口腔照護方案對口腔癌術後病人吞嚥功能之成效

Effects of an Oral Care Program on the Swallowing Function in Post-Operative Patients With Oral Cancer

背景：口腔癌位居台灣男性罹癌第四位，口腔癌術後會引發吞嚥障礙、嗆咳及吸入性肺炎等合併症，改善病人吞嚥功能成為一迫切的議題。目的：探討口腔照護方案對口腔癌術後病人吞嚥功能之成效。方法　採類實驗設計，以口腔癌術後病人為對象，實驗組（n = 20）執行口腔照護方案12週，對照組（n =20）接受一般照護；繼而比較兩組改良式鋇劑吞嚥（modified barium swallow）攝影結果，與病人自覺吞嚥困難程度，以檢視介入措施的成效。結果　接受口腔照護方案的口腔癌術後病人，其改良式鋇劑吞嚥攝影與自覺吞嚥困難改善之成效，皆比對照組佳（p ＜ .001）。結論／實務應用　口腔照護方案能有效改善口腔癌術後病人吞嚥功能，期望此結果可供臨床醫護人員參酌，以提升照護品質。

Background: Oral cancer is the fourth leading cause of death among men in Taiwan. Dysphagia, choking, and aspiration pneumonia are often noted in post-operative patients with oral cancer. Improving patients' swallowing function is an urgent problem that cannot be neglected. Purpose: To investigate the effects of an oral care program on the swallowing function of post-operative patients with oral cancer. Methods: A quasi-experimental research design was conducted and post-operative patients with oral cancer were recruited. The experimental group (n = 20) received 12 weeks of the oral care program intervention, while the control group (n = 20) received standard post-operative care. The modified barium swallow (MBS) study and self-rated degree of dysphagia were compared between the two groups after the intervention period. Results: Post-intervention scores on the MBS test and for the self-rated degree of dysphagia were significantly better in the experimental group than in the control group (p ＜ .001). Conclusions / Implications for Practice: Performing the oral care program was found to improve the swallowing function of post-operative patients with oral cancer. The results of the present study provide a reference for healthcare providers to improve quality of care.