Zhu Jizhe, Wang Xin, Chen Suxiang, Du Ruofei, Zhang Haoning, Zhang Menghan, Shao Mengwei, Chen Changying, Wang Tao
College of Nursing and Health, Zhengzhou University, Zhengzhou, China.
Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, WA, Australia.
Asia Pac J Oncol Nurs. 2022 Nov 19;10(1):100169. doi: 10.1016/j.apjon.2022.100169. eCollection 2023 Jan.
Dysphagia, one of the most common complications in head and neck cancer (HNC) treated with radiotherapy, can severely affect patients' quality of life. Currently, because no "gold standard" treatment exists, swallowing exercise remains the main rehabilitation strategy for dysphagia. However, patients' compliance with long-term swallowing exercise is only 40%, thus, greatly compromising outcomes. This article aims to analyze thefactors influencing swallowing exercise compliance in patients with HNC and explains strategies developed to date for improved rehabilitation outcomes.
Research studies published between 2005 and 2022 were retrieved from seven databases: PubMed, Cochrane Library, Embase, CINAHL, CNKI, Wan Fang Database, and VIP Database, and 21 articles were shortlisted and systematically reviewed.
The swallowing exercise compliance in patients with HNC undergoing radiotherapy was affected by multiple factors, including socio-demographic factors, illness-associated factors, treatment-associated factors, and psychosocial factors. Regarding the interventions, current strategies mainly address psychosocial issues via developing various education programs.
Different factors influencing swallowing exercise compliance are important and should be observed. Measures including developing multidisciplinary teams, applying innovative equipment, refining the intervention procedure, and applying systematic theory frameworks should be performed to achieve better outcomes of compliance interventions.
吞咽困难是头颈部癌（HNC）放疗后最常见的并发症之一，会严重影响患者的生活质量。目前，由于不存在“金标准”治疗方法，吞咽训练仍然是吞咽困难的主要康复策略。然而，患者长期吞咽训练的依从性仅为40%，因此，极大地影响了治疗效果。本文旨在分析影响HNC患者吞咽训练依从性的因素，并阐述迄今为改善康复效果而制定的策略。
从七个数据库检索2005年至2022年间发表的研究：PubMed、Cochrane图书馆、Embase、CINAHL、中国知网、万方数据库和维普数据库，筛选出21篇文章并进行系统综述。
接受放疗的HNC患者的吞咽训练依从性受多种因素影响，包括社会人口学因素、疾病相关因素、治疗相关因素和心理社会因素。关于干预措施，目前的策略主要通过开展各种教育项目来解决心理社会问题。
影响吞咽训练依从性的不同因素很重要，应予以关注。应采取包括组建多学科团队、应用创新设备、完善干预程序和应用系统理论框架等措施，以取得更好的依从性干预效果。
