Application And Effect Assessment Of Orem Self-care Theory In Oral Care Of Radiotherapy Patients With Head And Neck Cancer

Objectives:1、Evaluate the self-care agency of radiotherapy patients with head and neck cancer.2、Under the guidance of Orem self-care theory, explore the intervention to enhancing self-care agency, establish reasonable intervention model.3、Investigate the effects of self-care intervention on self-care agency of radiotherapy patients with head and neck cancer, which is under the guidance of the Orem self-care theory4、Investigate the effects of oral care on prevention of RTOM, which is under the guidance of the Orem self-care theory.5、Investigate the effects of oral care on comfort level of radiotherapy patients with head and neck cancer, which is under the guidance of the Orem self-care theory.Methods:During May2013to November2014, selected97cases of patients with head and neck cancer who were from the department of radiotherapy and daytime radiation chamber of the First Hospital of Jilin University as the research subjects. Divided the patients into two group randomly,50cases in intervention group,47cases in control group. The control group used regular oral care. In addition to given regular oral care, according to the patient’s own condition, the intervention group used Orem self-care theory, respectively select full compensation system、part of the compensation system、support-education system, given the patients oral care intervention. Respectively in the early、intermediate stage (total doses less then30Gy) or the end of radiotherapy (total doses more then30Gy), applied the Exercise of Self-Care Agency scale and Radiotherapy Comfort Questionnaire for Patients with Head and Neck Neoplasms to evaluated the patients. Used SPSS17.0statistical software to statistical analysis of data.Results:1、Self-care agency scores of radiotherapy patients with head and neck cancer was80.08±37.69, the majority of patients in the medium or higher level of the self-esteem and self responsible, and in the lower or medium level of self-care ability and health knowledge.2、After the intervention, the intervention group’s scores of self-care agency and each scales were all higher than the control group’s, the number of patients with higher level was significantly more than the control group,P<0.05, the differences were statistically significant.3、In the end of radiotherapy, the incidence rate of RTOM in intervention group(70.83%)was significantly lower than the control group(91.30%), and the severity was lighter than control group,P<0.05, the differences were statistically significant.4、There was a significant negative correlation between the severity of RTOM and self-care agency(rs=-0.839,P<0.05), so as with health knowledge level(rs=-0.790, P<0.05).5、After the intervention, the comfort level score of the intervention group was95.79±5.06, it is significantly higher than the control group score (74.74±7.80), P<0.05, the differences were statistically significant.6、There was a significant positive correlation between the self-care agency and comfort level, P<0.05.7、There was a significant negative correlation between the severity of RTOM and comfort level, P<0.05.Conclusion:1、The self-care agency of radiotherapy patients with head and neck cancer was in the medium level, and the level of self-care ability and health knowledge were significantly low.2、Self-care intervention, under the Orem self-care theory instruction, can effectively improve the self-care agency of patients. 3、The oral care under the guidance of the Orem self-care theory, can significantly reduce the incidence rate and the severity of RTOM for the radiotherapy patients with head and neck cancer.4、The oral care under the guidance of the Orem self-care theory, can make the comfort level of the radiotherapy patients with head and neck cancer increased effectively.