肿瘤科护士对放化疗患者口腔评估的现状调查分析
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摘要
目的探讨肿瘤科护士对放化疗患者口腔评估的现状,为规范放化疗患者口腔评估和预防口腔并发症提供依据。方法采用便利抽样法,抽取肿瘤科护士198名,对放化疗患者口腔评估现状进行问卷调查。结果 12.63%护士对口腔并发症出现前的初次放化疗患者进行口腔评估,其中12.63%使用评估工具进行评估;97.98%护士对出现口腔并发症患者进行口腔评估,其中46.97%使用评估工具;42.93%护士对再入院化疗患者进行口腔评估,其中10.10%使用评估工具。结论护士对口腔并发症发生前和再入院化疗患者的口腔评估重视不够,评估内容不足,且缺乏针对性口腔评估工具。应加强未发生口腔并发症患者和再入院患者的口腔评估,并完善评估内容与流程,制定针对性评估工具。
Objective To assess oncology nurses′ practices regarding oral assessment for patients on radiochemotherapy treatment, and to provide reference for standardizing oral assessment and preventing oral complications. Methods A total of 198 oncology nurses were selected by convenience sampling and were invited to complete a questionnaire survey in terms of their practices regarding oral assessment for patients on radiochemotherapy treatment. Results Only 12.63% of the respondents performed oral assessment for patients initially receiving radiochemotherapy before the occurrence of oral complications and 12.63% of them used assessment tools. About 97.98% of the nurses conducted oral assessment when patients developed oral complications and 46.97% used assessment tools. More than forty percent(42.93%) of the nurses performed oral assessment for rehospitalized patients and 10.10% used assessment tools. Conclusion Nurses paid less attention to oral assessment for patients without oral complications before radiochemotherapy treatment and for those who were rehospitalized for treatment, and they generally were inadequate to perform oral assessment. At the same time, there was a shortage of targeted oral assessment tool. Oral assessment should be strengthened in patients before radiochemotherapy treatment and in rehospitalized patients. The assessment contents and process should be improved as well as the assessment tool should be designed.
Objective To assess oncology nurses′ practices regarding oral assessment for patients on radiochemotherapy treatment, and to provide reference for standardizing oral assessment and preventing oral complications. Methods A total of 198 oncology nurses were selected by convenience sampling and were invited to complete a questionnaire survey in terms of their practices regarding oral assessment for patients on radiochemotherapy treatment. Results Only 12.63% of the respondents performed oral assessment for patients initially receiving radiochemotherapy before the occurrence of oral complications and 12.63% of them used assessment tools. About 97.98% of the nurses conducted oral assessment when patients developed oral complications and 46.97% used assessment tools. More than forty percent(42.93%) of the nurses performed oral assessment for rehospitalized patients and 10.10% used assessment tools. Conclusion Nurses paid less attention to oral assessment for patients without oral complications before radiochemotherapy treatment and for those who were rehospitalized for treatment, and they generally were inadequate to perform oral assessment. At the same time, there was a shortage of targeted oral assessment tool. Oral assessment should be strengthened in patients before radiochemotherapy treatment and in rehospitalized patients. The assessment contents and process should be improved as well as the assessment tool should be designed.
引文
[1] 张志愿,余光岩.口腔科学[M].8版.北京:人民卫生出版社,2013:3.
[2] 徐高鑫,宋金霞,周静,等.口含冰冻康复新药液冰块防治放射性口腔黏膜炎的疗效观察[J].护士进修杂志,2017,32(19):1771-1773.
[3] 严凌花,朱霆,陈星,等.应用口腔护理液治疗放疗后口腔溃疡[J].护理学杂志,2017,32(21):37-38.
[4] 路燕燕,姜元喜.Meta分析:洗必泰预防化疗诱导致口腔黏膜炎的作用[J].上海护理,2017,17(5):67-71.
[5] 廖金莲.鼻咽癌患者放射性口腔炎防治进展[J].护理实践与研究,2017,14(9):30-32.
