| Objective1.Establish a thirst management scheme for postoperative gastric cancer patients based on evidence to provide reference for nursing staff to carry out postoperative thirst management.2.Conduct preliminary clinical verification of the thirst management scheme for patients with gastric cancer after surgery,with a view to reducing the thirst degree of patients with gastric cancer after surgery,improving the moistness of the lip,tongue and oral mucosa of patients,improving patient satisfaction and improving the quality of nursing services.Methods1.Scheme constructionSystem search Up To Date,National Guide Library(NGC),BMJ Best Practice,(JBI)Database of Evidence-Based Health Care Centres,English Intercollegiate Guidelines website(SIGN),UK National Institute for Health and Clinical Excellence(NICE),Canadian Society of Nursing Guidelines Network(RNAO),Pub Med,Ovid,Web of Related studies on thirst nursing management in databases of science,Embase,Cochrane Library,VIP,Wanfang and CNKI were conducted to strictly evaluate and analyze literature,extract contents of thirst related nursing management,integrate and summarize various measures,and form a summary of evidence on thirst management in patients with gastric cancer after surgery.The importance and feasibility of intervention program items were consulted by letter using Delphi method,two rounds of expert recommendations were summarized,and the final draft of thirst management program for postoperative gastric cancer patients was determined considering the clinical working environment.2.Program implementationThe experimental method was used to conveniently select 38 cases of thirsty patients after gastric cancer surgery in a third-class A hospital in Zhengzhou from April to June 2022 as the control group,and routine nursing was carried out.From July to September 2022,38 patients were included in the intervention group,and evidence-based thirst management program was implemented based on routine nursing.After the intervention,thirst score,lip,tongue and oral mucosa moisture and patient satisfaction were compared between the two groups before intervention,6h after intervention,from the first day to the third day after intervention.Results1.Scheme construction result(1)A total of 11 literatures were included in this study,including 3 guidelines,2 systematic reviews,2recommended practices,and 4 RCTS.21 pieces of evidence were preliminarily formed in 5 aspects,including risk factors,thirst assessment,early prevention,symptom management,education and training.(2)In this study,a total of 15 experts from Shanghai,Henan,Hainan,Hebei,Fujian and Shandong were consulted by letter.The positive coefficients of the two rounds of expert correspondence were 88.2%and 93.3% respectively,and the authority coefficients were both 0.89.The coefficients of variation of the importance scores of questionnaire items were 0.10-0.28 and 0.05-0.17,respectively.Kendall harmony coefficients were 0.212 and 0.196,respectively.After two rounds of correspondence consultation,the thirst management program for postoperative gastric cancer patients was finally determined,including thirst assessment,thirst management and effect evaluation.2.Program implementation result(1)A total of 76 patients with thirst after gastric cancer surgery meeting the criteria were included in this study.During the study,a total of 2 patients in the control group were transferred to ICU due to changes in their condition and withdrew from the study,while 1 patient in the intervention group withdrew due to discharge.A total of 73 subjects completed the study,including 36 patients in the control group and 37 patients in the intervention group.The general data of the two groups were comparable.(2)The independent sample T-test of thirst score showed that there was no significant difference in thirst score between the two groups before intervention and 6h after intervention(P > 0.05).From the first day after surgery to the third day after surgery,the thirst score of the two groups had statistical significance(P < 0.05).The results of variance analysis of repeated measurement of thirst score at different time points before and after intervention showed that the time effect of thirst score at different time points was statistically significant between the two groups(F=125.320,P < 0.001),and the thirst score showed a decreasing trend with time.The interaction effect between time and group was statistically significant(F=2.972,P < 0.05),indicating that the decrease trend of thirst score in the two groups was different,and the decrease range of thirst score in the intervention group was greater than that in the control group.There were statistically significant differences in thirst assessment between the two groups at each time point(F=36.632,P < 0.05).(3)The results of Mann-Whitney U test showed that there was no statistical significance in the moistness of lip,tongue and oral mucosa between the two groups before intervention(P > 0.05).After 6h of intervention,lip,tongue and oral mucosa moisture of 2 groups was improved,but there was no statistical significance in Mann-Whitney U test(P > 0.05).From the first day after surgery to the third day after surgery,the moisture of lip,tongue and oral mucosa had statistical significance(P < 0.05).(4)After intervention,nursing service satisfaction of patients in the intervention group was higher than that in the control group,and the difference was statistically significant(P < 0.05).ConclusionEvidence-based thirst management scheme can effectively improve thirst degree and lip,tongue and oral mucosa moistness of patients with gastric cancer after operation,and improve patients’ satisfaction with nursing services. |
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