| Objectiv:This study aims to the Trans-Theoretical Model for theoretical guidance,for laryngeal cancer postoperative patients build based on We Chat platform esophageal pronunciation training continue nursing intervention program,for the esophageal pronunciation training patients with laryngeal cancer with mobile continuity nursing support,so as to improve esophageal pronunciation training effect,improve the negative emotions,improve the quality of life,in order to provide a new way for patients with laryngeal cancer postoperative care.Methods:1.Esophageal pronunciation training continues the construction and development of nursing We Chat platform.(1)Laryngeal cancer postoperative esophageal pronunciation training continued nursing We Chat platform demand: In order to understand the real needs of patients’ esophagus for pronunciation training after laryngeal cancer surgery,using the description of the study,using the purpose sampling method,according to the biggest difference sampling strategy,the Jilin University Second Hospital otolaryngology head and neck surgery in July 2022-August 2022 outpatient income of laryngeal cancer back to hospital review of 12 patients as an interview object semi-structured interview.Within 24 hours after the interview,two researchers will transcribe the interview materials(including the patient’s expression,pauses and mood words)into the text,repeatedly listen to the recording to determine the content,input the text into the qualitative data analysis software NVivo12,and record the general data of the interviewees by using the Excel form.(2)Construction of We Chat platform for esophageal pronunciation training continued nursing: We Chat platform for esophageal pronunciation training continued nursing constructed according to the Trans-Theoretical model,Using the destination sampling method,After 5 nursing experts,2 voice therapist and 2 software engineers gave corresponding opinions and suggestions,Based on the design and modification of the Trans-Theoretical model to formulate the functional framework of the system;Build the content framework of We Chat platform based on laryngeal cancer,total laryngectomy,and esophageal pronunciation related guidelines,expert consensus,and monographs,And using the purpose sampling method,Invite 9 otolaryngology head and neck surgeons to review,Summarize the feedback of experts to form the final content module of We Chat platform.(3)The development of nursing We Chat platform: through We Chat developer tools,the front-end development of the We Chat platform uses uni-app,and the open-end database-Vant,u View component and uni-app native components;the back-end development mainly uses Java language,Mysql database,spring boot micro service architecture,We Chat developer tool 1.05.2110290 Stable version.2.Research on the application of esophageal pronunciation training and continuous nursing We Chat platform.To evaluate the clinical effectiveness of esophageal pronunciation training continuation nursing We Chat platform,by convenience sampling method,14 patients undergoing total laryngectomy for laryngeal cancer of otolaryngology head and neck surgery from October 2022 to November 2022 were selected as study subjects in the Jilin University Second Hospital.The statistical software SPSS 26.0 was used to realize the simple randomization of participants.In SPSS26.0 software,RV.UNIFORM(0,14)was used to generate 0 to 14 random numbers,rank the random numbers in ascending order,and the top 7 ranks were listed as experimental groups,and the bottom 7 were listed as the control group.Before the start of the study,the general data were collected and esophageal pronunciation training was conducted.The control group performed routine out-of-hospital follow-up after laryngeal cancer surgery,and the intervention group implemented the We Chat platform intervention based on the control group.The intervention time of both groups was 3 months.Finally,the scores of the two groups of patients before and after intervention were evaluated based on the Chinese head and neck cancer quality of life measurement scale,anxiety self-evaluation scale,depression self-evaluation scale,and Qin Jianwu’s subjective evaluation method.Using SPSS26.0for data processing.For ± was used to describe the normal distribution,two independent sample t-tests to compare differences between groups,paired sample t-tests to compare differences within the groups,and outcome measures at different time points were analyzed using repeated measures tests.For qualitative data,frequency(N)and percentage(%)were used to describe the count data,chi-square test or Fisher to compare the exact probability method,and Wilcoxon(Massive of Multiple).Two-sided P<0.05 were considered statistically significant.Results:1.Esophageal pronunciation training continues the construction and development of nursing We Chat platform.(1)Esophageal pronunciation training of patients after laryngeal cancer surgery Continuing nursing We Chat platform requirements:12 interviewees successfully completed the interview.Through inductive content analysis and integration,four themes were extracted in the function,content,visual design and cost of We Chat platform.(2)Esophageal pronunciation training continues the construction of nursing wechat platform:the function of We Chat platform according to the phased transformation theory of TTM model.After expert review,the functional framework of We Chat platform is determined,including knowledge,program setting,my course,experience record,experience sharing,family and friends number and other functions.(3)Esophageal pronunciation training continues the development of nursing We Chatt platform:the wechat applet designed and developed is called "Yue Er Center",and the user side includes four modules: knowledge,service,family and friends number,and me.We Chat platform server(background)mainly includes user management,administrator / authority,course management,online message management,integral management,setting and other modules.2.Research on the application of esophageal pronunciation training and continuous nursing We Chat platform.(1)The general demographic data of age,marriage,education level,and region of the study subjects showed no significant difference between the two groups(P >0.05).(2)The total anxiety score between the experimental group and the control group was statistically different at the three time points(P<0.05).Comparing the difference in total anxiety scores between the two groups,the results showed that there was no statistically significant difference in total anxiety scores before the intervention(P >0.05),and the total anxiety score of the experimental group at 1 month and 3 months was lower than that of the control group in the same period,and the difference was statistically significant(P< 0.05).(3)The total depression scores between the experimental group and the control group were statistically different at the three time points(P<0.05).Comparing the differences in total depression scores between the two groups,the results showed that there was no statistically significant difference in total depression scores before the intervention(P > 0.05),and the total depression scores in the experimental group at 1 month and 3 months were lower than that of the control group in the same period,and the differences were statistically significant(P<0.05).(4)The scores of the items of the Chinese head and neck cancer quality of life measurement scale between the experimental group and the control group were statistically significant between the three time points(P<0.05).Intervention at 1 month in the experimental group showed the scores of the psychological function,social function,common symptoms,adverse reactions and specific modules(P < 0.05);the total score of the group was higher than that of the control group,and the difference were statistically significant(P<0.05).(5)The rank sum ratio of the speech speech assessment of the two groups was tested.The P value of each item was less than 0.05,and the results were significantly different.The speech evaluation effect of the experimental group was significantly higher than that of the control group.(6)At 3 months of intervention,the days adhered to esophageal pronunciation training in the experimental group than in the control group(83.000 ± 3.79,62.714 ± 8.65,P<0.001).Conclusions:Based on the Trans-Theoretical model,a descriptive study was used to explore the demand of patients for the We Chat platform for esophageal pronunciation training after laryngeal cancer.Based on this,a We Chat platform for patients undergoing total laryngectomy for laryngeal cancer was constructed.In addition,the developed esophageal pronunciation training continuation nursing We Chat platform was designed for 3 months to evaluate the effectiveness of esophageal pronunciation training continuation nursing We Chat platform.The results showed that the psychological function,social function,common symptoms,adverse effects,and specific modules in Quality of life instruments for cancer patients-Head and Neck,reduced the negative emotions.After 3 months,the compliance of esophageal pronunciation training,significantly improve the effect of esophageal pronunciation training,effectively improve the anxiety and depression,and improve the quality of life. |
