Improving Quality of Life, Mental Health, and Reducing Complications in Nasopharyngeal Carcinoma Patients Undergoing Chemoradiotherapy: A Randomized Controlled Trial of the Omaha System Nursing Model

Improving Quality of Life, Mental Health, and Reducing Complications in Nasopharyngeal Carcinoma Patients Undergoing Chemoradiotherapy: A Randomized Controlled Trial of the Omaha System Nursing Model | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Improving Quality of Life, Mental Health, and Reducing Complications in Nasopharyngeal Carcinoma Patients Undergoing Chemoradiotherapy: A Randomized Controlled Trial of the Omaha System Nursing Model Shuixiu Yang, Shumin Yu, Qinglin Shen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6354392/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: To explore the effect of Omaha System nursing model (OSNM) on the quality of life, mental status and complications of patients with nasopharyngeal carcinoma (NPC) undergoing chemoradiotherapy. Methods : A total of 356 patients with NPC were randomly divided into experimental group and control group by random number grouping method, and there are 178 cases in each group. The control group received routine nursing and the experimental group received OSNM; The scores of qualities of life, mental status and the incidence of complications were compared and analyzed between the two groups before and after nursing. Results : The scores of physical function, role function, social function, cognitive function, emotional function and overall quality of life in the experimental group were significantly higher than those in the control group (P<0.05); Whereas, the scores of somatization, interpersonal sensitivity, depression, anxiety, terror, hostility, compulsion, paranoia and psychotic symptoms in the experimental group were obviously lower than those in the control group (P < 0.05); In addtion, the incidence of nasal mucosal reaction, oral infection and complications in the experimental group were also significantly lower than those in the control group (P < 0.05). Conclusion : OSNM demonstrates obvious advantages and deserves the expansion of its popularization in routine clinical nursing work. Omaha System nursing model Nasopharyngeal carcinoma Chemoradiotherapy Quality of life Mental status Complication Introduction Nasopharyngeal carcinoma (NPC) is one of the common malignant tumors in China, and it is prevalent in Guangdong, Jiangxi and other regions, and its incidence has obvious racial and family tendencies [23]. NPC in China accounts for 38.29% and 40.14% of the incidence and death of NPC in the world, which is higher than the world average level [10]. About 60% ~ 87% of patients have cervical lymph nodes, even bone, lung and liver metastasis at the first diagnosis [7]. This not only increases the difficulty of clinical treatment and nursing, but also raise the expenditure of resource and time cost and the family burden of patients [6, 8]. NPC originates from the mucous epithelium of the nasopharynx and often occurs in the pharyngeal recess and the top wall of the nasopharynx. With the improvement of medical level, it has entered the era of intensity modulated radiotherapy. In addition, the treatment cycle of NPC is long, and there are many acute injury reactions in the process of radiotherapy, such as skin pruritus, pigmentation, peeling, eczema, blisters and ulceration, redness, erythema, congestion, dry mouth, pain and ulcer of oral mucosa, tinnitus, difficulty opening mouth, limited shoulder and neck movement and other symptoms. Affected by the negative emotion of the disease, patients are prone to poor treatment compliance, which decline the treatment effect and quality of life of patients [9]. In addition, cancer patients have unique medical and psychosocial needs [3, 12]. However, in the past, routine nursing of chemoradiotherapy of NPC mainly started from the implementation of medical orders, diet education, medication education, condition observation, discharge guidance and improvement of service attitude. There was no systematic, complete and continuous evaluation of its existing problems from the perspective of patients, so routine nursing could rarely meet the comprehensive needs of patients. With the continuous improvement of people's demand for health, clinical nursing work is no longer simply nursing diseases in the past, but starting from the patient's body and mind, providing high-quality nursing services for patients, taking patients as the center, establishing a good relationship between doctors and patients, nurses constantly improve their nursing skills and create a good medical environment for patients, Make patients get better care, reduce patients' pain, improve patients' negative psychology, improve