[6] 谷心灵,郭莹.一例多发性骨髓瘤患者化疗致口腔黏膜炎的循证护理[J].护理管理杂志,2017,17(11):790-792.
[7] 王焕,郭素萍,钱玉霞.回授法在化疗患者口腔黏膜炎防护中的应用[J].齐鲁护理杂志,2018,24(3):65-67.
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[9] 罗彩凤,贾静,柏素萍,等.围手术期患者压疮评估及评估工具使用现状的调查研究[J].中华护理杂志,2017,52(4):409-413.
[10] 温淼淼,曾铁英,赵梅珍.经口气管插管患者口腔护理的评估及操作现状调查[J].中华护理杂志,2016,51(7):858-863.
[11] Eilers J,Berger A M,Petersen M C.Development,tes-ting,and application of the oral assessment guide[J].Oncol Nurs Forum,1988,15(3):325-330.
[12] Ames N J,Sulima P,Yates J M,et al.Effects of systematic oral care in critically ill patients:a multicenter study[J].Am J Crit Care,2011,20(5):e103-e114.
[13] Hayes J,Jones C.A collaborative approach to oral care during critical illness[J].Dent Health (London),1995,34(3):6-10.
[14] Vera-Llonch M,Oster G,Hagiwara M,et al.Oral mucositis in patients undergoing radiation treatment for head and neck carcinoma[J].Cancer,2006,106(2):329-336.
[15] 林苑云,冯盈,陈德健,等.急性髓系白血病患者化疗前口腔治疗预防化疗性口腔黏膜炎的初步研究[J].中华口腔医学研究杂志(电子版),2015,19(4):305-307.
[16] 郑窑文,蒋莉莉,胡嘉乐,等.口腔护理临床实践指南的质量评价及内容分析[J].中国护理管理,2018,18(3):345-351.
[17] 吴军,邓翠琴,崔伟燕,等.多学科协作干预防治鼻咽癌患者放化疗所致口腔黏膜炎[J].护理学杂志,2018,33(23):9-11.
[18] 刘小敏,李敏玲,李会玲,等.危重患者口腔并发症高危风险评估量表的研制与应用[J].中国循证医学杂志,2017,17(1):108-112.
[19] 温淼淼,赵梅珍,曾铁英.经口气管插管患者口腔护理评估量表的研制[J].护理学杂志,2015,30(11):5-8.
[20] 温淼淼,赵梅珍,曾铁英.我国27所医院经口气管插管患者口腔护理操作流程的内容分析[J].护理学杂志,2016,31(8):43-47.
[21] 司旭艳,殷艳玲,郭新荣,等.口腔冲洗器在经口气管插管患者口腔护理中的应用[J].护理学杂志,2012,27(2):59-60.
[22] 张伟媛,苏英,杨羚.布地奈德雾化吸入对COPD急性加重期患者口腔pH值的影响及与口腔真菌感染的相关性研究[J].护士进修杂志,2017,32(1):75-78.
[23] 陆水红.鼻咽癌放疗对口腔和鼻腔pH值影响的研究[D].南宁:广西医科大学,2013.
[24] 沈燕,周玉峰,杨娟,等.碳酸氢钠溶液不同漱口方案对恶性肿瘤化疗患儿口腔pH值的影响研究[J].中华护理杂志,2017,52(12):1413-1417.
[25] 姚丹,仲君,陶志芳.Orem护理模式对头颈部恶性肿瘤放疗患者预防放疗诱发性口腔黏膜炎与自我护理能力的影响[J].护理实践与研究,2018,15(23):100-102.
[2] 徐高鑫,宋金霞,周静,等.口含冰冻康复新药液冰块防治放射性口腔黏膜炎的疗效观察[J].护士进修杂志,2017,32(19):1771-1773.
[3] 严凌花,朱霆,陈星,等.应用口腔护理液治疗放疗后口腔溃疡[J].护理学杂志,2017,32(21):37-38.
