| Objective:1.Compile the "Oral Comfort Evaluation Questionnaire for Inpatients with Heart Failure" to evaluate the oral comfort of HF patients.2.Observe the effect of gargle with sodium bicarbonate solution on oral care of HF patients,and provide a reference for clinical intervention in oral hygiene care of HF patients.Methods:1.Questionnaire preparation and reliability and validity test:(1)The questionnaire item pool was formed through literature review and clinical qualitative interviews,and the first draft of the questionnaire was formed after two rounds of expert consultation;(2)20 patients with heart failure were included in the pre-survey to the questionnaire Make modifications and debugging.Include 190 patients with heart failure for a formal investigation and test the reliability and validity of the questionnaire.2.Clinical intervention:(1)Case inclusion and grouping: using convenience sampling method,108 HF patients who were hospitalized in the cardiovascular department of a tertiary general hospital from October 2020 to December 2020 were selected as the research objects.They were randomly divided into control group(group A,36 cases),intervention group 1(group B,36 cases),and intervention group2(group C,36 cases).(2)Intervention method: Group A was given routine oral cleaning for 7 days;group B was given routine oral cleaning twice a day(1 time in the morning and 1 time in the evening)5% sodium bicarbonate solution gargle,intervention 7 Day;on the basis of routine oral cleansing,group C was added 5 times a day(morning,evening and after three meals)with 5% sodium bicarbonate solution,and the intervention was 7 days.(3)Effect evaluation indicators:(1)Tongue coating:Winkel’s tongue coating coefficient;(2)Oral hygiene: oral colony count,oral plaque index;(3)Oral comfort: scores in the "Oral Comfort Assessment Questionnaire for Inpatients with Heart Failure";(4)Oral Health: Beck oral score;(5)Oral p H;(6)Disease observation: NYHA classification,LVEF.Results:1.Reliability and validity of the questionnaire:(1)Reliability of the questionnaire:the Cronbach’s α coefficient of the questionnaire is 0.810,and the Spearman-Brown coefficient is 0.732;(2)the validity of the questionnaire: the final questionnaire contains 4 dimensions and 24 Item,item I-CVI is between 0.833～1,S-CVI/UA is0.875,S-CVI/Ave is 0.979,and the Pearson correlation coefficient with the Beck oral score table is 0.233.Through exploratory factor analysis,4 items are extracted The common factor,the cumulative variance contribution rate is 59.611%.2.Results of oral care intervention:(1)Tongue coating:(1)Comparison between groups: There was no statistically significant difference in Winkel tongue coating coefficient between groups A,B and C on the first to 3 days of intervention(P>0.05);from the fourth day of intervention,B The coefficient of Winkel tongue coating in group and group C was lower than that in group A(P<0.05);from the 6th day of intervention,the coefficient of Winkel tongue coating in group C was lower than that in group B(P<0.05).(2)Comparison within the group: There was no statistically significant difference in the Winkel tongue coating coefficient of group A patients from the first to the seventh day of intervention compared with before the intervention(P>0.05),and the Winkel tongue coating coefficient of the patients in group B and C was second to the intervention period.The difference between 7 days and before the intervention was statistically significant(P<0.05).Before the intervention,Winkel’s tongue coating coefficient had a regulating effect on oral hygiene,but when the Winkel tongue coating coefficient was less than 4.600,the intervention effect was not obvious.(2)Oral hygiene:(1)Comparison between groups: On the 7th day of intervention,there was a statistically significant difference in the number of oral colonies between the three groups of patients in groups A,B,and C and the oral plaque index(P<0.05).(2)Comparison within the group: the number of oral colonies and oral plaque index of patients in group A on the 7th day of intervention was not statistically significant(P>0.05),and the number of oral colonies and oral cavity of patients in groups B and C on the 7th day of intervention The plaque index was significantly different from that before the intervention(P<0.05).(3)Oral comfort:(1)Comparison between groups: Before the intervention and within1-7 days of the intervention,there was no significant difference in the oral comfort scores of patients in groups A,B,and C(P>0.05).(2)Comparison within the group:The daily comfort scores of patients in group A were not significantly different from those before intervention during the first to 7 days of intervention(P>0.05);the daily oral comfort scores of patients in group B were compared with those before intervention on the 4th to 7th days of intervention.The difference before the intervention was statistically significant(P<0.05);the daily score of oral comfort in group C patients on the 2nd to 7th day of the intervention was significantly different from that before the intervention(P<0.05).(4)Oral health:(1)Comparison between groups: Within the first to 7 days of intervention,the Beck oral scores of patients in groups A,B,and C had statistically significant differences(P<0.05).(2)Intra-group comparison: The daily Beck oral scores of patients in group A were not significantly different from those before intervention on the 1st to 7th days of intervention(P>0.05);the daily Beck oral scores of patients in group B were 3-7 days of intervention Compared with the pre-intervention,the difference was statistically significant(P<0.05);the daily Beck oral score of the patients in group C was significantly different from the pre-intervention on the 2nd to 7th day of the intervention(P<0.05).(5)Oral p H:(1)Comparison between groups: Before the intervention and within the first to 6 days of the intervention,there was no significant difference in the oral p H between the three groups of patients in groups A,B,and C(P>0.05);on the seventh day of the intervention On the day,the oral p H value of patients in groups A,B,and C had statistically significant differences(P<0.05).(2)Intra-group comparison: There was no significant difference in daily oral p H between the first and seventh days of intervention in group A compared with before intervention(P>0.05);the daily oral p H of patients in group B was 6-7 days after intervention Compared with the pre-intervention,the difference was statistically significant(P<0.05);the daily oral p H value of patients in group C on the 5th to 7th day of the intervention was statistically significant(P<0.05).(6)Observation of the condition:(1)Comparison between groups: On the 7th day of intervention,there was a statistically significant difference in NYHA classification between groups A,B,and C(P<0.05),and there was no significant difference between LVEF groups(P>0.05).(2)Intra-group comparison: The NYHA classification of patients in groups A,B,and C on the 7th day of intervention was statistically significant compared with that before intervention(P<0.05);there was no statistical difference in LVEF of patients in group A on the 7th day of intervention compared with that before intervention Significance(P>0.05).There was a statistically significant difference in LVEF of patients in group B and C on the 7th day of intervention compared with before intervention(P<0.05).Conclusion:1.The "Oral Comfort Evaluation Questionnaire for Inpatients with Heart Failure" has good reliability and validity,and can be used to evaluate the oral comfort of patients with heart failure.2.Carrying out oral care with 5% sodium bicarbonate solution for HF patients is beneficial to improve the thickening of the tongue coating of HF patients,and can improve the oral hygiene,oral comfort,oral health,oral p H of HF patients,and improve the course of HF patients No significant effect. |
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