| ObjectiveTo evaluate the effect of symptom management education program on self-management and quality of life of oropharyngeal symptom groups in patients with nasopharyngeal cancer,such as pain,dysphagia,sticky saliva and dry mouth.MethodsThrough literature review method,expert consultation method,combined with symptom management theory and knowledge and practice theory,the symptom management education intervention plan was constructed according to the characteristics of oropharyngeal symptom group of patients with nasopharyngeal cancer chemotherapy,and the intervention plan was improved through expert demonstration and preliminary experiment.A total of 108 patients with nasopharyngeal carcinoma who received concurrent chemoradiotherapy in the radiotherapy department of a Third-class A hospital in Bengbu were randomly divided into three wards as the control group(n=54)and the other three wards as the intervention group(n=54).The first intervention lasted from the first day of radiotherapy to the second week after discharge.The control group received routine health education during radiotherapy for nasopharyngeal carcinoma,and twice of telephone follow-up after discharge.The intervention group received symptom management education on the basis of routine nursing.The intervention form was one-to-one health education,twice a week,20-30 min each time.The intervention content included three stages of information guidance,belief strengthening and behavior guidance,twice a week,a total of 8 interventions,and the patients were given 2 times of telephone follow-up after discharge.Grade of acute radiation oral mucositis,Anderson Scale-head and neck Module,Self-efficacy Scale,and Quality of Life Measurement Scale were used to evaluate the intervention effect of symptom management education program in oropharyngeal symptom group of patients with nasopharyngeal cancer after radiotherapy and chemotherapy at 2,4,6 weeks and 2 weeks after discharge,respectively.SPSS 26.0 statistical software was used for statistical analysis.Statistical data were analyzed usingχ~2test and Wilcoxon sign rank sum test.Repeated measure ANOVA and independent sample t test were used for quantitative data.Results(1)There were 54 patients in the intervention group,1 patient was lost to follow-up after radiotherapy,and 53 patients were effectively studied.In the control group of 54patients,2 patients withdrew from the test due to disease progression during radiotherapy,1patient was lost to follow-up after radiotherapy,and 51 patients were effectively studied.(2)There was no significant difference in age between the two groups(t=-0.84,P=0.40).There were no significant differences in gender,education level,physical strength score,T stage,N stage,clinical stage and chronic disease combination between 2 groups(P>0.05).Before intervention,there were no significant differences in 5 functional areas,3symptom areas,6 individual items and 1 overall quality of life between the two groups(P>0.05).Before intervention,there was no significant difference in self-management efficacy scores between the two groups(t=0.626,p=0.533).(3)After intervention,there were statistically significant differences in the severity of oropharyngeal symptom groups between the two groups in the main effect of intervention(P<0.05).The scores of pains,dysphagia,sticky saliva and dry mouth of 2 groups had statistical significance in time effect(P<0.05).There were statistically significant differences in pain symptom scores between the two groups(P<0.05).There were statistically significant differences in the incidence of all levels of radioactive oral mucositis injury between the intervention group and the control group(P<0.05).The incidence of grade 3-4 oral mucositis at T2 was 11.321%in the intervention group and 29.412%in the control group,the difference was statistically significant(χ~2=5.278,P=0.022).In T3,the ratio was 24.528%in the intervention group and 45.098%in the control group,the difference was statistically significant(χ~2=4.859,P=0.028).At T4,16.981%in the intervention group and 39.216%in the control group,the difference was statistically significant(χ~2=-2.437,P=0.015).(4)After intervention,the self-management efficacy scores of patients in the intervention group were higher than those in the control group at each time point,and the difference was statistically significant(P<0.05).The self-management efficacy scores of the two groups had statistical significance in the main effect of intervention(P<0.05).There were significant differences in the time effect of self-management efficacy scores between2 groups(P<0.05).There was significant difference in the interaction effect between the two groups(P<0.05).(5)After intervention,there were significant differences in body,cognition,mood,fatigue,pain,sleep disturbance,loss of appetite and overall function between the two groups(P<0.05).Before and after intervention,there were significant differences in social,physical,role,cognitive,emotional,fatigue,pain,sleep disorders,loss of appetite,dyspnea and overall function in the intervention group(P<0.05).ConclusionSymptom management education can reduce the severity of pain,dry mouth,sticky saliva,dysphagia and other oropharyngeal symptoms in patients with nasopharyngeal cancer and chemotherapy,as well as the severity of radioactive oral mucositis,and improve the self-management efficacy and quality of life in patients with nasopharyngeal cancer and chemotherapy.In the nursing intervention period,the adherence of patient is much higher,no related side effects,which is suitable for clinical nursing of nasopharyngeal carcinoma patients undergoing radiotherapy and chemotherapy. |
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