| ObjectiveTo establish the Nursing version and Patient version of Clinical Nursing Pathways(CNP)on non-tube and fast-track recovery in patients with esophageal cancer;To explore the clinical application of the non-tube and fast-track recovery clinical nursing pathways in esophageal cancer.It is aim to accelerate the patients of postoperative rehabilitation,decrease the length of hospital stay and improve the patients satisfaction.MethodsThis study consists of two parts.The first part:to establish the CPN on non-tube and fast-track recovery in patients with esophageal cancer.By retrospective analysis the data of 100 cases taken from February 2014 to August 2016 with the non-tube and fast-track program for esophageal cancer,SPSS 20.0 software was used for data analysis.It is aim to determine the basic nursing items,days of hospitalization and days of postoperative hospitalization.On the basis of reviewer literature and the Delphi expert consultation method,the final prototype of the Nursing version and Patient-guided version of CNP on non-tube and fast-track recovery in patients with esophageal cancer was established.The second part:the application of clinical nursing pathway was practiced in the clinical.From November 2016 to November 2017.a total of 62 esophageal cancer patients with non-tube and fast-track recovery were collected in A Cancer Hospital in the Henan Province.Patients were randomized into pathway group and control group.The pathway group was received the care of CNP,while the control group was received with routine holistic care.Compare the general data,postoperative recovery,postoperative complications,patients satisfaction,anxiety and depression condition,hospitalization costs,and length of hospital stay for two groups of patients.Input the data using the software EpiData 3.1,and SPSS 20.0 software to analysis data.For analysis,independent sample t tests and?~2tests were used to compare between the two groups.Results1.We had constructed CNP on non-tube and fast-track recovery in patients with esophageal cancer.2.It was analysis to the effects of the CNP with non-tube and fast-track recovery patients in the esophageal cancer in the clinical.(1)There was no significant difference in general demographic data such as sex,age,and education between the two groups(P>0.05).(2)Postoperative recovery were compared between the control group and the pathway group.(1)The wound healing of the two groups of patients were compared.In the control group,there were 2cases of poor wound healing and 4 cases of poor wound healing in the pathway group.There was no significant difference between the two groups(P>0.05).(2)The postoperative recovery of bowl sound were compared.It was(2.23±0.42)in the control groups and(1.87±0.72)in the experimental group,There was no significant difference between the two groups(P>0.05).(3)The diet calories(kcal)on the first day,the second day,and the third day after the operation were compared between the two groups.The calorie intake through mouth on the first,second,and third day of the control group was(94.84±32.30),(200.32±117.28),(573.52±85.08)respectively.The oral calorie intake on the first,second and third day of the pathway group was(101.29±42.06),(272.30±152.26),(631.32±94.47)respectively.There was no significant difference in diet calories between the control group and the pathway group on the first day after surgery((P>0.05),but there was a statistical difference on the second and third day(P<0.05).(4)The pain score on the first,second,and third day of the control group was(4.97±1.17),(4.74±1.03),(3.42±0.85)respectively.The pain score of the first,second and third day of the pathway group was(4.68±1.04),(4.61±1.17),(2.94±0.85)respectively.There was no significant difference in pain scores between the two groups on the first day and the second day after operation(P>0.05).There was a statistically significant difference in pain scores on the third day after operation between the two groups(P<0.05).(3)Postoperative complications were compared between the two groups.There were 8 cases with postoperative complications in the control group,including 5 pulmonary complications,3 arrhythmia.There were 1 patients with postoperative complications in the pathway group,all were pulmonary complications.There was statistically significant difference on postoperative complications between the two groups(P<0.05).(4)The SAS/SDA score of patients as compared.The SAS score in the control group and experimental group was(52.97±3.98),(51.61±3.20)respectively before intervention,there was no significant difference between the two groups(P>0.05).The SAS score in the control group and experimental group after intervention was(45.61±6.48),(42.32±5.64)respectively,there was a significant difference after intervention(P<0.05).The SDS score in the control group and experimental group was(50.77±2.58),(49.42±3.77)respectively,the SAS score in the control group and experimental group after intervention was(45.61±6.48),(42.32±5.64),there was no statistical difference before intervention(P>0.05),but there was statistical significant difference after intervention(P<0.05).(5)The average hospitalization expenses and hospitalization days were compared.The average hospitalization expenses(RMB)for the control group and the pathway group were(71151.84±9310.75)and(65515.15±11070.24)respectively,The difference in hospitalization expenses between the two groups was statistically significant(P<0.05).The average hospitalization days in the control group and pathway group was(18.06±2.68)and(16.81±1.72)respectively,and the difference between the two groups was statistically significant(P<0.05).The average postoperative days in the control group and pathway group was(8.9±2.7)and(7.6±1.7)respectively,there were a significant difference between the two groups(P<0.05).(6)Satisfaction survey between the two groups was compared.The satisfaction score of the control group was(94.77±1.59).The satisfaction score of the pathway group was(96.52±1.44).There was a statistically significant difference in patients satisfaction score between the two groups(P<0.01).Psychological state score was compared between the two groups.ConclusionThe application of Clinical Nursing Pathway(CNP)on non-tube and non-fasting of fast-track recovery in patients with esophageal cancer can accelerate postoperative recovery of patients,reduce the hospitalization costs and hospitalization days,promote communication between doctors and patients,improve patients'satisfaction to nurses'work,reduce disputes between nurses and patients,and provide clinical nurses with useful value in the care of these surgical patients. |
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