patients' quality of life, prolong patients' survival time, and improve nursing satisfaction. Omaha System was founded in the 1970s in the United States. Its purpose is a problem-oriented comprehensive solution system, which is divided into three parts: problem classification system, intervention system and effect evaluation system[5]. It is one of the 12 standardized nursing management systems recognized by the American Nurses Association (ANA) [18], with content validity of 0.863 and Cronbach's alpha coefficient of 0.729 [11]，and has been well applied in the Netherlands, Japan, China and other regions. Many researchers applied Omaha management system in patients with chronic heart failure, diabetes, gastric cancer, patients with elevated myocardial infarction, rheumatoid arthritis, breast cancer, hypertensive cerebral hemorrhage patients, and so on. Patients with dysphagia after radiotherapy of NPC have achieved positive effects. It is confirmed that the nursing management method guided by Omaha management system can better improve patients' disease and quality of life, improve their self-care ability, improve nurse-patient relationship, reduce medical disputes and improve nursing job satisfaction [1, 2, 17]. However, the efficacy and evaluation of Omaha management system in nursing patients with NPC radiotherapy are still lack of large sample retrospective study. The purpose of this study was to explore the application and effect evaluation of Omaha System in nursing patients with NPC after radiotherapy. Materials and methods Participants A total of 356 patients with NPC treatment in our department from January 2016 to December 2019 were recruited. This study was conducted in accordance with the ethical guidelines of the Declaration of Helsinki and was approved by the Ethics Committee of Jiangxi Provincial People's Hospital (Approval No. 2016-018). Written informed consent was obtained from all participants prior to the study. Clinical trial number is not applicable. All data were kept confidentially by the hospital to ensure their privacy. Inclusion criteria: NPC diagnosed by imaging or pathology with obvious clinical symptoms; Age 18~70 years old; Vital signs are stable and can be completed by themselves. Exclusion criteria: congenital heart disease, acute myocardial infarction or blood disease, liver and kidney dysfunction; Mentally abnormal, or suffering from serious mental illness; Pregnant or lactating female patients. They were equally divided into control group and experimental group according to the number table method. There were 86 males and 92 females in the control group. The age ranged from 18 to 70 years, with an average of (48.63±14.78) years. There were 81 males and 97 females in the experimental group; The age ranged from 19 to 69 years, with an average of (45.76 ± 13.58) years. There was no significant difference in age, sex and other conditions between the two groups (P > 0.05). The details see Table 1 . Intervention The control group was given routine nursing such as basic nursing, medication guidance, environmental nursing and health education. On this basis, the experimental group adopted OSNM. The specific measures are as follows: (i) according to Likert scoring method [16], the range is 1 ~ 5 points. The lower the score, the more serious the existing nursing problems. The main problems were mouth opening training and oral care, nasal care, neck functional exercise, negative emotion and social support. Personalized nursing intervention measures were formulated according to nursing problems. (ii) Mouth opening training and oral care. Guide patients to brush their teeth with fluoride toothpaste in the morning and evening, gargle with honeysuckle mouthwash, and assist patients in early functional exercises such as mumps, temporomandibular joint massage and tapping; Do mouth opening exercise by biting the cork of the kettle, 3 ~ 5 times a day, 15 ~ 20 minutes each time. Timely adjust the exercise plan according to the patient's own condition. (iii) Nasal care. From the beginning of radiotherapy to the third day of radiotherapy, assist the patient in nasal flushing. Before radiotherapy, rinse 1 ~ 2 times a day. The nurse instructs the patient to rinse by himself. After discharge, rinse continuously for 6 months. (iv) Neck functional exercise. Assist the patient to rotate the neck left and right 10 ~ 15 times a day to improve the tension of the patient's neck muscle tissue and avoid neck stiffness or muscle fibrosis. (v) Health education and psychological nursing. According to the patient's education level, disease characteristics and disease awareness, explain the disease related knowledge for the patient, so that they can fully understand the process and purpose of treatment and