临床护理专题

线上课程联合回授法在喉切除患者及照顾者中的应用效果

  • 黄佳露 ,
  • 李珊 ,
  • 张才云 ,
  • 徐菲
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  • 上海市长海医院,海军军医大学第一附属医院耳鼻咽喉科,上海 200433
黄佳露(1995—),女,护师,学士;电子信箱:hjl951110@163.com
徐 菲,电子信箱:feifei08082010@163.com

收稿日期: 2024-01-22

  录用日期: 2024-04-23

  网络出版日期: 2024-10-28

基金资助

促进市级医院临床技能与临床创新三年行动计划(SHDC2020CR6011)

Application of online courses combined with teach-back method to laryngectomy patients and family carers

  • Jialu HUANG ,
  • Shan LI ,
  • Caiyun ZHANG ,
  • Fei XU
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  • Department of Otolaryngology, Shanghai Changhai Hospital, The First Affiliated Hospital of Naval Military Medical University, Shanghai 200433, China
XU Fei, E-mail: feifei08082010@163.com.

Received date: 2024-01-22

  Accepted date: 2024-04-23

  Online published: 2024-10-28

Supported by

Three-Year Action Plan to Promote Clinical Skills and Clinical Innovation in Municipal Hospitals(SHDC2020CR6011)

摘要

目的·探讨线上课程联合回授法在喉切除患者及照顾者中的应用效果。方法·采用便利抽样法,选取2022年7月—2023年6月在上海市长海医院耳鼻咽喉科收治的喉切除患者及其家庭照顾者,运用随机数字表分为对照组和观察组,分别安置在2个病区进行干预。收集2组患者及照顾者的一般资料。对照组于入院后线下观看科室录制的喉癌相关知识讲解以及气道造口护理、吸痰和鼻饲等操作标准流程视频;视频分4次观看,每周1次,30 min/次。观察组入院后在线上自行观看相同的视频(8个课程),同时护理人员应用回授法进行每周1次的健康教育,每次巩固2个课程,45 min/次,共4次。分别于基线(第1周)、出院前(第4周)、出院后1个月(第8周)采用照顾者准备度量表(Caregiver Preparedness Scale,CPS)、家庭照顾者照顾能力量表(Family Caregiver Task Inventory,FCTI)、中国头颈癌患者生命质量测定量表(Quality of Life Instruments for Cancer Patients-Head and Neck Cancer,QLICP-HN),以及出院后居家护理期间不良事件发生率进行效果评价。结果·共纳入120对患者及其照顾者,对照组和观察组各60对,因各种原因2组各剔除5对,最终每组入选55对。2组患者和照顾者的一般资料、基线时患者的QLICP-HN得分,以及照顾者的CPS和FCTI得分,差异均无统计学意义(均P>0.05)。出院前和出院后1个月,观察组照顾者的CPS得分和患者的QLICP-HN得分均显著高于对照组,FCTI得分显著低于对照组(该量表得分越低表示照顾能力越强),差异均具有统计学意义(均P<0.05)。观察组在出院后1个月内居家护理不良事件发生率低于对照组(5.5% vs 29.1%),差异具有统计学意义(P<0.05)。结论·线上课程联合回授法有助于提高喉切除术后患者的家庭照顾者的照顾准备度及照顾能力,提高患者的生活质量,降低居家护理期间不良事件发生率。

本文引用格式

黄佳露 , 李珊 , 张才云 , 徐菲 . 线上课程联合回授法在喉切除患者及照顾者中的应用效果[J]. 上海交通大学学报(医学版), 2024 , 44(10) : 1221 -1228 . DOI: 10.3969/j.issn.1674-8115.2024.10.002

Abstract

Objective ·To explore the effect of online courses combined with the teach-back method among patients with laryngectomy and their family caregivers. Methods ·Convenience sampling was used to select patients with laryngectomy treated in the Department of Otolaryngology, Shanghai Changhai Hospital from July 2022 to June 2023 and their family caregivers. The participants were divided into a control group and an observation group using the random number table method. The intervention was conducted in two different wards. General information of the two groups of patients and caregivers was collected. After admission, the control group watched offline videos recorded by the department. The videos introduced laryngocarcinoma-related knowledge and standard procedures of airway stoma care, suctioning, nasal feeding, etc., which were divided into 4 sessions with 30 min each. The patients watched one session per week. The observation group watched the same videos (8 lessons) online on their own after admission, while the nursing staff used the teach-back method for health education, consolidating 2 lessons once a week, 45 min/session for 4 weeks. The effectiveness of the intervention was evaluated by using Caregiver Preparedness Scale (CPS), Family Caregiver Task Inventory (FCTI), and Chinese Quality of Life Instruments for Cancer Patients-Head and Neck Cancer (QLICP-HN) at baseline (1st week), before discharge (4th week), and one month after discharge (8th week), as well as the incidence of adverse events during home care. Results ·The study included a total of 120 pairs of patients and caregivers, with 60 pairs in each group. Five pairs in each group were excluded due to various reasons, leaving a total of 55 pairs in each group. There were no statistically significant differences between the two groups in terms of general information of the patients and the caregivers, QLICP-HN scores of the patients, and CPS and FCTI scores of the caregivers at baseline (P>0.05). Before discharge and 1 month after discharge, the CPS scores of the caregivers and the QLICP-HN scores of the patients in the observation group were significantly higher than those in the control group, and the FCTI scores were significantly lower (lower scores indicating better nursing care), with statistically significant differences (P<0.05). Within 1 month after discharge, the incidence of adverse home care events in the observation group was lower than that in the control group (5.5% vs 29.1%), and the difference was statistically significant (P<0.05). Conclusion ·The online courses combined with the teach-back method help improve the readiness to care and caregiving competence of family caregivers of post-laryngectomy patients, improve patients' quality of life, and reduce the incidence of adverse events during home care.