[4] 路燕燕,姜元喜.Meta分析:洗必泰预防化疗诱导致口腔黏膜炎的作用[J].上海护理,2017,17(5):67-71.
[5] 廖金莲.鼻咽癌患者放射性口腔炎防治进展[J].护理实践与研究,2017,14(9):30-32.
[6] 谷心灵,郭莹.一例多发性骨髓瘤患者化疗致口腔黏膜炎的循证护理[J].护理管理杂志,2017,17(11):790-792.
[7] 王焕,郭素萍,钱玉霞.回授法在化疗患者口腔黏膜炎防护中的应用[J].齐鲁护理杂志,2018,24(3):65-67.
[8] 李小寒,尚少梅.基础护理学[M].4版.北京:人民卫生出版社,2017:64.
[9] 罗彩凤,贾静,柏素萍,等.围手术期患者压疮评估及评估工具使用现状的调查研究[J].中华护理杂志,2017,52(4):409-413.
[10] 温淼淼,曾铁英,赵梅珍.经口气管插管患者口腔护理的评估及操作现状调查[J].中华护理杂志,2016,51(7):858-863.
[11] Eilers J,Berger A M,Petersen M C.Development,tes-ting,and application of the oral assessment guide[J].Oncol Nurs Forum,1988,15(3):325-330.
[12] Ames N J,Sulima P,Yates J M,et al.Effects of systematic oral care in critically ill patients:a multicenter study[J].Am J Crit Care,2011,20(5):e103-e114.
[13] Hayes J,Jones C.A collaborative approach to oral care during critical illness[J].Dent Health (London),1995,34(3):6-10.
[14] Vera-Llonch M,Oster G,Hagiwara M,et al.Oral mucositis in patients undergoing radiation treatment for head and neck carcinoma[J].Cancer,2006,106(2):329-336.
[15] 林苑云,冯盈,陈德健,等.急性髓系白血病患者化疗前口腔治疗预防化疗性口腔黏膜炎的初步研究[J].中华口腔医学研究杂志(电子版),2015,19(4):305-307.
[16] 郑窑文,蒋莉莉,胡嘉乐,等.口腔护理临床实践指南的质量评价及内容分析[J].中国护理管理,2018,18(3):345-351.
[17] 吴军,邓翠琴,崔伟燕,等.多学科协作干预防治鼻咽癌患者放化疗所致口腔黏膜炎[J].护理学杂志,2018,33(23):9-11.
[18] 刘小敏,李敏玲,李会玲,等.危重患者口腔并发症高危风险评估量表的研制与应用[J].中国循证医学杂志,2017,17(1):108-112.
[19] 温淼淼,赵梅珍,曾铁英.经口气管插管患者口腔护理评估量表的研制[J].护理学杂志,2015,30(11):5-8.
[20] 温淼淼,赵梅珍,曾铁英.我国27所医院经口气管插管患者口腔护理操作流程的内容分析[J].护理学杂志,2016,31(8):43-47.
[21] 司旭艳,殷艳玲,郭新荣,等.口腔冲洗器在经口气管插管患者口腔护理中的应用[J].护理学杂志,2012,27(2):59-60.
[22] 张伟媛,苏英,杨羚.布地奈德雾化吸入对COPD急性加重期患者口腔pH值的影响及与口腔真菌感染的相关性研究[J].护士进修杂志,2017,32(1):75-78.
[23] 陆水红.鼻咽癌放疗对口腔和鼻腔pH值影响的研究[D].南宁:广西医科大学,2013.
[24] 沈燕,周玉峰,杨娟,等.碳酸氢钠溶液不同漱口方案对恶性肿瘤化疗患儿口腔pH值的影响研究[J].中华护理杂志,2017,52(12):1413-1417.
[25] 姚丹,仲君,陶志芳.Orem护理模式对头颈部恶性肿瘤放疗患者预防放疗诱发性口腔黏膜炎与自我护理能力的影响[J].护理实践与研究,2018,15(23):100-102.