Objective To evaluate the impact of the intrauterine device (IUD) insertion on the mental state of women.Methods From Jan.2009 to Jun.2010,a multi-center clinical observational study was performed.Totally 641 women were selected in the six provinces' 18 family planning service stations and hospitals for IUD insertion surgery study.Analysis of the change of women's mental state which was evaluated by symptom checklist-90 (SCL-90) scale before and after IUD insertion surgery.Results Before and after IUD insertion surgery,10 factors' scores in SCL-90 of the observed objects were between 1.1 to 1.2,total scores were 107 ± 27 and 105 ± 25,respectively.Before and after surgery,total average score both were 1.2,the average score of positive items both were 2.1.The difference of the above results were not statistically significance (all P ＞0.05).Preoperative and postoperative,the rate of positive items was 9.2％-19.6％ and 7.7％-17.6％,respectively.In addition to anxiety and fear,the rate of other factors' positive items postoperative was significantly lower than those in the preoperative (all P ＜ 0.05).The incidence of the observed objects postoperative of each factor score,deteriorated was in the range of 4.9％ to 23.0％,improved was in the range of 26.3％-50.1％.The incidence of total scores,deterioration was 28.8％ (166/575),improved was 45.6％ (262/575).The incidence of the average score of positive items,deterioration was 3.7％ (21/575),improved was 52.3％ (301/575).Logistic analysis showed that,in addition to unit level,there were no other significant influencing factors for women' mental state of postoperative (all P ＞ 0.05).Conclusion IUD insertion surgery has no adverse effect on women's mental state.

Objective To evaluate the method, efficacy and safety of nasal spray inhalation by applying nasal inhalation of budesonide suspension in preoperative preparation for patients with chronic sinusitis and nasal polyps.Methods Totally 25 hospitalized patients with chronic rhinosinusitis and nasal polyps were enrolled, who were given a dose of 1 mg/2 ml budesonide suspension by nasal spray inhalation twice a day for one week before surgery. Their symptoms were evaluated before and after treatment, with their Kennedy endoscopic score, morning serum glucocorticoid, surgical time and surgical bleeding measured.Results The patients showed lower scores in nasal symptoms and endoscopic polyps than they were at admission (P<0.01); their morning serum glucocorticoid decreased slightly after treatment (P>0.05); the surgical time was (93.36 ± 14.43) min and the surgical bleeding score was level-5.Conclusions The application of budesonide suspension by nasal spray inhalation one week before surgery can improve nasal symptoms, reduce the volume of nasal polyps as well as surgical bleeding, thus it is a safe and effective method for preoperative preparation.

Objective To prevent the gastrointestinal intolerance in patients after laryngectomy by care bundles, so as to improve the effectiveness of enteral nutrition. Methods A total of 117 cases of laryngectomy patients were divided into control group (n=58) and experimental group (n=59) by random number table method. The patients in the control group were given routine nursing care, while the patients in the experimental group were treated by care bundles. The incidence of gastrointestinal intolerance was compared between the two groups in bloating, vomiting, gastroesophageal reflux, diarrhea and gastric retention. Results The incidences of bloating, vomiting, diarrhea and gastric retention of the experimental group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). The time of indwelling gastric tube in the experimental group and the control group was (12.35±2.29) days and (14.23±2.16) days respectively, and the difference was statistically significant (t=4.79, P< 0.01). Conclusions Care bundles can effectively prevent the occurrence of gastrointestinal intolerance in patients with indwelling gastric tube after laryngectomy.

