基于自我管理为导向的5A护理路径对头颈癌放疗病人吞咽困难的干预效果

    The intervention effects of the 5A nursing pathway based on self-management on dysphagia in head and neck cancer patients with radiotherapy

    • 摘要:
      目的: 探讨基于自我管理为导向的5A护理路径对头颈癌放疗病人吞咽困难的干预效果。
      方法: 选取住院放疗的头颈癌病人60例作为研究对象,随机分为对照组和观察组,各30例。对照组病人采取头颈部肿瘤放疗常规护理,观察组病人在对照组的基础上实施基于自我管理为导向的5A护理路径,进行预防性吞咽功能训练。比较2组病人的改良洼田饮水试验(MWST)分级、中文版癌症病人自我管理效能感(C–SUPPH)评分及中文版安德森吞咽困难(C–MDADI)评分。
      结果: 观察组放疗结束时吞咽功能分级优于对照组(P < 0.05)。干预前,2组C–SUPPH评分、C–MDADI评分差异均为统计学意义(P > 0.05);干预后,观察组C–SUPPH评分、C–MDADI评分均明显高于对照组(P < 0.01)。
      结论: 对头颈癌放疗病人实施基于自我管理为导向的5A护理路径,进行预防性吞咽功能训练,可有效改善其吞咽功能,提高自我管理能力,提升生活质量。

       

      Abstract:
      Objective To explore the intervention effects of the 5A nursing pathway based on self-management on dysphagia in head and neck cancer patients with radiotherapy.
      Methods Sixty patients with head and neck cancer who received inpatient radiotherapy were selected as the research subjects, and randomly divided into the control group and observation group, with 30 cases in each group. The control group received routine radiotherapy care for head and neck tumors, while the observation group were nursed with the 5A nursing pathway based on self-management on the basis of the control group, and preventive swallowing function training. The modified Wada Water Test (MWST) classification, Chinese version of the Cancer Patient Self-management Efficacy (C-SUPPH) score and Chinese version of the Anderson dysphagia (C-MDADI) score between two groups were compared
      Results The swallowing function classification of the observation group at the end of radiotherapy was better than that of control group (P < 0.05). Before the intervention, There was no statistical significance in the C-SUPPH score and C-MDADI score between two groups (P > 0.05). After the intervention, the C-SUPPH score and C-MDADI score in the observation group were significantly higher than those of control group (P < 0.01).
      Conclusions Implementing a 5A nursing pathway based on self-management for radiotherapy patients with head and neck cancer and conducting preventive swallowing function training can effectively improve their swallowing function, enhance their self-management ability, and improve their quality of life.

       

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