关键词: 鼻咽癌；放疗后张口困难；预防；康复；循证护理

Abstract: Objective: To implement evidence-based strategies for preventing and rehabilitating radiation-induced trismus in Nasopharyngeal Carcinoma (NPC) patients into clinical practice and evaluate their effectiveness, to further standardizing the prevention and rehabilitation of radiation-induced trismus. Methods: Guided by the Evidence-Based Continuous Quality Improvement Model, this study was conducted from June 2023 to August 2024 following four stages: evidence retrieval, current practice assessment, evidence implementation, and post-implementation review. The study compared compliance rates with audit criteria, departmental organizational culture, nurses' Knowledge-Attitude-Practice (KAP) levels regarding trismus prevention/rehabilitation, and the incidence/severity of trismus before and after evidence implementation. Results: In 24 audit criteria, compliance rates for criteria with baseline compliance <60% significantly improved after two rounds of post-implementation audits (P<0.001). Organizational culture scores and nurses' KAP scores post-implementation were significantly higher than baseline, the incidence of trismus significantly decreased, and patients' trismus degree was significantly lower than that in baseline measurements (all P<0.05). Conclusion: The clinical implementation of evidence-based strategies effectively reduced trismus incidence and improved mouth-opening function in NPC patients after radiotherapy.

Key words: Nasopharyngeal Carcinoma; radiation-induced trismus; prevention; rehabilitation; evidence-based nursing