Objective:To investigate the awareness and implementation of swallowing training for laryngectomy patients among nurses of Otolaryngology Department in ClassⅢ Grade A hospitals of China so as to provide a basis for standardizing the swallowing training for laryngectomy patients and training for nurses.Methods:From September 2019 to October 2019, this study selected 274 nurses of Otolaryngology Department from 46 hospitals in 26 provinces or cities of China as subjects by convenience sampling. All of nurses were investigated with the self-designed awareness of swallowing training for laryngectomy patients questionnaires among nurses of Otolaryngology Department. SPSS 19.0 was used for data analysis, and enumeration data were expressed as the frequency, percentage or constituent ratio.Results:A total of 274 questionnaires were sent out and 268 valid questionnaires were collected. Among 268 nurses, there were 4.10% (11/268) of them completely understood the swallowing function training knowledge. Departments with the swallowing function training standard for the laryngectomy patients accounted for 43.66% (117/268) . A total of 95.52% (256/268) of nurses thought that it was necessary to unify the swallowing function training standard for the laryngectomy patients, and 93.28% (250/268) of nurses agreed to carry out swallowing function taining for patients. However, there were only 30.22% (81/268) of nurses carrying out swallowing assessment by scales.Conclusions:In China, nurses of Otolaryngology Department in ClassⅢ Grade A hospitals have inadequate knowledge of swallowing function training for laryngectomy patients, and the swallowing function training lacks unified standard. Swallowing training and standardized nursing practice needs to be further improved.

Objective:To understand the current status of subjective symptoms and self-management efficacy in patients with chronic rhinosinusitis and nasal polyps after endoscopic sinus surgery, and analyze the correlation between the two.Methods:This study was a cross-sectional study. From July 2018 to June 2020, a total of 228 patients with chronic rhinosinusitis and nasal polyps who underwent endoscopic sinus surgery in a ClassⅢ Grade A hospital in Beijing were selected as the research object. The survey was conducted using the General Information Questionnaire, Visual Analogue Scale (VAS) , and Chronic Disease Self-Efficacy Scale (CDSES) . Pearson correlation and Spearman rank correlation were used for the correlation analysis.Results:Among 228 patients with chronic rhinosinusitis and nasal polyps, there were still 184 cases (80.70%) of nasal congestion, 134 cases (58.77%) of runny nose, 116 cases (50.88%) of olfactory symptoms, 112 cases (49.12%) of head and face pain symptoms, and 208 cases (91.22%) of general discomfort. Among 228 patients with chronic rhinosinusitis and nasal polyps, the symptom management self-efficacy dimension in CDSES score was (6.19±1.04) , and the disease common management self-efficacy dimension score was (7.42±0.95) , and there were 32 cases with a total score of ≥7, accounting for 14.04% (32/228) . The VAS score of various subjective symptoms was negatively correlated with the total score of CDSES and the score of each dimension, and the difference was statistically significant ( P<0.05) . Conclusions:Patients with chronic rhinosinusitis and nasal polyps still have disease symptoms after endoscopic sinus surgery, and the self-management efficacy needs to be further strengthened. Clinical nurses should pay attention to subjective symptoms of these patients after surgery, teach them how to manage disease symptoms, and improve the patient's self-management efficacy.

Objective:To assess respondents' understanding of the items in the Neck Dissection Impairment Index (NDII) through cognitive interviews and to revise the items accordingly.Methods:Totally 30 postoperative neck dissection patients returning for follow-up at Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University from November 2023 to February 2024, were selected by purposive sampling for two rounds of cognitive interviews. Based on the interview results, the Chinese version of the NDII was revised.Results:The Chinese version of the NDII included ten items. The first round of interviews identified issues such as "incomplete expression, abstract language, and written form, " leading to revisions of five items. The second round of interviews showed that all respondents understood the revised items, and no new suggestions for modification were made.Conclusions:Cognitive interviews can improve respondents' comprehension of the Chinese version of the NDII, identify cognitive biases caused by cultural differences and improper linguistic expressions during the translation process, and enhance the understanding and acceptance of the scale's content among the target population.

Objective:To construct an inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients.Methods:From June 2022 to May 2023, a preliminary program for inpatient-outpatient-home step swallowing rehabilitation training for partial laryngectomy patients was developed through literature search and analysis. Delphi method was used for two rounds of expert inquiry on the inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients.Results:A total of 15 experts were included for two rounds of expert inquiry. The effective response rates of the questionnaires from the two rounds of expert inquiries were 100.0% (15/15). The expert authority coefficients for the two rounds of inquiry were 0.885 and 0.855, respectively, and the Kendall harmony coefficients were 0.217 and 0.230, respectively ( P<0.01). The final inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients included three primary items (swallowing training step, swallowing training methods, and feeding guidance methods), 21 secondary items, and 35 tertiary items. Conclusions:The inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients based on the Delphi method has certain scientific and feasibility and can provide a reference for medical and nursing staff.

