Application value of clinical pathway nursing based on multi-disciplinary team combined with early postoperative functional exercise in patients with thyroid adenoma resection
Objective To explore the application value of multi-disciplinary team(MDT)based clinical pathway nursing combined with early postoperative functional exercise in patients with thyroid adenoma resection before and after surgery.Methods All 108 patients with thyroid adenoma admitted to the Seventh People's Hospital of Zhengzhou from July 1,2020,to August 31,2022 were selected as the study objects,and they were divided into routine nursing group(54 cases)and combined nursing group(54 cases)using random number table method.Both groups received surgical treatment,and routine nursing group received conventional nursing intervention.The combined nursing group received MDT based clini-cal pathway nursing combined with early postoperative functional exercise on the basis of routine nursing.After interven-tion,neck function[neck disability index(NDI)],incidence of neck stiffness and cicatricial contracture,mood status[profile of mood states(POMS)],self-care ability[exercise of self care agency(ESC A)]and quality of life[thyroid canc-er-specific quality of life(THYCA-QoL)]were compared between the two groups.Results After adjusting for baseline data before intervention,8 weeks after intervention,both groups of patients showed increased positive mood scores,ES-CA scores,NDI,and THYCA-QoL scores,and decreased negative mood scores.Positive mood score of patients in com-bined nursing group was(35.26±3.73)points,which was higher than that in routine nursing group(29.70±4.16)points,F=26.782,P＜0.001;the negative mood score was(32.67±4.29)points,which was lower than that in routine nursing group(40.74±4.07)points,F=49.887,P＜0.001;the ESCA score was(132.06±10.29)points,which was higher than that that in routine nursing group(103.24±9.82)points,F=110.388,P＜0.001;NDI was(25.78±2.87)％,which was lower than that in routine nursing group(36.85±3.37)％,F=177.223,P＜0.001;THYCA-QoL score was(42.61±3.72)points,which was lower than that in routine nursing group(50.37±3.66)points,F=59.128,P＜0.001.After 8 weeks of intervention,the incidence of neck stiffness in the combined nursing group was 9.26％,which was lower than that in routine nursing group 25.93％,x2=5.173,P=0.023;the incidence of cicatro contracture was 5.56％,which was lower than that in routine nursing group 18.52％,x2=4.285,P=0.039.Conclusion MDT based clinical pathway nursing combined with early postoperative functional exercise can regulate the mood state of thyroid adenoma patients,reduce the incidence of neck stiffness and scar contracture,promote the recovery of neck function and improve the quality of life of patients.
thyroid adenomaearly functional exercisemulti-disciplinary teamclinical pathway nursingneck function
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