自我管理教育对声带息肉发声训练患者嗓音康复的效果研究

摘要

目的:探讨自我管理教育对发声训练的声带息肉手术患者嗓音康复效果的影响,对患者的自我管理效果进行评价.方法:将109例声带息肉患者随机分为常规组44例与发声训练组(训练组)65例,常规组按常规进行护理并给予音声卫生指导(音声教育)；训练组除按常规组完成护理及指导外还进行了发声训练,在训练指导期间加强了对患者的自我管理教育；两组患者分别在术后10,20,30 d进行嗓音声学参数的测试,同时调查发声训练患者的有利于嗓音康复的嗓音保健行为.结果:训练组患者术后10,20 d嗓音声学测试结果在振幅微扰、声门噪声能量低于常规组(P＜0.05),其余时段的嗓音声学参数两组比较无统计学差异(P＞0.05)；训练组术后20 d内在克服不良生活习惯行为、避免用声不当行为方面管理良好(P＞0.05),术后30 d在避免过度用声行为及主动参与发声训练行为方面其自我管理有下降趋势(P＜0.05)；自我管理良好的患者术后20 d的嗓音声学测试结果在振幅微扰方面优于中差患者(P＜0.05),术后30 d声门噪声能量优于中差者(P＜0.05).结论:发声管理教育能提高声带息肉手术患者术后嗓音康复的质量；可帮助患者建立一套正确的嗓音保健方法并做到良好的自我管理；嗓音疾病患者自我管理可作为患者进行嗓音康复的一种较理想的管理模式.%Objective: To investigate the impact of self - management education in vocal training,polyp of vocal cord surgery voice rehabilitation effect on patient self - management effectiveness evaluation. Methods: The patients with polyp of vocal cord were randomly divided into conventional group with vocal training group ( training group ) ,the conventional group,44 cases gived conventional nursing and health guidance (voice education) ;training group of 65 cases in addition to the conventional group completed care guidance outside of vocal training, during training guidance to strengthen self - management education for patients; two groups of patients, respectively, after 10 days, 20 days, 30 days of the voice acoustic parameters of the test, while investigating patients with vocal training conducive to the voice of voice rehabilitation care behavior. Results:The training group was on the 10th days ,on the 20th days of voice a-coustic test results in the amplitude perturbation was lower than the conventional group (P<0.05) ,the NNE was significantly lower than the conventional group (P < 0.05 ) , voice acoustic parameters of the rest of the time, there was no difference. The training group after 20 days to overcome unhealthy living habits of behavior, to avoid well - managed sound misconduct (P > 0.05 ) , after 30 days to avoid excessive use of acoustic behavior and active participation in vocal training behavior the self - management on a downward trend ( P < 0.05 ) . Self - management of patients on the 20th of voice acoustic test results to patients (P <0.05) difference in the amplitude perturbation was superior on the 30th days postoperative NNE significantly better than the difference (P < 0.05 ). Conclusion: The sound management education can improve the quality of the voice rehabilitation of vocal cord polyp surgery patients; may help the patient to a proper voice care and do a good self - management; voice disease self - management can be used as the patient voice rehabilitation an ideal management model.