舌癌术后吞咽障碍患者居家吞咽康复需求现状及影响因素分析

Analysis on current situation of the demands and influencing factors of swallowing rehabilitation in patients with dysphagia after undergoing tongue cancer surgery

目的了解舌癌术后吞咽障碍患者居家吞咽康复需求并分析其影响因素,为构建舌癌术后吞咽障碍患者的延续护理管理体系提供参考依据。方法抽取2020年7月—2021年10月存在吞咽障碍风险即吞咽筛查量表(EAT-10)≥3分的114例舌癌术后患者为研究对象,并采用自制的舌癌术后患者居家吞咽康复需求问卷进行在线调查。结果发放问卷114份,回收有效问卷111份。舌癌术后患者居家吞咽康复需求总分为39.50±10.38分。目前进食方式、肿瘤发生部位、出院时间、目前是否有气管套管是吞咽康复需求的相关影响因素(P<0.05)。多因素分析结果显示,出院时间是吞咽康复需求的主要影响因素(P<0.05)。结论舌癌术后吞咽障碍患者居家吞咽康复需求较高且受出院时间因素影响,医护人员应以患者需求为导向,对居家舌癌术后吞咽障碍患者提供及时全面个体化的吞咽康复服务方案,满足患者延续康复护理需求,提升护理服务质量。

Objective To understand the demands of home-based swallowing rehabilitation in patients with swallowing disorder after undergoing tongue cancer surgery and analyze the influencing factors,so as to provide reference for the construction of continuous nursing management system for tongue cancer patients with swallowing disorder after undergoing tongue cancer surgery.Methods A total of 114 postoperative patients with tongue cancer who had the risk of swallowing disorder,that is,swallowing screening scale(EAT-10)≥3 points,were selected as the study objects from July 2020 to October 2021.and an online survey was conducted by using a self-made questionnaire on home-based swallowing rehabilitation demands of postoperative tongue cancer patients.Results A total of 114 questionnaires were sent out and 111 valid questionnaires were collected.The total score of home-based swallowing rehabilitation needs of patients after undergoing tongue cancer surgery was 39.50±10.38 points.The current eating style,tumorigenesis site,discharge time and whether there were current tracheal tub were the infl uencing factors for swallowing rehabilitation demands(P<0.05).Multivariate analysis showed that the discharge time was the main infl uencing factor of swallowing rehabilitation demands(P<0.05).Conclusion Patients with swallowing disorder after tongue cancer surgery have higher demands on home-based swallowing rehabilitation,medical staff should be guided by the demands of patients.A comprehensive and individualized swallowing rehabilitation service plan should be provided to patients with dysphagia after tongue cancer surgery at home in a timely manner to meet the patient's continuing rehabilitation nursing needs and improve the quality of nursing services.