[Application of 4R crisis management theory in the protection of oral mucositis in patients with autologous hematopoietic stem cell transplantation].

Abstract

Purpose: To investigate the clinical value of nursing care plans employing 4R crisis management model for prevention of oral mucositis in patients with autologous hematopoietic stem cell transplantation.

Methods: According to different intervention time points, totally 40 transplantation patients from May 2019 to December 2020 were selected as the control group, while 68 transplantation patients from January 2021 to January 2023 were selected as the experimental group. Compared to the control group, patients in the experimental group adopted more comprehensive risk management measures and applied 4R crisis theory. The preventive and therapeutic outcomes were compared in the aspects of oral mucosal inflammation incidence, grade, time to resume orally fed diet and inpatient stay of two groups of patient. SPSS 27.0 software package was used for statistical analysis.

Results: Oral mucositis occurred in 76.5% of patients in the experimental group, which was significantly lower than the control group (100%) (P＜0.05). Severe oral mucositis (grades Ⅲ and Ⅳ) were 11.8% in the experimental group, which was significantly lower than the control group(65.0%). The clinical nursing satisfaction of the experimental group was significantly higher than that of the control group(P＜0.001). There was no significant difference in hospital duration or oral refeeding time between the two groups(P＞0.05).

Conclusions: The application of 4R crisis management strategy can substantially decrease oral mucositis occurrences and severity, thereby enhancing the effectiveness of oral care management for autologous hematopoietic stem cell transplantation patients, reducing patient discomfort, accelerating recovery time and improving quality of life . The strategy has promising clinical potential of application.