Abstract
Background: Head and neck cancer (HNC) have a considerable mortality and
morbidity rate. Surgery is one of the most effective treatments, however
it may compromise the independence of patients after its performance.
The Rehabilitation Nurse (RN) intervention is essential for recovery.
Objective: To compare the dependence degree between patients who
underwent RN intervention versus general health care after HNC surgery.
Methods: Patients submitted to different types of HNC surgery, were
divided into two groups intervention by the RN versus general health
care, the outcome was the Barthel Index Discharge categorized as
dichotomic to assess the patient independence at discharge and their
differences calculated by statistical analysis. To analyze the effect of
the RN intervention on dependence, a Poisson regression model was used,
adjusting the confounding factors Initial Barthel Index and Age in the
variable Barthel Index Discharge>91. Results: In
middle/late postoperative period, in the group with RN intervention
(n=79) the hospitalization time was reduced by 4.29 days versus general
health care (n=72). At discharge, the Barthel Index (p<0.005)
improved significantly in the RN intervention group compared to the
general health care group. The intervention of the RN after surgery had
a positive effect on the functional capacity of the patients, after
adjusting the confounding factors (RR:1.47; 95%CI[1.02; 2.12]).
Conclusion: The RN intervention is an added value in the independence of
the patient submitted to HNC surgery. It is an innovative study in
patient after diagnosis HNC, showing that intervention of RN through
rehabilitation programs allows independence after his surgery. 5
succinct Key points: Independence of the patient submitted to HNC
surgery; early rehabilitation in postoperative period; rehabilitation
nursing programs; self-care optimization; regression model.