Application Of Continuous Nursing Based On Omaha System In Patients With Dysphagia After Radiotherapy For Nasopharyngeal Carcinoma

Purposes: This article attempts to explore a continuous nursing model based on the Omaha system,apply to patients with dysphagia after radiotherapy for nasopharyngeal carcinoma,and evaluate the feasibility and effectiveness of the model.Methods:(1)Through reviewing domestic and foreign literatures,this article is based on the theory of holistic nursing and Maslow’s basic needs of human basics,combined with the physiological and anatomical features of the nasopharyngeal site and the characteristics of dysphagia after radiotherapy.Then,through pre-experiment and expert consultation,and using the Omaha system’s problem classification,intervention and outcome evaluation system,a continuous nursing model for patients with dysphagia after radiotherapy for nasopharyngeal carcinoma was established based on the Omaha system.(2)According to inclusion exclusion criteria,a total of 106 patients with radiotherapy for nasopharyngeal carcinoma in a top three hospital were randomly divided into groups.The final participants were 103 patients(51 in the control group and 52 in the intervention group).The control group was given routine discharge guidance and follow-up.The intervention group was given a continuous care model based on the Omaha system on the basis of the control group.The patients’ cognition(K),behavior(B),and status(S)were evaluated on the day of discharge from the aspects of environment,psychosocial,physiology,and health.In response to the nursing problems on the day of discharge,the Omaha system’s intervention direction and measures were used to develop a personalized and detailed intervention method.Finally,the outcome evaluation system(K-B-S score)was used to evaluate the improvement effect of each nursing problem.The assessment intervention and evaluation were repeated one month and three months after discharge.Outcomes: There was no significant difference in the general data between the two groups(P>0.05).In the intervention group only the status scores of health supervision problems were not statistically significant(P>0.05).The K-B-S score of other nursing problems on the day of discharge is statistically significant in different periods after discharge of 1 month and 3 months(P<0.05).The VFSS/PAS score,NRS combined FRS score,LENT/SOMA level,monitor the nutritional indicators of patients(BMI,Hb,ALB,TSF)at 1 month and 3 months after discharge were statistically significant in two groups of patients(P<0.05),and the improvement grades of PAS classification and LENT/SOMA classification were respectively presented(PAS,0.001,and 0.001).Comparing the scores of EORTC QLQ C30 and EORTC QLQ-H&N35,the overall quality of life of the intervention group was higher than that of the control group,and the difference was statistically significant(P<0.05).The extended care model based on the Omaha system is suitable for patients with dysphagia after radiotherapy for nasopharyngeal carcinoma,which can effectively improve the patient’s swallowing ability,nutritional status,mouth restriction,pain score,and quality of life.