| ObjectiveRetrieve and evaluate oral care-related guidelines and systematic reviews of patients with radiation-induced oral mucositis(RTOM),and summarize evidence-based evidence;After constructing an oral care clustering strategy for RTOM patients,apply it to the clinic and discuss its application effects to provide clinical practice basis for the oral care of RTOM patients.Methods(1)Search 16 guide networks and 7 comprehensive databases for guidelines and systematic reviews related to the oral care of RTOM patients,and evaluate the quality of these guidelines and systematic reviews,and summarize the evidence-based evidence based on the JBI evidence classification and recommendation methods.(2)Based on comprehensive evidence,construct the first draft of the oral care clustering strategy for RTOM patients,and then hold an expert meeting to revise and perfect the first draft,and finally draw up the final draft of the RTOM patient’s oral care clustering strategy.(3)Convenience sampling is used to select RTOM patients who meet the inclusion criteria in the radiotherapy department of a tertiary hospital in Hengyang City as the research objects,and the research objects admitted from May 1 to June 30,2020 are included in the control group,and the routine RTOM oral cavity of the radiotherapy department is implemented.Nursing;the study subjects admitted from August 1 to September 30,2020 will be included in the intervention group,and the oral care clustering strategy for RTOM patients will be implemented;the care plans for the two groups of patients will be implemented from the day the patient is diagnosed with RTOM until The patient stopped on the day of discharge after radiotherapy.The changes in the oral function status,RTOM severity,and oral odor of the two groups of patients on the day of RTOM diagnosis and the day before discharge were compared.In order to avoid interference between the care plans between the two groups,on July 31,2020,the collection of effect evaluation indicators for all undischarged control patients(hospital expenses and length of stay will be collected until the patient is discharged).Data analysis uses SPSS20.0 statistical software,double entry,proofreading,measurement data is indicated by"?X±S",comparison between groups is by t Hengyang Hengyang test;count data comparison is byχ~2 test,P<0.05,it is statistically significant.Results(1)A total of 33 documents were included in this study,including 13guidelines and 20 systematic reviews.The included guidelines and systematic reviews were of high quality,and 37 high-level evidences were summarized,of which 13 were recommended for level A and 24 were recommended for level B.This study divided the evidence into three modules:oral assessment(11 items),oral care measures(15 items),and oral health education(11 items).(2)The clustering strategy of oral care for RTOM patients includes three parts:(1)oral assessment system;(2)oral care intervention system;(3)oral health education system.(3)A total of 99 patients completed the clinical application study of the oral care clustering strategy for RTOM patients,including 51 cases in the control group and 48 cases in the intervention group.There was no statistical difference in the general information of the two groups of patients(P>0.05).Comparison of the results of the two groups before the intervention:the oral function status score of the intervention group,the proportion of oral odor,the proportion of severe,moderate and mild RTOM injury,the p H value of the mouth,the plaque index and the pain score of the intervention group.There was no statistical difference between the control group(P>0.05).Comparison of the results of the two groups of patients before and after intervention:(1)After the intervention,the oral function status score,dental plaque index and pain score of the intervention group were significantly lower than those before the intervention,while the oral p H value of the intervention group was significantly higher than that before the intervention,and the difference was statistically significant(P<0.05).(2)After the intervention,the plaque index of the control group was significantly higher than that before the intervention,and the difference was statistically significant(P<0.05);the oral function status score,oral p H value and pain score of the control group were compared with those before the intervention.There was no statistical difference(P>0.05).Comparison of the results of the two groups after the intervention:(1)The oral function status score of the intervention group[(10.29±1.93)points]was lower than that of the control group[(17.75±3.60)points],the difference was statistically significant(P<0.05).(2)The proportion of patients in the intervention group(12.5%)of oral odor was lower than that of the control group(33.3%),and the difference was statistically significant(P<0.05).(3)The proportion of patients in the intervention group with severe RTOM injury(8.3%)was lower than that in the control group(25.5%),and the difference was statistically significant(P<0.05).(4)The oral p H value of patients in the intervention group(6.65±0.54)was higher than that of the control group(5.27±1.07),and the difference was statistically significant(P<0.05).(5)The plaque index(0.93±0.50)of the intervention group was significantly lower than that of the control group(2.79±0.64),and the difference was statistically significant(P<0.05).(6)The pain score[(4.07±1.45)points]of the intervention group was significantly lower than that of the control group[(6.52±1.11)points],and the difference was statistically significant(P<0.05).(7)The proportion of patients in the intervention group who were satisfied with nursing care was(95.8%)was significantly higher than that of the control group(82.4%),and the difference was statistically significant(P<0.05).(8)There was no significant difference in the ratio of moderate to mild RTOM injury,hospitalization time and hospitalization expenses between the intervention group and the control group(P>0.05).Conclusion(1)Evidence-based is an effective way to construct a bundling strategy for oral care for RTOM patients.The bundling strategy for oral care for RTOM patients constructed in this study consists of three parts,namely,the oral assessment system,the intervention system for oral care,and the oral health education system.(2)The implementation of oral care clustering strategy for RTOM patients can reduce the incidence of oral odor,reduce the number of dental plaque,reduce RTOM damage and pain,significantly improve the oral function state,and increase patient satisfaction. |
PDF Full Text Request