| Objective:The elderly patients with oral cancer in perioperative period have different clinical and oral features from the general patients.The general oral nursing operation is difficult to nursing and may cause serious complications such as infection.But there is no oral care program for this population.The purpose of this study is to find out the framework of oral care program by analyzing the existing universal oral nursing guidelines,and to understand the needs and clinical status of patients in combination with the in-depth interviews of patients and patients.Thus,the oral nursing program for elderly patients with oral cancer during perioperative period was constructed.Methods:Based on the analysis of the contents of the guidelines,patients interviews and medical staff interviews,under the premise of defining the oral characteristics of elderly patients with oral cancer,this study synthesizes the existing evidence,patient needs and the opinions of medical professionals.Content analysis was used to construct the first draft of oral nursing program for elderly patients with oral cancer during perioperative period.After that,the first draft of the program was revised by Delphi’s expert consultation method,and the final oral care program for elderly patients with oral cancer was finalized.Results:1.The content analysis of the guidelines:13 guidelines for clinical practice related to oral nursing at home and abroad were included.Through content analysis,three topics were obtained:oral nursing management,oral nursing education,oral nursing practice(evaluation,preparation with materials,implementation,etc.)Evaluation and documentation),including 11 broad categories and 56 items.2.Patients interview:This study found that the patient’s oral care knowledge is insufficient and lacks effective guidance.The patient’s demand for oral care knowledge suggests that we include oral care guidance content in the program design.3.Medical staff interview:This study found that the existing clinical experience can provide a realistic basis for the oral care of elderly patients with oral cancer,such as wet compress,cotton ball shaping,etc.can effectively improve the patient’s oral cleanliness and comfort.However,the current preoperative periodontal scaling is not popular,and the use of mouthwash is not necessary.In the construction of oral care programs for elderly patients with oral cancer,it is necessary to learn from each other.4.Content analysis:according to several treatment stages of patients with oral cancer perioperative period,combined with PDA circulation,the first draft of oral nursing plan for elderly patients with oral cancer was formed during perioperative period.The first draft of the program includes three stages of oral care:preoperative,postoperative,and chemoradiotherapy.The preoperative stage includes 4 dimensions,12 first-level items,61 second-level items;the postoperative stage includes 4 dimensions,16 first-level items,124 second-level entries;the radiotherapy and chemotherapy period includes 4 dimensions,12 first-level items,35 second-level items.A total of 40 level one entries,220 level 2 entries.5.Delphi expert consultation:this study revised the first draft of oral nursing program for elderly patients with oral cancer during perioperative period through two rounds of Delphi consultation,and finally formed 4 dimensions,12 first-level items and 56 second-level items in the preoperative stage.There were 4 dimensions,18 first-level items,102 second-level items,4 dimensions in radiotherapy and chemotherapy stage,13 first-level items and 35 second-level items in the postoperative stage.A total of 43 first-level items and 193 second-level items were formed.Conclusion:This study focused on the oral features of elderly patients with oral cancer during perioperative period.The systematic guide retrieval,the interview of medical patients and patients,and the two rounds of Delphi expert consultation make this scheme rigorous and reliable and can provide some reference for clinical practice. |
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