参考文献

1 潘新良, 林云. 正确选择喉癌治疗方式、提高患者的生存率及生活质量[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55(12): 1111-1115.
1 PAN X L, LIN Y. The correct selection of treatment strategies for laryngeal cancer to improve the survival rate and quality of life for patients[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2020, 55(12): 1111-1115.
2 FORASTIERE A A, ISMAILA N, LEWIN J S, et al. Use of larynx-preservation strategies in the treatment of laryngeal cancer: American Society of Clinical Oncology clinical practice guideline update[J]. J Clin Oncol, 2018, 36(11): 1143-1169.
3 MCCORMICK M E, WARD E, ROBERSON D W, et al. Life after tracheostomy: patient and family perspectives on teaching, transitions, and multidisciplinary teams[J]. Otolaryngol Head Neck Surg, 2015, 153(6): 914-920.
4 林郁清, 周益君, 史定妹. 视频宣教结合回授法在头颈部肿瘤放疗患者口腔功能锻炼中的应用[J]. 中华护理杂志, 2016, 51(9): 1090-1093.
4 LIN Y Q, ZHOU Y J, SHI D M. Application of teach-back method and video education on oral function exercise in head and neck cancer patients underwent radiation treatment[J]. Chinese Journal of Nursing, 2016, 51(9): 1090-1093.
5 戴亚端, 林丽媛, 郭进华, 等. 团体产前保健联合线上孕妇学校在高龄初产妇健康教育中的应用[J]. 中华护理教育, 2020, 17(9): 803-808.
5 DAI Y D, LIN L Y, GUO J H, et al. Application of the group prenatal care combined with pregnant women school for high-aged primiparous women[J]. Chinese Journal of Nursing Education, 2020, 17(9): 803-808.
6 陈悦, 李萍, 毛艳, 等. 头颈肿瘤气管切开带管出院患者家庭参与式延续护理的实施[J]. 护理学杂志, 2022, 37(18): 98-101.
6 CHEN Y, LI P, MAO Y, et al. Implementation of family integrated transitional care for discharged head and neck cancer patients carrying tube after tracheotomy[J]. Journal of Nursing Science, 2022, 37(18): 98-101.
7 褚冲冲, 杨学梅, 雷婷婷, 等. 基于新型传播媒介的居家延续护理在喉癌切除术后气管套管患者中的应用[J]. 护理实践与研究, 2023, 20(8): 1156-1160.
7 CHU C C, YANG X M, LEI T T, et al. Application of home extended care based on new communication media in patients with tracheal cannula after laryngectomy for laryngeal cancer[J]. Nursing Practice and Research, 2023, 20(8): 1156-1160.
8 常晓未. 喉癌患者围术期护理方案的构建及初步应用[D]. 太原: 山西医科大学, 2022.
8 CHANG X W. Construction and preliminary application of a perioperative nursing program for patients with laryngeal cancer[D]. Taiyuan: Shanxi Medical University, 2022.
9 刘延锦, 王敏, 董小方. 中文版照顾者准备度量表的信效度研究[J]. 中国实用护理杂志, 2016, 32(14): 1045-1048.
9 LIU Y J, WANG M, DONG X F. Reliability and validity of Chinese Version of the Caregiver Preparedness Scale in caregivers of stroke survivors[J]. Chinese Journal of Practical Nursing, 2016, 32(14): 1045-1048.
10 孙婧, 罗彩凤, 魏青, 等. 中文版家庭照顾者照顾能力量表在肠造口病人照顾者中的信度及效度研究[J]. 护理研究, 2018, 32(8): 1234-1238.
10 SUN J, LUO C F, WEI Q, et al. Study on reliability and validity of Chinese version of Family Caregiver Task Inventory of enterostomy patients[J]. Chinese Nursing Research, 2018, 32(8): 1234-1238.
11 罗家洪, 万崇华, 孟琼, 等. 中国头颈癌生命质量测定量表QLICP-HN的研制与考评[J]. 现代预防医学, 2007, 34(21): 4023-4025.
11 LUO J H, WAN C H, MENG Q, et al. Development and evaluation on Chinese Quality of Life Instruments for Cancer Patients-Head and Neck Cancer[J]. Modern Preventive Medicine, 2007, 34(21): 4023-4025.
12 李湘华, 刘学勤, 甘秀妮. 对全喉切除患者及家属实施同期护理干预的效果[J]. 中华护理杂志, 2010, 45(5): 436-438.
12 LI X H, LIU X Q, GAN X N. Impact of the family intervention on the quality of life in patients after total laryngectomy and their family members[J]. Chinese Journal of Nursing, 2010, 45(5): 436-438.
13 喻小燕. 喉癌住院患者照顾者的照顾准备度与疾病不确定感的相关研究[D]. 武汉: 武汉轻工大学, 2020.
13 YU X Y. A study on the correlation between caregiver's readiness to care and uncertainty of illness in laryngeal cancer hospitalised patients[D]. Wuhan: Wuhan Polytechnic University, 2020.
14 娄帅帅. 喉切除患者主要照顾者赋权能力及影响因素研究[D]. 青岛: 青岛大学, 2022.
14 LOU S S. Research on the status and influencing factors of primary caregivers' empowerment of laryngectomy patients[D]. Qingdao: Qingdao University, 2022.
15 EBBINGHAUS H. Memory: a contribution to experimental psychology[J]. Ann Neurosci, 2013, 20(4): 155-156.
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