nursing. Timely grasp and adjust patients' emotional changes to improve patients' treatment compliance. (vi) Social support. After treatment, the survival time of patients with NPC continues to prolong. Family members, relatives and friends need to maintain close communication and communication with patients, strive to create a happy and comfortable living environment, and enable patients to maintain an optimistic and positive attitude, so as to improve their quality of daily life. Evaluation tool (i) The anxiety and depression scores of the two groups before and after nursing intervention were stastistisized into comparision. SAS scale[20] was used for anxiety score. The scale contains 20 items, calculated according to grade 4, 3, 2, 1 and 4. The total score is 80 points, and the normal score is less than 50 points; Mild anxiety: 50 ~ 60 points; Moderate anxiety: 61 ~ 70 points, severe anxiety: more than 70 points. SDS scale [20] was used for depression score, including 20 items, which was divided into 4 grades, with a total score of 20 ~ 80. With the increase of scores, the depressive symptoms were more obvious. (ii) The patients were followed up after 1 month, and the quality of life of the two groups before and after nursing was evaluated according to the quality-of-life rating scale (SF-36) [13]. There are 8 dimensions and 36 items. The dimensions includesemotional function, physiological function, physical pain, physiological function, social function, general health status, vitality and mental health. The higher the score, the better the functional recovery. Statistical analysis The data were statistically analyzed by SPSS 20.0. The Chi-square test was used for paired group comparison of categorical variables. As to the comparison of two independent groups, and the differences of various influencing factors were compared by Chi-square test. P value less than 0.05 was regarded as statistically significant. Results Comparison of quality-of-life scores between the two groups before and after nursing After nursing, the scores of physical functions, role function, social function, cognitive function, emotional function and overall quality of life in the experimental group were higher than those in the control group, and the difference was statistically significant (P < 0.05). The details see Table 2 . Comparison of mental state scores between the two groups before and after nursing After nursing, the scores of somatizations, interpersonal sensitivity, depression, anxiety, terror, hostility, compulsion, paranoia and psychotic symptoms in the experimental group were lower than those in the control group, and the difference was statistically significant (P < 0.05). The details see Table 3 . Comparison of complications between the two groups before and after nursing The incidence of nasal mucosal reaction, oral infection and complications in the experimental group were lower than those in the control group (P < 0.05). The details see Table 4 . Discussion Chemoradiotherapy are essential methods for the treatment of NPC, which is of great significance to improve the condition of patients. However, these methods can not only inhibit the growth of malignant tumor cells, but also destroy normal cells of the body, which are inevitable to lead a variety of complications. Moreover, due to the low awareness of the disease, most patients with NPC will have adverse mental health such as depression and anxiety during the implementation of chemoradiotherapy; it will not only affect the quality of life, but also lead to poor medical compliance of patients, which will seriously lower the treatment effect and prognosis. Therefore, effective nursing intervention should be offered to patients [21]. However, traditional nursing program lacks of systematics, pertinence and integrity. After health education, it is difficult to timely and effectively evaluates the implementation status of patients, and it is reluctant to achieve the final nursing purpose [4, 19]. OSNM is mainly divided into three parts: problem classification, intervention system and outcome evaluation. Giving patients personalized and professional nursing services could effectively recover patients' negative emotions, promote the improvement of treatment effect and restore their health [24]. In this study, OSNM was implemented in the experimental group. The results showed that the incidence of complications in the experimental group was lower than that in the control group (P < 0.05). It indicates that the implementation of OSNM can significantly reduce the incidence of complications. The main reason is that after chemoradiotherapy, patients with NPC not only kill tumor cells, but also cause damage to normal tissues and organs, resulting in a significant increase