Study On Nursing Effect Of Ear Tongbian Scraping Combined With Ear Acupoint Bean Pressing On Patients With Chronic Sinusitis After Operation

ObjectiveTo investigate the degree of head and face pain,comfort and sleep quality in patients with chronic sinusitis after operation,and to analyze the influencing factors of sleep quality.To explore the nursing effect of Ear Tongbian Scraping combined with Ear Acupoint Bean Pressing on patients with chronic sinusitis after operation,and to provide reference for improving sleep quality of patients after operation and innovating nursing intervention scheme.Methods(1)360 patients with chronic sinusitis after operation were investigated 24 hours with self-made general data questionnaire,improved Kolcaba Comfort Scale,Numerical pain Rating Scales and Self-Rating Scale of Sleep as measurement tools to understand the degree of head and face pain,comfort and sleep quality,analyze the influencing factors of sleep quality,and explore the correlation between comfort and sleep quality.(2)Guided by the theory of bioholography,the method of ear tongbian scraping combined with ear acupoint bean pressing was used to carried out nursing intervention for patients with chronic sinusitis after operation.The patients were divided into 4 groups: namely the control group,the ear acupoint bean pressing group,the ear tongbian scraping group and the ear tongbian scraping combined with ear acupoint bean pressing group,with40 cases in each group.The control group received routine nursing for nasal surgery after operation,and the intervention measures in each intervention group were performed after the first evaluation 6 hours after operation.On the basis of the control group,the ear acupoint bean pressing group increased the care of ear acupoint bean pressing,the ear tongbian scraping group increased the care of ear Tongbian scraping,the ear tongbian scraping combined with ear acupoint bean pressing group increased the care of ear Tongbian scraping and ear acupoint bean pressing.General data survey,pain,comfort and nasal bleeding were evaluated at 6h after operation,and pain,comfort,sleep quality and nasal bleeding were evaluated at 30 h and 54 h after operation.SPSS26.0 software was used for statistical analysis,frequency,percentage,mean and standard deviation were used for descriptive statistics,independent sample T-test,one-way anova,Stepwise multiple linear regression analysis,Pearson correlation analysis,chiquare test,repeated measure anova and other statistical methods were used for statistical analysis.Results(1)The pain score of 360 patients with chronic sinusitis after operation was(5.34±1.54),52(14.4%),226(62.8%)and 82(22.8%)for mild,moderate and severe pain respectively.The comfort score of patients was(66.83±10.02),234(65.0%)and 126(35.0%)for moderate and low comfort.The sleep status score of the patients was(34.21±5.36),and the scores of mild,moderate and severe sleep problems were 63(17.5%),221(61.4%)and 63(17.5%),respectively.There was a positive correlation between patients’ comfort level and sleep quality(r=-0.733,P<0.001).Pain degree,comfort,postoperative nasal bleeding,allergic rhinitis and number of sinus fenestrations were the influencing factors of sleep quality of patients after operation.(2)There was no significant difference between the four groups in baseline comparison of socio-demographic and disease-related datas,pain scores,comfort scores and sleep status scores before intervention(P>0.05).(3)There was no significant difference in the pain scores of the four groups at 6 hours after operation(P>0.05).After the intervention,the pain scores of the patients in each intervention group were lower than those of the control group at 30 hours and 54 hours after the operation.The scores from low to high were the ear tongbian scraping combined with ear acupoint bean pressing group,the ear tongbian scraping group,the ear acupoint bean pressing group and the control group,with statistically significant differences(P<0.001).The results of repeated measure anova showed that there were statistically significant differences in time effect,intergroup effect and interaction effect of pain scores(P<0.05).With the passage of time,the pain scores of each group showed a decreasing trend,Among them,the ear tongbian scraping combined with ear acupoint bean pressing group decreased the most,followed by the ear tongbian scraping group and the ear acupoint bean pressing group,patients in the control group had the smallest decrease in pain scores.(4)There was no significant difference in the comfort scores of the four groups at 6 hours after operation(P>0.05).After the intervention,the comfort scores of the patients in each intervention group were higher than those of the control group at 30 hours and 54 hours after the operation.The scores from high to low were the ear tongbian scraping combined with ear acupoint bean pressing group,the ear tongbian scraping group,the ear acupoint bean pressing group and the control group,with statistically significant differences(P<0.001).The results of repeated measure anova showed that there were statistically significant differences in time effect,intergroup effect and interaction effect of comfort scores(P<0.05).With the passage of time,the comfort scores of each group showed a increasing trend,Among them,the ear tongbian scraping combined with ear acupoint bean pressing group increased the most,followed by the ear tongbian scraping group and the ear acupoint bean pressing group,patients in the control group had the smallest increase in comfort scores.(5)After the intervention,the sleep status scores of the patients in each intervention group were lower than those in the control group at 30 h and54h after operation,and the scores from low to high were the ear tongbian scraping combined with ear acupoint bean pressing group,the ear tongbian scraping group,the ear acupoint bean pressing group and the control group,with statistically significant differences(P<0.001).(6)There was no significant difference in nasal bleeding volume between the four groups at 30 h and 54 h after operation(P>0.05).Conclusions(1)Moderate to severe sleep problems are prevalent in patients with chronic sinusitis after operation.Medical staff can pay attention to pain degree,comfort,postoperative nasal bleeding,allergic rhinitis,number of sinus fenestrations and other influencing factors to improve the sleep quality of patients.(2)Both ear tongbian scraping and ear acupoint bean pressing can relieve the pain of patients with chronic sinusitis after operation,inhance their comfort and improve their sleep quality.The effect of ear tongbian scraping combined with ear acupoint bean pressing is more effective than the single use of ear tongbian scraping or ear acupoint bean pressing.