Application of Orem's self-care model in postoperative rehabilitation of patients undergoing digit replantation

Digit replantation is often caused by sudden trauma, with 75% of amputated patients being low-income, low-education workers, and adding societal pressure. Orem's self-care model emphasizes self-care and may be an optimal nursing model for digit replantation, but its clinical application and research are limited. This study explores Orem's self-care model's impact on digit replantation. This single-center retrospective observational study included 389 patients who underwent digit replantation in our hospital from June 2019 to November 2023. Based on previous nursing methods, patients were divided into an experimental group (153 cases, Orem's self-care model) and a control group (236 cases, conventional nursing). After propensity score matching, indicators such as replanted finger function, self-efficacy, daily living ability, finger sensory recovery, and complications were compared between the 2 groups. Data were analyzed using t test, analysis of variance, and chi-square test. After matching for gender, age, education level, degree of finger amputation, time to hospital admission, number of amputated fingers, and medical history, the 2 groups showed no significant differences. Function scores at discharge showed no difference, but 2 months post-discharge, the experimental group scored higher (P < .001), with the gap widening at 6 months (P < .001). Sensory recovery showed no difference at discharge; 2 months post-discharge, 8% of the experimental group recovered to S3 level, and 7% to S3+ at 6 months (P < .05). Complication rates showed no significant differences, but the experimental group had a lower rise curve. Daily living ability scores showed no difference at discharge; 2 months post-discharge, the experimental group scored higher (P < .001), with a sustained advantage at 6 months (P < .001). At 6 months, high self-efficacy was 44.3% in the experimental group and 34.3% in the control group; low self-efficacy was 19.5% in the experimental group and 35.3% in the control group (P < .05). Higher education levels correlated with higher self-efficacy (P < .05). After matching, the experimental group outperformed the control group in functional recovery, sensory recovery, daily living ability, and self-efficacy. Orem's self-care model improves physical recovery and promotes psychological recognition in digit replantation patients.