Study On The Recovery Of Swallowing Function And The Real Experience Of Patients With Acquired Swallowing Disorder After Cardiac Surgery

[Objective]To explore the recovery time of swallowing function and its influencing factors in patients with acquired swallowing disorder after cardiac surgery,and to explore the experience of acquired swallowing disorder in patients after cardiac surgery,so as to provide reference for optimizing the rehabilitation program of acquired dysphagia,optimizing the quality of nursing and accelerating the rehabilitation process of patients.[Methods]In this study,quantitative and qualitative research methods are used.The quantitative study is a prospective follow-up survey,through convenient sampling,a total of 85 patients with acquired swallowing disorders after cardiac surgery who were admitted to Eastern theater General Hospital in Nanjing from October 2018 to October 2019 were selected,demographic and clinical data were collected,the outcome and recovery time of swallowing function before discharge were the dependent variables,Kaplan-Meier method and Cox proportional hazards model were used to analyze the recovery time of swallowing function and its influencing factors.Qualitative research using purpose sampling,ten patients with with acquired swallowing disorders after cardiac surgery who were admitted to Eastern theater General Hospital in Nanjing from March to June 2019 were selected.Semi-structuredinterviews were conducted with phenomenological methods,and data were collated and analyzed by Colaizzi's 7-step analysis method.[Results]1.Quantitative research results: the recovery time of swallowing function in patients with acquired swallowing disorder after cardiac surgery was 1-12 days,the mean recovery time was 2.72±1.85 days.Univariate analysis showed that gender,preoperative self-care ability,operation type,emergency operation,operation time,extracorporeal circulation time,aortic occlusion time,dosage of fentanyl and propofol during intubation,time of indwelling nasal feeding tube,endotracheal intubation time,length of ICU stay,postoperative hemodialysis and first SSA score after extubation would prolong the recovery time of swallowing function(P <0.05).Cox proportional hazards analysis indicated that endotracheal intubation time and the first SSA score after extubation had a significant impact on the recovery time of swallowing function in patients with acquired swallowing disorder after cardiac surgery(P<0.05).2.Qualitative research results: the experience of acquired swallowing disorder in patients after cardiac surgery was distilled into five themes: somatic discomfort associated with dysphagia,negative emotional feeling,cognitive bias of dysphagia,diverse coping styles and information needs for rehabilitation of dysphagia.[Conclusion]1.There were individual differences in the recovery time of swallowing function in patients with acquired swallowing disorder after cardiac surgery.2.The swallowing function of patients with acquired swallowing disorder after cardiac surgery is affected by a variety of factors,among which the time of endotracheal intubation and the first SSA score after extubation are independent risk factors for the recovery of swallowing function of patients with acquired swallowing disorder after cardiac surgery.3.The occurrence of acquired swallowing disorder can bring adverse physiological and emotional experience to patients undergoing cardiac surgery,patients lack of related disease awareness and coping plans,and patients with acquired swallowing disorders need rehabilitation care.4.In the future,it is still necessary to further clarify the recovery process of acquired swallowing disorders and related prognostic indicators,so as to create conditions for optimizing clinical practice and improving prognosis and outcome of patients.5.Medical staff should pay attention to the adverse effects of acquired swallowing disorders on patients,timely meet the needs of patients care,so as to promote the physical and mental rehabilitation of patients as soon as possible,constantly optimize the quality of nursing service.