| Objective:1.The purpose of this study is to investigate the related risk factors of vocal cord polyps in occupational voice population,explore measures to prevent the disease in these people,and make postoperative health guidance.2.To construct the strategy of nursing intervention based on the IMB model,and to explore the effect of IMB model-based nursing intervention on vocal acoustic parameters,VHI score,ESCA score and dynamic laryngoscope results,and to evaluate the effect of nursing intervention on the recovery of vocal cord function,self-care ability and quality of life.Methods:Part one:From November 2018 to August 2019,132 cases with vocal fold polyps confirmed by dynamic laryngoscope in laryngoscope examination room of Otolaryngology Head and neck surgery clinic of a top three hospital in Shanxi Province were selected as the case group.At the same time,122 patients without vocal fold polyps as the control group.Based on a large number of references and interviews,a questionnaire was developed and the risk factors were determined by logistic regression analysis.Part two:82 professional voice users with vocal cord polyps were divided into the experimental group(n=42)and the control group(n=41)according to the method of random number table.The control group was given routine nursing intervention,and the experimental group was given 2-month nursing intervention based on IMB model.Voice acoustic examination,VHI score and ESCA score were performed before operation,1month and 2 months after intervention,and dynamic laryngoscopy was performed 1 month and 2 months after intervention.The intervention effect was evaluated by comparing the results of the two groups.Results:The first part:The univariate analysis results showed that average smoking,average weekly alcohol intake,daily number of spicy foods,history of allergic rhinitis,history of upper respiratory infections in the last month,history of upper gastrointestinal reflux disease,and work in noise There were 9 differences between the two groups,including environment,daily speaking time,and voice abuse(P<0.05).Multi-factor logistic regression analysis of the above 9 factors showed that the 6 factors: average smoking,average weekly alcohol consumption,number of spicy foods per day,noise environment,daily speaking time and voice abuse are the vocal cord polyps Risk factors(P<0.05).The second part:A total of 82 patients completed all data collection,including 41 cases in the test group and 41 cases in the control group.There was no statistical difference between the two groups in general data(P>0.05),and they were comparable.Voice acoustic parameters,VHI scale score,ESCA scale score,and dynamic laryngoscopy results are as follows:1.It is known from repeated measurement analysis of variance that the Jitter,Shimmer,MPT and DSI values of the two groups of patients at different time poin ts are statistically different(F=39.599,P<0.001;F=68.017,P<0.001;F=71.581,P<0.001;F=54.632,P<0.001).Jitter and Shimmer values decreased with time,and MPT and DSI values increased with time.There was no statistically significant interaction bet ween time and groups(P>0.05).Before surgery,there were no significant difference s in Jitter,Shimmer,MPT and DSI between the two groups(P>0.05).One month after the intervention,the Jitter value of the experimental group was significantly lo wer than that of the control group,and the difference was statistically significant(P<0.05).The Shimmer value of the two groups was not statistically different(P>0.05).In the control group,the difference was statistically significant(P<0.05)Two m onths after the intervention,the Jitter and Shimmer values in the experimental grou p were significantly lower than those in the control group that did not receive stud y intervention,and the MPT and DSI values were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).2.Results of statistical methods for repeated measures analysis of variance show that the VHI scale scores of patients at different time points were statistically different(F=91.631,P<0.001),and showed a downward trend with time.The interaction between time and group was statistically significant(F=15.814,P<0.001).There was no statisticaldifference in the scores between the two groups before surgery.The scores in the test group were significantly lower than those in the control group at 1 and 2 months after the intervention.The difference was statistically significant(P<0.05).3.Results of statistical methods for repeated measures analysis of variance show that the ESCA scale scores of patients at different time points were statistically different(F=170.826,P<0.001),and the scores showed an upward trend with time.The interaction between time and group was statistically significant(F=83.357,P<0.001).There was no statistical difference in the scores between the two groups before surgery.The scores in the experimental group were significantly higher than those in the control group at 1 and 2months after intervention.The difference was statistically significant(P<0.05).4.Dynamic laryngoscopy: The chi-square test showed no significant difference in vocal cord recovery between the two groups at 1 month(P>0.05).The vocal cord recovery of the experimental group was significantly better than that of the control group at 2months after operation.Significance(P<0.05).Conclusion:1.The risk factors of vocal cord polyps of professional voice users include noise environment,smoking,drinking,times of eating spicy and stimulating food,too long time of daily use and voice abuse.2.Nursing intervention based on IMB model can improve the patient's voice acoustic parameters and reduce the severity of voice disorders.3.Nursing intervention based on IMB model can improve the functional,physiological,and emotional negative effects of voice disorders and improve the quality of life.4.Nursing intervention based on IMB model can improve patient self-care ability.5.Nursing intervention based on IMB model can promote vocal cord recovery in patients. |
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