Establishment And Effect Evaluation Study Of Health Education Pathway In Patients With Esophageal Cancer During Perioperative Period

Objective:To construct the health education pathway for patients with esophageal cancer during perioperative period,and to explore the effect of health education pathway in the health knowledge,beliefs,behaviors and discharge readiness of patients,so as to build the basis for the development of health education strategies for patients with esophageal cancer surgery.Methods:1.Based on the literature analysis,semi-structured interview and pre-survey,a preliminary draft of the health education path for esophageal cancer patients during the perioperative period was developed.Two rounds of expert letter consultation were conducted among 22 experts by using Delphi method.Combined with the index screening criteria and the suggestions of each expert,the health education pathway for esophageal cancer during perioperative period was finally formed.2.A similar experimental study was conducted.From February 2020 to September 2020,a total of 70 patients receiving surgical treatment of esophageal cancer ina comprehensive Grade A hospital in Anhui Province were recruited,with controlgroup and experimental group each had 35 patients.The control group was giving routine health education and the experimental group was giving health education according to the health education pathway during perioperative period.The intervention period was from admission to discharge.The evaluation standard of health education for chest surgery,readiness for hospital discharge scale,self-care ability score,postoperative rehabilitation index and nursing satisfaction were used to evaluate the effect of interventions.Chi-square test was used to compare the general information.Two independent sample t test was used to compare the health knowledge,health beliefs,health behaviors,first time of getting out of bed,indwelling time of gastrointestinal deco-mpression tube and thoracic drainage tube,nursing satisfaction.Repeated measure analysis of variance was used to compare the scores of self-care ability score between the two groups,P<0.05 was considered statistically significant.Results:1.Through literature analysis,an interview outline for patients and medical staff was drawn up.10 patients and 6 medical staff were interviewed,and the preliminary draft of the health education pathway for esophageal cancer perioperation was developed,including 5 first-grade indexs,11 second-grade indexs and 58third-grade indexs.Through the pre-survey,the first round of expert letter questionnaire was formed.The expert response rates in the two rounds of Delphi experts letter consultation were 100.00% and 91.67% respectively,the average authority coefficients of the experts were 0.89 and 0.9 respectively,and the variation range of the experts letter consultation results was 0.00～0.21.Two rounds of expert letter consultation were used to select the indexs,and the health education pathway of esophageal cancer patients during perioperative period was constructed with admission assessment education,preoperative education,surgical education,postoperative education,rehabilitation education and discharge education as the main structural framework,covered 6 first-grade indicators and 43 second-grade indicators.2.During the clinical applied study of perioperative health education pathway for patients with esophageal cancer,35 patients were recruited in both two groups respectively.The general information characteristic of the two groups showed no statistically significance(P>0.05),which was comparable.The scores of health knowledge(83.40±7.349),health belief(21.23±2.486)and health behavior(41.34±4.425)in experimental group were higher than those in control group,and the compare between the two groups were statistically significant(P<0.05).In the postoperative rehabilitation indexs,the indwelling time of gastrointestinal decompression tube and thoracic drainage tube between the two groups were statistically significant(P<0.05),while there were no statistically significant differences in the first postoperative activity time(P>0.05).The scores of discharge readiness,self-care ability and nursing satisfaction in experimental group were higher than those in control group,and the differences were statistically significant(P<0.05).Conclusion:In this study,a health education pathway for esophageal cancer during perioperative period was preliminarily constructed,which include admission evaluation education,preoperative education,surgical education,postoperative education,rehabilitation education and discharge education as the first-level indexes.The path construction process was scientific and reliable.The health education path can improve the health knowledge,belief and behavior of patients undergoing esophageal cancer surgery,as well as the degree of discharge preparation.It has good clinical applicability and provides an effective tool for the clinical standardization of perioperative health education for esophageal cancer.