| Objective:1.To explore the nursing effect of ear holographic copper needle scraping on constipation symptoms of patients after stroke and its advantages over the existing ear point nursing technology through clinical controlled trials;2.Through qualitative interview,understand the real experience of patients with constipation after stroke on ear holographic copper needle scraping technology,as well as the recognition and satisfaction of this technology;3.In order to provide new exploration,new ideas and new methods for clinical effective nursing of patients with constipation after stroke,and provide theoretical basis and guiding basis for the application and promotion of ear holographic copper needle scraping technology.Methods:The first part is a kind of experimental study.Using the convenient sampling method,105 patients with post-stroke constipation who were hospitalized in the rehabilitation department of a class III class a hospital of traditional Chinese medicine in Harbin from March 2021 to December 2021 and met the acceptance criteria were selected as the research objects.Then,a simple random grouping method is adopted to make it enter the corresponding test unit.The experiment was divided into three groups.The specific contents are as follows:blank control group(group A):given basic treatment and routine nursing in the hospital.Ear point seed embedding group(group B):on the basis of group A,ear point seed embedding was given.3 days as a course of treatment,a total of 5 courses of treatment.Ear scraping group(Group C):on the basis of group A,ear holographic copper needle scraping was given.30 minutes at a time.3days as a course of treatment,a total of 5 courses of treatment.For the first visit on day 1 after enrolment,complete the General Data Questionnaire,Bristol Stool Trait Scale and Constipation Clinical Symptom Scoring Scale(CCS Scale);After the first operation is completed,the time of the first bowel movement is recorded;After 1week and 2 weeks of enrollment,fill in the Bristol stool trait scale and CCS scale,and if there is an operation on the same day,fill in after completing the operation.Clinical trial data collection and entry are double-checked by two people,analyzed by SPSS 26.0 software,and statistical methods such as analysis of variance or non-parametric test are adopted according to the data type,P<0.05 is statistically significant.The second part is a qualitative study.Through objective sampling,the patients with post-stroke constipation who received ear copper needle scraping in the first part are selected as the research object.The recording data and nonverbal behavior data of patients were collected by semi-structured interview,and the seven step analysis method of Colaizzi data was used to encode,summarize and refine the theme of the transcribed text data.Results:1.Comparison between groups before intervention:the three groups were compared in general information,Bristol fecal scale score and CCS scale score,and the difference was not statistically significant(P>0.05),indicating that the baseline levels of the three groups were basically the same before intervention,and the three groups were comparable.2.Comparing the Standardol stool scale scores and CCS scale scores before and after the intervention with the three groups of patients except the history,the scores after the intervention were better than before the intervention(P<0.05),and the differences between the groups after the intervention were statistically significant(P<0.05).3.After 1 week of intervention,the patients in group B and group C were better than those in group A(P<0.05)in terms of bristol stool scale scores,CCS scale defecation difficulties and total scores after the intervention;after 2 weeks of intervention,the B and C patients in the B and C groups were better than the Bristol stool scale scores,CCS scales except for frequency and history of defecation,and the total scores of the patients in group A(P<0.05),and the patients in group C were better than those in group A(P<0.05).The duration and total score of bowel movements were better than those in group B(P<0.05),and the first time of defecation after intervention in group B and group C was earlier than that in group A(P<0.05).4.There were significant differences in clinical efficacy among the three groups((?)~2=65.342,P<0.001).5.A total of 10 patients were included in the qualitative interview of this study.There are 4 themes and 11 sub themes:(1)negative experience of constipation after stroke:physical discomfort,poor psychological coping and changes in social activities;(2)Recognize the effect of ear copper needle scraping:good experience of ear copper needle scraping,improvement of constipation symptoms after stroke and other discomfort symptoms;(3)The problems of ear copper needle scraping:insufficient promotion,economic expenditure and convenient treatment;(4)Health management needs:eager for information support and psychological support.Conclusions:1.Ear acupoint seed embedding and ear copper needle scraping can improve the constipation symptoms of patients with constipation after stroke;2.Ear copper needle scraping can improve the constipation symptoms of patients with constipation after stroke faster than ear acupoint seed embedding,and the improvement effect is better and the curative effect is better;3.The themes and sub themes obtained from qualitative interviews can be dealt with and improved through the following measures:(1)multi-level joint intervention to improve the negative experience of patients;(2)Multi means to strengthen the promotion and improve the degree of adaptation;(3)Continuously improve nursing quality and establish evaluation indexes;(4)Systematic and scientific guidance to meet the needs of health education. |
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