基于微信平台的视频宣教对甲状腺癌扩大根治术后患者肩颈功能锻炼情况和心理弹性的影响

Effects of video education based on WeChat platform on the shoulder and neck functional exercise and mental elasticity in patients with thyroid cancer after extensive radical surgery

目的分析基于微信平台的视频宣教对甲状腺癌扩大根治术后患者肩颈功能锻炼情况和心理弹性的影响。方法选择2019年1月至2020年10月耳鼻咽喉头颈外科收治的甲状腺癌扩大根治术后患者94例。采用随机数字表法分为对照组和观察组,每组47例。对照组采用常规护理,观察组在对照组的基础上采用基于微信平台的视频宣教,2组均干预3个月。比较2组干预前和干预3个月后颈部功能锻炼情况、肩部功能锻炼情况及心理弹性,统计2组干预3个月后瘢痕挛缩程度。结果与干预前比较,2组干预3个月后颈部前屈、后伸、向患侧屈、向健侧屈角度均增大,观察组后伸、向患侧屈角度大于对照组(P<0.05)。与干预前比较,2组干预3个月后疼痛、肩关节活动范围、日常生活能力评分及应对压力、坚韧性、适应性、信念评分均升高,观察组高于对照组(P<0.05)。与干预前比较,2组干预3个月后控制感评分均升高,但差异无统计学意义(P>0.05)。干预3个月后,观察组瘢痕挛缩程度为Ⅰ、Ⅱ级患者占比(65.96%、21.28%)显著高于对照组(44.68%、6.38%)(P<0.05),瘢痕挛缩程度为Ⅳ级患者占比(4.26%)显著低于对照组(27.66%)(P<0.05)。结论基于微信平台的视频宣教对甲状腺癌扩大根治术后患者进行干预,可有效改善患者肩颈功能锻炼情况,提高心理弹性,同时改善患者瘢痕挛缩情况,具有较好的干预效果。

Objective To investigate the effects of video education based on WeChat platform on shoulder and neck functional exercise and mental elasticity in patients with thyroid cancer after extensive radical surgery.Methods A total of 94 patients with thyroid cancer who were treated by extensive radical surgery in our hospital from January 2019 to October 2020 were enrolled in the study,who were randomly divided into two groups,with 47 cases in each group.The patients in control group were treated by conventional nursing intervention,however,the patients in observation group,on the basis of control group,were treated by video education based on WeChat platform,with a intervention course of 3 months for both groups.The neck functional exercise,shoulder functional exercise and mental elasticity as well as the degree of scar contracture were observed and compared between the two groups.Results After 3-month intervention,the angles of neck flexion forward,extension back,flexion to the affected side and flexion to the healthy side in both groups were significantly increased,moreover,the angles of extension back and flexion to the affected side in observation group were significantly bigger than those in control group(P<0.05).And the scores of pain,range of motion of shoulder joint,daily living ability,coping with stress,toughness,adaptability and belief in both groups were significantly increased,moreover,which in observation group were significantly higher than those in control group(P<0.05).Moreover,the proportions of patients with scar contracture extentⅠ,Ⅱproportion(65.96%,21.28%)in observation group were significantly higher than those(44.68%,6.38%)in control group(P<0.05),but the proportion of patients with scar contracture extentⅣ(4.26%)in observation group was significantly lower than that(27.66%)in contrtol group(P<0.05).Conclusion The video education based on WeChat platform can effectively improve the shoulder and neck functional exercise and mental elasticity in patients with thyroid cancer after extensive radical surgery,and improve the patients’scar contracture,which has better intervention effects.