Objective To evaluate the effect of different operation methods on the early swallowing function in the patients with laryngocarcinoma.Methods A total of 138 patients with the first time of open laryngectomy in this hospital from January 2021 to December 2022 were selected as the research subjects by convenience sampling method.The patients were divided into the vertical laryngeal resection group(vertical group,n=34),horizontal laryngeal partial resection(horizontal group,26 cases),suprachloroid laryngeal par-tial resection annular hyoid epiglottis fixation group(SCPL-CHEP group,n=26)and total laryngeal resection group(total laryngeal group,n=52)according to the operation methods.The Anderson Dysphagia Scale,Syd-ney Dysphagia Scale and modified swale drinking water test were used to evaluate the swallowing function on the first day of postoperative oral feeding in the patients.Results The total scores and scores of various di-mensions of the Chinese version of Anderson Dysphagia Scale,total scores and scores of various dimensions of Sydney Swallowing Scale and the results of the modified swale drinking water test had statistical differences a-mong the various groups(P＜0.01);the above indexes had statistical difference between the total laryngeal group and the other groups(P＜0.01),but the above indexes had no statistical difference between the two groups in the horizontal group,vertical group and SCPL-CHEP group(P＞0.05).Conclusion In the patients with laryngeal cancer undergoing open laryngectomy,the dysphagia is less severe during early eating after to-tal laryngectomy,which has little impact on life.

Objective To explore the application of health education of keywords in the chronic sinusitis patients with functional endoscopic sinus surgery (FESS).Methods One hundred and eight chronic sinusitis patients with FESS from February 2012 to May 2012 were chosen and divided into the control group (n=56) and the observation group (n=52).The control group received the traditional health education , and the observation group received the health education of keywords on the basis of the control group .The awareness of health education knowledge and the nursing satisfaction of health education were compared between two groups .Results The scores of the awareness of health education knowledge 1 d before the operation , the day of the operation and 1 d after the operation were respectively (17.67 ±1.29), (14.94 ±1.35), (18.48 ±1.45) in the observation group , and were higher than those of the control group , and the differences were statistically significant (t=8.124, 10.741, 8.700, respectively;P<0.01).The score of the nursing satisfaction of health education in the patients was (3.40 ±0.53) in the observation group, and was (2.86 ±0.77) in the control group, and the difference was statistically significant (t=4.303, P<0.01).Conclusions The implementation of the health education of keywords can effectively improve the mastery of health education knowledge and the nursing satisfaction of health education in the chronic sinusitis patients with FESS , and increase the quality of nursing.

Objective To explore the effects of evidence-based nursing practice on reducing the incidence of pharyngo-cutancous fistula, shortening hospital day after surgery and easing the financial burden among laryngectomy patients.Methods From June 2017 to March 2018, we selected laryngectomy patients as subjects in Beijing Tongren Hospital. Patients were numbered according to the order being admitted to hospital and randomly divided into two groups with the random number table. Control group (n=51) received routine nursing. Experimental group (n=50) carried out routine nursing along with transforming evidence into nursing plan, implementing and evaluating nursing care effects by the Johns Hopkins nursing evidence-based practice (JHNEBP) model. We observed the incidence of pharyngo-cutancous fistula and hospital stay of patients between two groups.Results The incidence of pharyngeal fistula of experimental group and control group were 10.00 ％ and 27.45％ respectively with a significant difference (χ2=5.034,P=0.025). The hospital day of experimental group and control group were (12.78±3.99)d and (17.22±6.45)d respectively with a significant difference (t= -4.151,P<0.001).Conclusions The evidence-based nursing practice based on JHNEBP can reduce the incidence of pharyngo-cutancous fistula and shorten hospital day after surgery.