| Objective:The purpose of this study was to explore the effect of feeding training in different eating positions(30 ° supine position,60 ° supine position,90 ° upright sitting position)on postoperative patients with laryngeal cancer.To analyze the effects of feeding training with different feeding positions on swallowing safety,swallowing function,self-efficacy and food surplus in patients after laryngeal cancer surgery,and to provide reference and clinical basis for the best feeding position of feeding training for patients after laryngeal cancer surgery.Methods:A total of 108 patients with laryngeal cancer who met the inclusion criteria in a tertiary hospital in Shanxi Province from June 2022 to December 2022 were selected as the research objects by convenient sampling method.The patients were numbered according to the order of admission.According to the random number table method,the patients were divided into experimental group 1,experimental group 2 and experimental group 3.The three groups of patients were guided to carry out feeding training in three feeding positions : 90 ° upright sitting position,60 ° supine position and 30 ° supine position.The swallowing safety,swallowing function,food intake and self-efficacy of the three groups were evaluated.The incidence of swallowing safety impairment was evaluated by the incidence of swallowing safety impairment.The incidence of swallowing safety impairment = the number of symptoms of safety impairment / the number of times of oral feeding × 100 %.The patients were divided into mild(60 %)according to the incidence.Swallowing function was evaluated by Functional Oral Intake Scale(FOIS)before operation,1 week and 2 weeks after operation.General Self-Efficacy Scale(GSES)was used to evaluate self-efficacy before operation,1 week and 2 weeks after operation.The total amount of food remaining after feeding training was evaluated at 1 week and 2 weeks after operation.SPSS25.00 statistical software was used for statistical description,repeated measurement analysis of variance,rank sum test and chi-square test.P < 0.05 was considered statistically significant,and the test level was α = 0.05.Results:1.Clinical baseline data : There was no significant difference in general data and clinical data among the three groups(P > 0.05).2.Swallowing safety : There were significant differences between the experimental group3 and the experimental group 1 and the experimental group 2(P < 0.05).The incidence of impaired swallowing safety in the experimental group 3 was less than that in the experimental group 1 and the experimental group 2(P < 0.05).There was no significant difference in swallowing safety between the experimental group 1 and the experimental group 2(P > 0.05).3.Swallowing function : There was no significant difference in FOIS scores among the three groups before intervention,1 week and 2 weeks after intervention(P > 0.05).The FOIS scores of patients at different time points were statistically different(P < 0.05).With the increase of postoperative time,the FOIS score of patients gradually increased.With the increase of postoperative time,the FOIS score of patients gradually increased.4.Self-efficacy: One week after the intervention,the self-efficacy scores of patients in the3 rd group of the trial were statistically significant compared with the 1 group and the 2nd group(P<0.05),and the self-efficacy scores of the 3rd group were higher than those in the 1st group and the 2nd group,and the difference between the 1 group and the 2nd group was not statistically significant(P>0.05).At two weeks after the intervention,there was no statistically significant difference in self-efficacy scores between the three groups(P>0.05).There were statistically significant differences in self-efficacy between different time points(P<0.05),and the self-efficacy score gradually increased with the increase of postoperative time.5.Food surplus: At one week post-intervention,the difference in food surplus in trial 3group was statistically significant compared with trial 1 and trial 2(P<0.05),the food surplus in trial group 3 was significantly lower than in trial group 1 and trial 2,and the difference in trial group 1 was not statistically significant compared with trial group 2(P>0.05).At two weeks post-intervention,there was no significant comparison of food surplus between the three groups(P>0.05).Conclusion:(1)Bed head elevation 30 ° supine position is an ideal position for patients after laryngeal cancer surgery,which can improve the occurrence of impaired swallowing safety during early feeding training,and improve the self-efficacy and food intake of patients during early feeding training.(2)With the increase of postoperative time,the food intake and self-efficacy of the three groups of patients tended to be consistent.In the early postoperative period,patients should be guided to raise the bed head by 30 ° supine position for feeding training. |
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