| Objective : To investigate the status quo of airway safety management in patients without larynx,and to analyze the factors influencing the activation of patients 'participation in airway management,Adopting systematic education as a means of intervention to explore the effect of their enthusiasm on the management of airway in patients without larynx.Methods:This study is divided into two parts.The first part of the descriptive study:three hospitals in the top three hospitals in Wuhan ENT clinics,selected from 2016 to August 2016,68 patients without laryngeal baseline survey.Through the general Information questionnaire and the Patient Activation Measure(PAM),The investigators investigated the status of airway safety management in patients without larynx and the influencing factors of activation.The second part of the experimental study:30 patients without laryngeal after informed consent,Otolaryngology of a hospital in Wuhan City,to carry out systematic education of airway safety management.The whole systematic education lasts for 3 months.the first 6 weeks,The airway management group of patients without larynx gives weekly group health education to patients without larynx through handouts,PPT,case analysis,video,etc;and after 6 weeks used WeChat,SMS,telephone,family visits to push the airway safety information,to solve the problem of non-throat patients and difficulties.The researchers evaluated the efficacy of systematic education in three aspects of self-efficacy(Strategies Used by People to Promote Health,SUPPH),airway physiology(Airway Physiological Status Questionnaire)and cognition of airway Safety(Airway Safety Survey).Patients with no larynx in the intervention before and after completing the Patient Activation Measure to evaluate the systematic education for patients with non-throat participation in airway management.The research data is analysed using SPSS 22.0 statistic software,and the statistic analysis method includes pairing T sample test,Wilcoxon symbol anecdotal test,Spearman test and statistic description analysis.Setting P <0.05 is statistically significant.Results:The first part:(1)37 of 68 patients with no larynx had complications.Among them,18 cases(26.5%)had hemorrhage,10 cases(14.7%)had respiratory tract obstruction,7 cases(10.3%)were pharyngeal fistula,5 cases(7.4%)had infection;(2)68 cases of non-larynx patients activated score was 37.8~74.3 score,the average was divided into 53.68±7.29 points,According to Hibbard standards the first level 17.6%,the second level 48.5%,the third level 27.9%,The fourth level 5.9%,the age of the patientswith no throat was negatively correlated with positive degree.The second part:The results of systematic health education are evaluated as follows:(1)The self-efficacy of 30 patients without larynx was compared before and after systematic education,the difference was statistically significant(P <0.01);(2)The airway physiology of patients with no larynx after the completion of the course was significantly improved than before the intervention;(3)30 patients with no-throat safety cognition better,patients without larynx think they can solve the first five safety problems are bleeding,respiratory tract obstruction,infection,improper medication of airway,improper nursing operation;(2)The activation and its level of 30 patients without larynx were compared before and after systematic education,the difference was statistically significant(P <0.01).Conclusion:(1)The status of airway safety in non-larynx patients with hemorrhage,respiratory tract obstruction,pharyngeal fistula and infection incidence are higher;(2)The activation of non-laryngeal patients participating in airway management is not satisfactory.Age is the influencing factor;(3)After systemic education,the selfefficacy of non-larynx patients participating in airway management has improved,the physiological condition of airway has been markedly improving,and the cognition of safety problem has been improved;(4)Systemic education improves the activation of nonlarynx patients participating in airway management. |
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