Study On The Uncomfortable Experience And Status Of Secondary Xerostomia In Patients With Fasting After Gastrointestinal Surgery

Objective: The purpose of this study was to investigate the comfort needs and current situation of secondary xerostomia in patients with fasting after gastrointestinal surgery. To catch the attention of medical staff, and to provide scientific basis for exploring targeted nursing interventions. To analyze the correlation characteristics between the time and the extent of xerostomia in order to seek the best time to start effective nursing interventions, and to promote the rehabilitation of patients. Methods: This study adopted the methods of combining qualitative research and quantitative research:Part one: The phenomenological methodology and purposive sampling were used in qualitative research. this part finally took 12 patients with xerostomia's uncomfortable experience after gastrointestinal surgery,accepting semi-structured in-depth interview and tape recording. The data was analyzed by Colaizzi's analysis method to explore the real uncomfortable experience of patients with xerostomia.Part two: Cross-sectional study design and convenient sampling were used in quantitative study, taking 180 patients with xerostomia after gastrointestinal surgery from a ?-A grade hospital in Wuhan as research object. The instruments were self-designed questionnaires based on the results of qualitative research, including patients' general condition questionnaire, xerostomia situation assessment form and visual analog scales(VAS). Epidata 3.1 was used to established the database, and SPSS20.0 was used to analyze the data. Results:1. Qualitative Research:(1) Five major themes and ten secondary concepts were extracted from the data of patients with xerostomia's uncomfortable experience after gastrointestinal surgery: emotional reaction(helplessness, irritability anxiety and self-examination, burden in care, happiness in care, uncertainty in illness), oral discomfort(multiple dry places and manifestations, accompanied symptoms of xerostomia, xerostomia serious period), cognition of fasting in operative period(poor compliance, excessive compliance), desperate for attention, return to the basic physiological requirements.(2) The more prominent themes of xerostomia's uncomfortable experience in patients with fasting after gastrointestinal surgery.2. Quantitative Research:(1)General information of patients: Significant difference was found in age and the status of medical insurance(P<0.05). The proportion of patients over 45 years old was 81.25%, and most concentrated between 45 to 60 years old.(2)Disease related data: The influence of surgical site, gastric tube placement time, and actual water deprivation time before and after operation on the xerostomia severity score was statistically significance. Before operation, patients with fating except water over 8 hours accounted for 88.07% and Patients with water deprivation over 4 hours accounted for 89.77%. After operation, patients with water deprivation over 12 hours accounted for 81.82%. Patients with gastric tube over 12 hours accounted for 86.93%.(3)The data of xerostomia situation assessment: The property of xerostomia had significant influence on the xerostomia severity score(P<0.05). Patients with moderate and severe xerostomia after operation accounted for 89.77%. In addition, the proportion of patients with moderate and severe xerostomia increased significantly from 6 to 12 hours and reached peak at 18 hours after surgery. Conclusions:1. Qualitative Research:(1) Because of the uncomfortable experience of secondary xerostomia in patients with fasting after gastrointestinal surgery is complex changeful, medical staff should strengthen the awareness of this patients.(2)Although the properties of xerostomia that secondary to fasting in the patients with gastrointestinal surgery are transient and reversible, it not only makes patients exist physical discomfort, but also affect their psychology, behavior and cognition. Therefore, clinical researchers should actively explore the effective measures of dry mouth, providing quality care to meet patients' needs.2. Quantitative Research:(1) Because of significant difference on xerostomia severity score in patients with different age, medical personnel should strengthen xerostomia status monitoring and nursing for middle-aged and old patients(especially aged 45 to 60 years old). In addition, medical workers should pay attention to the psychological care of patients with medical expenses by their own.(2)The time of most patients with fasting had beyond the traditional standard time. Clinical workers should standardize preoperative education guidance, and adjust these according to the acrual situation. In addition, because of the results, fast-track rehabilitation should be positively practiced.(3)Relieving the uncomfortable experience of xerostomia, nurses should deal with the symptoms at the same time. They should reasonably strengthen nursing management according to the xerostomia severity characteristics at different periods.