| Objective: Apply auricular acupressure and music relaxation therapy to the postoperative care of patients with laryngeal cancer after laryngectomy,and verify their effectiveness in improving postoperative pain and sleep in such patients,in order to provide scientific reference for clinical nursing of patients with laryngeal cancer after laryngectomy.Methods: This is a quasi-experimental with two-arm study design,with single blind to the patients.Using a convenience sampling method,100 patients underwent laryngectomy for laryngeal cancer in the Second Affiliated Hospital of Xi'an Jiao Tong University from April to December 2019 were selected and randomly allocated divided into an experimental group and a control group,with 50 patients in each group.The control group received routine care,and the experimental group received auricular acupressure and music relaxation therapy on the basis of routine care.The acupuncture points were chosen for the patient at 9:00 am on the first day after the operation.The ear beans are checked for position to avoid displacement and the skin damage on the 3rd,5th and 7th day after the operation.The ear beans were replaced if necessary.The patients are instructed to press the ear bean every day at 9:00 am,15:00 pm,21:00 pm,1 ~ 2min each time,until the bean massage part of the ears got hot and sore,for 7 days.Music relaxation therapy was carried out daily from 9:00 am-10:00am,15:00 pm-16:00pm,21:00 pm-22:00 pm,with each time 30 min,totally for 7 days.Both groups were evaluated by the data collection instruments including the Pittsburgh Sleep Quality Index Scale(PSQI)and Visual Analogue Scale(VAS)at 7:00 am on the first,third,fifth,and seventh day after surgery,and the general information was filled in during the first evaluation Questionnaire.The pain and sleep of the two groups of patients before intervention(day 1 postoperatively)and after intervention(days 3,5,and 7 postoperatively)were compared.Used Excel to put into data and analyzed by SPSS 22.0.Used mean,standard deviation and percentage to descriptive statistical all data.Used these inferential statistical methods of data,including t-test,Chi-square test,One-way ANOVA analysis and Spearman s correlation.Results: A total of 100 patients participated in the study in this study.The patients' age was 37~78(57.49±8.86)points,mostly male and Han nationality,99(99.0%);30 smokers(30.0%)and 33 quitted smokers(33.0%);99 patients(99.0%)with squamous cell carcinoma,70 patients(70.0%)with stage I to II tumor staging;50 patients(50.0%)received partial laryngectomy.1.Pain and sleep of the two groups before the interventionPain: The VAS pain scores of the experimental group and the control group before intervention were score(5.48±1.09)and score(5.68±1.11)respectively with no significant statistical difference(P> 0.05).There were 42 patients(84.0%)with moderate VAS pain score in the experimental group,and 8 patients(16.0%)with severe VAS pain score;While 38 patients(76.0%)with moderate VAS pain score in the control group,and 12 patients(24.0%)with severe VAS pain score,the difference was no statistically significant(P> 0.05).Sleep: The total PSQI scores of the experimental group and the control group before intervention were score(10.04±2.26)and score(9.34±1.69),with no statistically significant difference(P> 0.05);With regarding to the subscales,such as: sleep quality,time to fall asleep,sleep time,sleep efficiency,sleep disorders,hypnotic drugs,and daytime dysfunction,there were no statistical difference found(P> 0.05),and they were comparable.VAS pain score was positively correlated with PSQI total score and subscale scores,e.g.sleep quality,time to fall asleep,sleep time,sleep efficiency,sleep disturbance factor(P <0.05),There was no correlation with hypnotic drugs and day dysfunction factors(P> 0.05)2.Pain and sleep of the two groups after the interventionPain: The VAS pain scores of the experimental group and the control group on the 3rd postoperative day were score(2.62±0.88)and score(5.62±1.06)respectively,on the 5th postoperative day were score(0.98±0.74)and score(2.70±0.78),respectively on the 7th postoperative day were score(0.16±0.37)and score(0.64±0.72).(1)Repeated measures analysis of variance: VAS pain scores indicated a significant differences in time factor effects,intergroup effects,and the interaction between time and grouping factors(P <0.001);(2)Comparison between groups: VAS pain scores in the experimental group were statistically different from those in the control group on the 3rd,5th,and 7th day after surgery(P<0.001);(3)Comparison within group: VAS pain scores in the experimental group had statistically significant differences on the 3rd,5th,and 7th days after the operation compared with those before the intervention(P <0.001);The VAS pain scores of the control group compared with before intervention had no statistically significant different on 3rd day(P >0.05),but on the 5th,and 7th days after surgery had statistically significant differences(P <0.001);Both the VAS pain level of the experimental group and the control group had statistically significant differences on different point in time after intervention(P <0.001).Sleep: The total PSQI scores of the experimental group and the control group on the 3rd postoperative day were score(6.06±1.70)and score(9.26±1.49),on the 5th postoperative day were score(3.54±1.27)and score(7.98±1.25),respectively on the 7th postoperative day were score(2.26±0.96)and score(6.96±1.17).The time factor effect of hypnotic drug factors,the effect between groups,the interaction between time and grouping factors,the comparison between groups,and the comparison between groups were no statistically significant different(P >0.05).(1)Repeated measures analysis of variance: the total PSQI scores,sleep quality,time to fall asleep,sleep time,sleep efficiency,sleep disturbance and daytime dysfunction factor time factor effect difference had statistically significant differences(P <0.001).the difference in effect between groups was statistically significant(P <0.001),the interaction between time and grouping factors effect of sleep quality and sleep time factors were no statistically significant different(P >0.05),but the total PSQI scores and other factors had statistically significant differences(P <0.001);(2)Comparison between groups: The total PSQI scores and various factors in the experimental group were statistically different from those in the control group on the 3rd,5th and 7th days after the operation(P <0.001);(3)Comparison within group: The total PSQI scores and various factors of the experimental group had statistically significant differences on the 3rd,5th and 7th days after the operation compared with those before the intervention(P <0.001);The total PSQI scores,sleep quality,and day dysfunction factors in the control group were no statistically significant different on the 3rd day after the operation compared with those before the intervention(P> 0.05);The total PSQI scores and other factors of the control group were statistically significant different on the 5th and 7th day after operation compared with those before intervention(P <0.05).Conclusions: 1.Most patients with laryngeal cancer after laryngectomy have moderate pain on the first day after surgery,and a small number of patients had severe pain;patients had varying degrees of sleep disturbance;age,smoking history and surgical approach are influencing factors of sleep.2.Auricular acupressure and music relaxation therapy can effectively reduce the pain of patients with laryngeal cancer after laryngectomy,which can also effectively improve the sleep disturbance of patients with laryngeal cancer after laryngectomy and promote the recovery of postoperative sleep,mainly from the subjective sleep quality and day dysfunction Sleep quality Index. |
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