple sclerosis (MS), as one of the major causes of disability in the world, is a chronic and progressive disease of the central nervous system which can cause depression in patients. Hence, self-care methods are of special importance for MS patients. Aim: The present study aimed to determine the effect of a self-care training program based on Orem model on depression in patients with MS. Materials and methods: In the present clinical trial, 88 patients with multiple sclerosis who were a member of the MS Association of Zahedan were selected as the sample based on the convenience sampling method and randomly divided into two intervention and control groups of 44. Based on the needs of patients, 9 sessions of a training program based on Dorothea Orem's Self-Care Theory were designed and implemented. The extent to which this training program was used by patients was evaluated using a self-reporting checklist. Before and 3 months after the intervention, the depression level of patients was measured using DASS21 questionnaire. All obtained data and information were statistically analyzed using the independent t-test, paired t-test, and chi-square in SPSS-16. Results: The mean score of depression in the intervention and control groups was not significantly different before the intervention (P> 0.05). In addition, the mean anxiety scores change before and after the intervention was higher in the intervention compared to the control group (P< 0.05). Conclusion: According to the study findings, it can be stated that implementation of self-care training programs based on Orem model can reduce depression in patients with multiple sclerosis. Considering the limitations of the present study, further studies are recommended to be conducted in this regard.

The Effect of a Self-Care Instructional Program based on Orem's Model on the Stress of Multiple Sclerosis Patients

The Effect of a Self-Care Instructional Program based on Orem's Model on the Stress of Multiple Sclerosis Patients

Effect of Self-Care Program based on Orem's Model on Complications of Disease in Patients with Multiple Sclerosis

Effect of Self-Care Program based on Orem's Model on Complications of Disease in Patients with Multiple Sclerosis

The Effect of Orem's Self-Care Model on Fatigue in Patients With Multiple Sclerosis: A Single Blind Randomized Clinical Trial Study.

BackgroundOrem’s self-care model is a nursing model that was introduced with the purpose of improving the self-care of individuals, especially patients suffering from chronic diseases.ObjectivesTo determining the effect of Orem’s self-care model on fatigue in multiple sclerosis patients.Patients and MethodsThis research involved a clinical trial. Sixty-three multiple sclerosis patients at the vice-chancellor in treatment affairs of Yasuj University of Medical Sciences were selected based on nonrandom sampling, but they were allocated to the two groups based on random allocation. In the intervention group, Orem’s model was applied during six sessions of 45 - 60 minutes in length, and the process continued for 1 month. The data were collected 1 week before and 7 weeks after the end of the intervention using the Orem’s self-care model-based assessment form and fatigue severity scale, the validity and reliability of which have beenResultsBefore the intervention, 11.11% of the participants had a good knowledge of self-care. In addition, self-care willingness and skills were observed in 76.19% and 4.76% of participants, respectively. The mean difference in fatigue reduced significantly in the intervention group after the intervention (P < 0.05). After the intervention, a statistically significant difference was observed in the mean difference of fatigue between the two groups (P < 0.05).ConclusionsOrem’s self-care model is significantly effective in reducing the fatigue of multiple sclerosis patients.

Effect of self-care training program based on Orem's model on the behaviors leading to sexually transmitted disease in vulnerable women.

Background:Vulnerable women are prone to sexually transmitted diseases due to their high-risk behaviors. The present study aimed to investigate the effect of self-care training program based on Orem's model on the behaviors leading to sexually transmitted diseases in vulnerable women.Materials and Methods:This field trial was initially conducted on 100 women covered under health services and welfare organization in Isfahan city, who were selected by rationing ssampling. For needs assessment, they filled the self-care needs assessment questionnaire in three domains of knowledge, attitude, and practice. Then, at the stage of intervention (self-care training), 64 subjects were selected through convenient sampling and were assigned to experimental and control groups by random allocation. Data were analyzed by descriptive and analytical statistical tests through SPSS 18.Results:Results showed that mean scores of knowledge (P < 0.001), attitude (P < 0.001), practice (P = 0.04), and behavior change (P = 0.01) were significantly higher immediately after and 3 months after intervention, compared to before intervention, but there was no significant difference in mean scores between immediately after and 3 months after intervention.Conclusions:With regard to these results, it can be concluded that if the educational programs are planned based on clients’ real needs assessment, the learners follow the educational materials, related to their problems, more seriously and it results in a notable behavior change in them.

