Application And Effect Evaluation Of HAPA Theory In Oral Care Of Patients With Head And Neck Cancer Radiotherapy

Objective:We investigate the current status of self-management efficacy of patients with head and neck malignant tumors and analyze its influencing factors,and explore the application and effect evaluation of the healthy behavior process orientation theory(HAPA theory)in the oral care of patients with head and neck cancer radiotherapy,in order to improve the future of head and neck malignant tumor radiotherapy The degree of oral mucositis of the patient and the improvement of the self-management efficacy of the patient provide a theoretical reference and basis.Methods:Part 1: We use the convenience sampling method to select patients with malignant tumors of the head and neck who were hospitalized in the head and neck department of a tertiary A tumor hospital in Shanxi Province from May to August 2020 as the research objects,using the general information questionnaire,Self-management Efficacy Scale and other cross-sectional surveys were conducted to initially understand the level of self-management efficacy of patients with head and neck malignant tumors and the factors that affect the level of self-management efficacy.Part 2: The second part: We take a randomized controlled trial study,and select 106 patients with head and neck malignant tumors in the head and neck department of a tertiary A tumor hospital in Shanxi Province from September to December 2020 as the research objects.According to the coin toss method,the patients were randomly divided into the experimental group and the control group,with 53 cases in each group.Both groups received routine oral care education.The control group only used routine oral care education,and the experimental group carried out HAPA theory on the basis of routine care.Intervene for basic oral care education..The test group received oral care education based on HAPA theory on a routine basis.The control group only use regular oral care education.Before the intervention and after the treatment,the two groups used cancer patient self-management efficacy scale,pain digital score scale,oral mucositis assessment scale and self-made radioactive oral mucositis index evaluation scale to evaluate the oral care of the two groups’ effect.Results:The first part of the cross-sectional study shows that:(1)The overall self-management efficacy of patients with malignant tumors of the head and neck is divided into:(99.06±18.07),which belongs to the medium efficacy level.(2)Pearson correlation analysis shows that there is a positive correlation between the various dimensions of self-management efficacy in patients with head and neck malignancies.Among them,positive attitudes were weakly positively correlated with self-decompression(r = 0.192,P < 0.05),strongly positively correlated with self-decision-making(r = 0.784,P<0.01),and strongly positively correlated with self-management efficacy(r = 0.961,P<0.01);self-decompression was weakly positively correlated with self-decision-making(r = 0.249,P<0.05),and was weakly positively correlated with self-management efficacy(r = 0.203,P < 0.05);self-decision-making There was a strong positive correlation with self-efficacy(r = 0.910,P <0.01).(3)Multivariate linear regression shows that six independent variables: education level,tooth brushing frequency,income,weight maintenance in the past 6 months,chronic disease,and exercise status enter the regression equation that affects the patient’s self-management efficacy.These variables can explain the head 43.4% of the total variation of self-management efficacy in patients with neck malignant tumors.The results of the second part of randomized controlled trials show that:The application of HAPA theory can significantly postpone the peak of radiation oral mucositis(Z=-3.222,P<0.05);compared with the control group,the average score of oral pain in the experimental group was lower than that of the control group,and the difference was statistically significant(P < 0.05),reduced the rate of gastric tube placement in patients with head and neck malignant tumors undergoing radiotherapy(X~2=3.852,P<0.05),and improved the patient’s sense of self-management..Conclusion:(1)The overall self-management efficacy of patients with head and neck malignancies was moderate.The self-management efficacy of patients with head and neck cancer was positively correlated with each other.The self-management efficacy of patients with head and neck cancer was influenced by education level,oral cleanliness frequency,income,weight maintenance,chronic disease and exercise status in recent 6months.(2)The application of HAPA theory has reduced the peak of radiation oral mucositis in patients with head and neck cancer,reduced the insertion rate of gastric tube in patients with head and neck cancer caused by radiation oral mucositis,improved the self-management efficacy of patients with head and neck cancer and alleviated oral pain in patients with head and neck cancer..