护士主导的多模式干预在脑肿瘤患者吞咽困难康复中的作用和有效性评估。

文献信息

中文摘要

背景： 吞咽困难是脑肿瘤患者常见的并发症，对患者的健康状况和生活质量产生深远的不良影响。然而，关于脑肿瘤患者吞咽困难康复的研究相对缺乏，尤其是护士主导的多模式干预在脑肿瘤患者吞咽困难康复中的作用和有效性，缺乏系统性评估和深入探讨。
目的： 本研究旨在评估护士主导的多模式干预在改善脑肿瘤吞咽困难患者吞咽功能和生活质量中的作用和有效性。
方法： 本研究采用随机对照试验（RCT）设计，选取2024年1月至2024年5月期间入住我院的脑肿瘤患者中的120例吞咽困难患者作为研究对象，并将其分层随机分为干预组（n = 60）和对照组（n = 60）。对照组接受常规护理和治疗方案，而干预组接受护士主导的多模式干预方案，包括个性化吞咽训练、营养支持、心理护理和家庭参与式康复方案，该方案由护士、康复治疗师和营养师制定并动态调整。干预前后数据的差异采用配对t检验或Wilcoxon符号秩检验进行分析，组间比较采用独立样本t检验或Mann-Whitney U检验。
结果： 干预组和对照组的患者吞咽功能均有所改善。干预组患者的洼田饮水试验评分、才藤吞咽功能分级和生活质量评分较对照组有显著提高（P < 0.05），表明干预效果优于对照组。组内比较时，干预组和对照组的所有评分均随干预时间逐渐改善（P < 0.05）。干预组的改善程度显著高于对照组。
结论： 本研究表明，护士主导的多模式干预在改善脑肿瘤患者吞咽功能和生活质量方面具有显著效果。该干预通过多学科协作和个性化护理为患者提供全面的康复支持，具有一定的临床推广价值。

英文摘要

BACKGROUND: Dysphagia is a common complication in patients with brain tumors, which has a profound adverse impact on patients' health status and quality of life. However, there is a relative lack of research on the rehabilitation of dysphagia in brain tumor patients, especially regarding the role and effectiveness of nurse-led multimodal interventions in the rehabilitation of dysphagia in brain tumor patients, which lacks systematic assessment and in-depth discussion.
AIM: This study aimed to evaluate the role and effectiveness of a nurse-led multimodal intervention in improving swallowing function and quality of life in brain tumor patients with dysphagia.
METHODS: In this study, a randomized controlled trial (RCT) design was used to select 120 dysphagia patients among brain tumor patients admitted to our hospital during the period of January 2024 to May 2024 as the study subjects, and they were stratified and randomly divided into an intervention group (n = 60) and a control group (n = 60). While the control group received conventional nursing care and treatment protocols, the intervention group received a nurse-led multimodal intervention program, including personalized swallowing training, nutritional support, psychological care, and a family-participatory rehabilitation program, which was developed and dynamically adjusted by nurses, rehabilitation therapists, and dietitians. Differences in data before and after the intervention were analyzed using the paired t-test or Wilcoxon signed-rank test, and between-group comparisons were made using the independent samples t-test or Mann-Whitney U test.
RESULTS: Both the intervention and control groups showed improvement in swallowing function among the patients. The Kubota drinking test score, Saito's swallowing function grading, and the quality of life scores for patients in the intervention group showed a significant enhancement compared to those in the control group (P < 0.05), indicating that the intervention was more effective than the control. When compared within groups, all scores in both the intervention and control groups improved gradually with the time of intervention (P < 0.05). The improvement was significantly higher in the intervention group than in the control group.
CONCLUSION: This study demonstrates that a nurse-led multimodal intervention is significantly effective in improving swallowing function and quality of life in patients with brain tumors. The intervention provides comprehensive rehabilitation support for patients through multidisciplinary collaboration and personalized care and has certain clinical promotion value.