Compare and Contrast of Grand Theories: Orem’s Self-Care Deficit Theory and Roy’s Adaptation Model

Nursing theories are developed to provide a connecting frame work which focus on nursing practice. Dorothy Orem’s Self-Care Deficit Theory and Sister Callista Roy’s Adaptation Model are grand theories; both developed these to enhance nursing practice and education. Orem Model emphasizes on the individuals demands of self care which the nurse can accomplish through certain actions to promote health and well being. However, the adaptation model gives an effective frame work for addressing the adaptive needs of individuals, families and groups. Orem’s theory is applicable in certain settings such as acute care units, ambulatory clinics, community, senior citizen homes, hospice, and rehabilitation centre. Whereas, Roy’s model is practical in many areas of nursing practice to enhance practical nursing for individuals of all ages in health and illness, it is also more relevant to assessment and intervention during the changes which occur with aging. In conclusion, both the models are well defined to promote better patient care, to enhance the image of nursing profession, and to improve communication among nurses.

Development and validation of self-care requisites assessment

AbstractBackground:Assessment of patient’s needs is the first step for recognizing problems andprevention of complications. Assessment tools are needed in order assess needs, and plannursing care to prevent complications such as diabetic foot ulcer .The purpose of the presentstudy was to develop self-care requisites assessment tool for prevention of diabetic footulcer and examine its validity and reliability.Material and Methods: This methodological study consisted of two phases, phrase I wasdevelopment of the comprehensive assessment form, for which a qualitative study and aliterature review was conducted. Phase 2consisted of testing the instrument for validity andreliability. In qualitative study unstructured interviews were conducted with 8 patients withtype 2 diabetes. Validity of the instrument was measured by content validity, concurrentvalidity (criterion related validity) and construct validity. A sample of153 type two diabeticpatients were selected to conduct factor analysis of the tool. Reliability was confirmed byinternal consistency. Data were analyzed by SPSS statistical software.Findings:The initial form consisted of 103 items. Final version of self –care requisitesassessment form for preventing diabetic foot ulcer consisted of 43 items with 5 sub scales.Validity was established for content, construct and concurrent validity. Content validity wasassured by a panel of experts .Concurrent validity was measured by comparing the scoresfrom assessment tool with self-care agency and diabetic clients' quality of life scales, whichdemonstrated an acceptable correlation among the scores. Internal consistency reliability ofthe tool was demonstrated with Cronbach'sP coefficient ranged from 0.70 to 0.89 forsubscales, the overall test re test reliability was 0.97..ConclusionThe self-care requisite assessment tool for prevention of diabetic foot ulcer is areliable and valid instrument to measure self-care needs for prevention of diabetic footamong individuals with type two diabetes mellitus.Key words : Orem model, Tool development, Diabetes, self-care requistisEFERENCES-Azizi F (2008). [Started learning course "foot care nurse" promise for prevention and care of diabetic foot]. IranianJournal of Endocrinology and Metabolism. 4 (10) 297-298. (Persian).-Burns N, Grove SK (2006). Understanding Nursing Research Building an Evidence Based Practice. 4th edition. StLouis, Mosby.-Darvishpoor Kakhaki A et al (1384). [Instrument development to measure diabetic client quality of life.] IranianJournal of Endocrinology & Metabolism.7 (2) 149-155. 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Goal-directed nursing model based on multivariate regression analysis for increasing response rates of patients with portal hypertension

Objective To analyze factors influencing β-blocker response rates of patients with portal hypertension and to explore the effect of nursing interference for increasing response rates with goal-directed nursing model. Methods 83 cases of portal hypertension were enrolled.Questionnaire about medical visiting behaviors and medication compliance were compared and analyzed after routine medication for 3 months.Bivariate and multivariate regression analysis were performed and related factors were used to establish a goal-directed nursing model for nursing interference guidance.52 non-response patients were randomly divided into the study group(27 cases)and the control group(25 cases).In the study group,compensation system and supportive-education according to Orem model were given,while the control group was given routine nursirng.Response rates and related factors were compared after 3 months of nursing intervention. Results Awareness of self-care responsibility,knowledge about the medication target,risk of sudden drug withdrawal,related medical knowledge,ability for pulse rate measurement and dose adjustment according to pulse rate changes were related to the response rates.Multivariate regression analysis showed that awareness of self-care responsibility,sudden drug withdrawal,utilization of social support and regular return visit were the independent factors.In the study group,ability for pulse rate measurement and dose adjustment acconding to pulse rate changes improved,phenomenon of sudden drug withdrawal declined and response rate increased,comparing with the control grpup. Conclusins For patients fail to respond to β-blockers,compliance behavior and medication compliance should be analyzed,and much attention should be paid to the education of the related medical knowledge,risk of sudden drug withdrawal and drag using targets.Goal-directed medel could be a guidance for nursing intervention to increase the response rates. Key words: Portalhypertension; β-blocker; Responzerate; Multivariate factors; Goal-directed nursing model