基于同伴教育的食管发音培训在全喉切除术后患者中的应用  

Application of Peer Education-based Esophageal Voice Training after Total Laryngectomy

作　　者：胡兰 徐春[1] 卢玉晨 刘淑娥 胡静 HU Lan;XU Chun;LU Yuchen;LIU Shu′e;HU Jing(Hubei Cancer Hospital,Wuhan,Hubei 430079;Optics Valley Branch of Hubei Provincial Hospital of TCM,Wuhan,Hubei 430074)

机构地区：[1]湖北省肿瘤医院,湖北武汉430079 [2]湖北省中医院光谷院区,湖北武汉430074

出　　处：《上海护理》2024年第4期7-11,共5页Shanghai Nursing

基　　金：湖北省卫生健康委员会面上项目(WJ2021M191);湖北省肿瘤医院护理科研项目(2022-HL19-15)。

摘　　要：目的评价基于同伴教育的食管发音培训对全喉切除术后患者食管发音质量及心理韧性的影响。方法选择在湖北省肿瘤医院行全喉切除手术后的患者作为研究对象。以2021年1-6月行手术治疗的24例患者作为对照组,以2021年7-12月行手术治疗的25例患者作为观察组。两组患者均分别接受1次食管发音集训课程(术后6个月后)及2次巩固课程(术后9个月及12个月后),同时辅以线上指导。对照组患者的食管发音指导及线上答疑由头颈外科护士进行,观察组则由经招募及培训的5名同伴教育者实施。比较两组患者术后短期及中长期食管发音质量以及心理韧性(CD-RISC)水平。结果观察组患者短期及中长期食管发音质量均优于对照组(P<0.05)。且集训课程及第2次巩固课程后,观察组患者的CD‑RISC得分均高于对照组(P<0.05)。结论基于同伴教育的食管发音培训可以帮助患者重建发声功能,促进其言语康复及心理状态调适,有助于提高患者的心理韧性水平。Objective To evaluate the effect of peer education‑based esophageal voice training on esophageal voice quality and resilience in patients who have undergone total laryngectomy.Methods Patients who underwent total laryngectomy in Hubei Cancer Hospital were selected.Patients who underwent surgery from January to June 2021 were included in the control group(n=24)while those who underwent surgery from July to December 2021 were included in the observation group(n=25).The patients in both groups received one intensive esophageal voice training course(6 months postoperative)and two consolidation courses(9 and 12 months postoperative),supplemented by online guidance.The esophageal voice training and online Q&A were performed by the nurses from the Head&Neck Surgery Department in the control group and by five specially recruited and trained peer educators in the observation group.The esophageal voice quality and resilience level[using the Connor‑Davidson Resilience scale,(CD‑RISC)]in the short‑,medium‑and long‑term postoperative period were compared between the two groups.Results The esophageal voice quality in the observation group was superior to that in the control group in the short‑,medium‑and long‑term postoperative period(P<0.05).After the intensive training course and the second consolidation course,the CD‑RISC scores of patients in the observation group were all higher than those in the control group(P<0.05).Conclusion Peer educationbased esophageal voice training can restore patients'vocal function to accelerate their speech rehabilitation and adjust their psychological state to enhance their resilience level.

关 键 词：喉肿瘤 喉切除术 食管发音 同伴教育 心理韧性 

分 类 号：R473.76[医药卫生—护理学]