| Objectives :1.Develop cluster nursing measures to meet the clinical rehabilitation demand of patients underwent thyroid microwave ablation2.Evaluation the validity and feasibility of cluster nursing in patients underwent thyroid microwave ablation.3.Provide the clinical basis for the application of cluster nursing in the rehabilitation of patients underwent thyroid microwave ablation.Methods:During December 2014 to December 2015, in the Department of general surgery, the first Central Hospital of Tianjin,96 cases with thyroid microwave ablation are selected in this research, using random sampling method. In the 6th floor, 48 patients were selected as the control group, and 48 patients as the intervention group in the 7th floor.Cluster nursing measures were used in the intervention group, and the control group received routine nursing measures. Using the patient's basic information collection table, numeric pain rating scale, general self-efficacy scale and health promotion strategy scale, the two groups were compared in postoperative neck swelling, pain, nutritional status, thyroid function recovery and self-efficacy etc. And then compare the two methods of nursing clinical intervention effects. The results obtained by using SSPS19.0 to analyze and count data were tested by T and Chi square test, P<0.05 indicated that the result is statistically significant.Results: 1. The two groups had no statistically significant difference(P > 0.05) with basic information.2. The two groups of patients in general self-efficacy scale and health promotion strategy scale 1 month after operation were surveyed. The results showed that the two groups in the Self-efficacy Sense score, positive attitude and self decompression scores had statistical significance(P < 0.05). There was no statistically significant difference in self decision making(P>0.05), and the control group was slightly lower than the intervention group.3. Compared two groups of patients with postoperative 1 week and after 1 month thyroid function laboratory indexes, serum TSH levels were decreased first and then increased, which had significant difference(P < 0.05) both after 1 week and 1 month. Serum FT3 and serum FT4 increased first and then decreased, which had significant difference(P < 0.05) after 1 week.4.Compared the two groups of patients with degrees of pain postoperative 6h, 8h, 10 h, the results showed that the two groups had statistical difference(P < 0.05) at each time point.5.Neck swelling was compared 6h, 8h, 10 h after operation, the results showed that the two groups had statistical difference(P < 0.05) in every time point. 6. Subjective global assessment score change before operation and 1 months after had no significant difference,but when 1 week after operation, there was significant difference(P < 0.05).Conclusion: Cluster nursing measures can reduce postoperative pain, promote the recovery of thyroid function, relief neck swelling, enhance patients' self-efficacy, so as to promote the rehabilitation of patients after thyroid microwave ablation. |
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