LERANS健康教育对甲状腺癌患者术后康复、吞咽功能及心理调适能力的影响  

Effects of listen,establish,adopt,reinforce,name,strengthen health education on postoperative rehabilitation,swallowing function,and psychological adjustment ability of patients with thyroid cancer

作　　者：汤洁 闫文润[1] 田海龙 陆晓梅 杨亚萍 TANG Jie;YAN Wen-run;TIAN Hai-long;LU Xiao-mei;YANG Ya-ping(Department of Throat,Head,and Neck Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Interventional Operating Room,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院咽喉头颈外科,河南郑州450000 [2]郑州大学第一附属医院介入手术室,河南郑州450000

出　　处：《海南医学》2024年第15期2265-2270,共6页Hainan Medical Journal

基　　金：国家自然科学基金(编号:U2004119)。

摘　　要：目的探究聆听、建立、应用、提高、反馈、强化(LEARNS)健康教育在甲状腺癌患者中的应用效果。方法选取2021年1月至2023年6月就诊于郑州大学第一附属医院的90例甲状腺癌患者作为研究对象,按随机数表法分为观察组和对照组各45例。对照组患者给予常规健康教育,观察组患者于此基础上给予LEARNS健康教育,干预至出院后1个月,比较两组患者的术后康复及术后1 d视觉模拟量表(VAS)评分,以及术后1 d和干预后的吞咽功能[洼田饮水试验、吞咽功能评估表(GUSS)]、颈部活动度及肩关节功能评价量表评分,并采用心理健康调查表(MHI-38)(由心理痛苦分量表、心理幸福感分量表构成)评价两组患者干预前后的心理调适能力。结果观察组患者术后1 d VAS评分为(2.96±0.45)分,明显低于对照组的(3.47±0.62)分,恢复进食时间、住院时间分别为(5.36±1.67)h、(4.12±1.56)d,明显短于对照组的(9.67±2.28)h、(6.77±2.00)d,差异均有统计学意义(P<0.05);干预后,观察组患者的洼田饮水试验评分为(1.45±0.20)分,明显低于对照组的(1.67±0.36)分,GUSS评分为(19.58±1.87)分,明显高于对照组的(18.67±2.20)分,差异均有统计学意义(P<0.05);干预后,观察组患者的颈部向健侧屈、向患侧屈、前屈及后伸活动度分别为(38.21±4.20)°、(35.64±4.36)°、(41.24±5.33)°、(35.16±3.54)°,明显高于对照组的(33.67±5.13)°、(31.25±4.65)°、(38.20±4.54)°、(32.00±3.12)°,差异均有统计学意义(P<0.05);干预后,观察组患者肩部功能量表中的肩关节活动范围、疼痛、日常生活能力、肌力评分分别为(25.47±4.15)分、(29.10±4.62)分、(35.26±5.10)分、(5.12±0.62)分,明显高于对照组的(21.56±3.98)分、(26.03±5.10)分、(31.06±4.78)分、(4.68±0.53)分,差异均有统计学意义(P<0.05);干预后,观察组患者心理痛苦分量表中焦虑、抑郁、行为/情绪失控评分分别为(15.39±3.44)分、(8.53±2.40)分、(14.33±Objective To explore the application effect of listen,establish,adopt,reinforce,name,strengthen(LEARNS)health education in patients with thyroid cancer.Methods Ninety patients with thyroid cancer who were treated in the First Affiliated Hospital of Zhengzhou University from January 2021 to June 2023 were selected as the re-search objects.They were randomly divided into an observation group and a control group,with 45 patients in each group.The patients in the control group received routine health education,while the patients in the observation group re-ceived LEARNS health education on this basis.The intervention lasted for one month after discharge,and the postopera-tive rehabilitation and Visual Analogue Scale(VAS)scores at 1 day after operation,as well as postoperative 1-day and post-intervention swallowing function[Watanabe drinking test,Gugging Swallowing Screen(GUSS)],neck mobility,and shoulder joint function scale scores were compared between the two groups.The mental health inventory(MHI-38,consisting of a psychological distress subscale and a psychological well-being subscale)was used to evaluate the psycho-logical adjustment ability of the two groups before and after intervention.Results The VAS score at 1 day after opera-tion in the observation group was(2.96±0.45)points,which was significantly lower than(3.47±0.62)points in the con-trol group;the time to resume eating and the length of hospital stay were(5.36±1.67)h and(4.12±1.56)d,respectively,which was significantly shorter than(9.67±2.28)h and(6.77±2.00)d in the control group(P<0.05).After intervention,the score of Watian drinking test in the observation group was(1.45±0.20)points,which was significantly lower than(1.67±0.36)points in the control group(P<0.05);the GUSS score was(19.58±1.87)points,which was significantly higher than(18.67±2.20)points in the control group(P<0.05).After intervention,the range of cervical flexion to the healthy side,flexion to the affected side,flexion to the anterior side,and extension to the posterior side

关 键 词：健康教育 甲状腺癌 心理调适能力 吞咽功能 肩关节功能 

分 类 号：R473.73[医药卫生—护理学]