in the incidence of complications. In this nursing intervention, guiding patients to wash nasopharynx correctly can effectively alleviate the symptoms of adhesion and scab of nasal endocrine substances, so as to completely remove nasal secretions, reduce the incidence of mucosal inflammation and edema; Oral mucositis is a high incidence complication in patients with NPC. Nurses guide patients to carry out correct oral care and gargle with gargle containing important components, so as to effectively avoid oral infection; Nurses can significantly improve the blood circulation in the mouth and nose, improve the tension of tongue and masticatory muscles, and significantly reduce the incidence of radiation mouth opening difficulties by allowing patients to open their mouth and knock their teeth [14]. In this study, the scores of somatizations, interpersonal sensitivity, depression, anxiety, terror, hostility, compulsion, paranoia and psychotic symptoms in the experimental group were lower than those in the control group (P < 0.05). It demonstratesthat OSNM for patients with NPC undergoing concurrent chemoradiotherapy can effectively upgrade their mental status. The main reason is that through effective psychological nursing, patients can master the correct way to vent their bad emotions, so as to alleviate their negative emotions such as anxiety and depression; Provide sufficient care and help to patients through family members and social support, so that patients can enhance their confidence in treating diseases, and finally significantly improve their mental status [22]. The scores of physical function, role function, social function, cognitive function, emotional function and overall quality of life in the experimental group were higher than those in the control group( P＜0.05). It shows that the implementation of OSNM can effectively improve the quality of life of patients. The factors affecting the quality of life of patients are not only physiological conditions, but also psychological, social and spiritual factors. OSNM intervention can effectively evaluate the psychological and physiological conditions of patients, give patients personalized nursing intervention measures, and finally significantly raise the quality of life [15, 25]. To sum up, this study uses the three systems of Omaha management system to evaluate each NPC patient undergoing radiotherapy or chemoradiotherapy, formulate nursing plans and observe nursing effects, and finally form a NPC nursing plan based on the theoretical framework of Omaha management system, so as to reduce patients' pain and improve their negative psychological state, improve their quality of life and satisfaction, reduce the cost of disease treatment and rehabilitation, refresh the relationship between nurses and patients, and avoid the waste of health resources; It can also improve the medical staff's sense of social responsibility and the noble pursuit of life first, and improve the nursing staff's awareness, skills and nursing level of treatment and nursing management for patients with NPC. OSNM can improve the quality of life, improve mental state and reduce the incidence of complications in patients with NPC undergoing concurrent chemoradiotherapy. This nursing model has obvious advantages and is worth popularizing in clinical nursing work. Declarations Author contributions Q. S. conceived the project, and provided funding. Q.S. and S.Y. wrote the manuscript. All authors edited and commented on the manuscript. Declaration of conflicting interests The authors declare that there is no conflict of interest. Funding This work was supported by a grant from the Science and technology project of Jiangxi Province Health Commission (Grant No. 202130003). Acknowledgments The authors would like to express their gratitude to all participants who were committed to this study during this critical period. Data availability statement None. ORCID ID Qinglin Shen http://orcid.org/0000-0002-1658-2768 References Bayuo J, Wong FKY, Agyei FB (2020) "On the Recovery Journey:" An Integrative Review of the Needs of Burn Patients From Immediate Pre-Discharge to Post-Discharge Period Using the Omaha System J Nurs Scholarsh 52: 360-368 Chan RJ, Teleni L, McDonald S, Kelly J, Mahony J, Ernst K, Patford K, Townsend J, Singh M, Yates P (2020) Breast cancer nursing interventions and clinical effectiveness: a systematic review BMJ Support Palliat Care 10: 276-286 Fles R, Bos A, Supriyati, Rachmawati D, Waliyanti E, Tan IB, Haryana SM, Schmidt MK, Dewi FST (2017) The role of Indonesian patients' health behaviors in delaying the diagnosis of nasopharyngeal carcinoma BMC Public Health 17: 510 Ilgaz A, Gözüm S (2021) Integrative Nursing and Omaha System-Based Nursing Care Interventions in Older Women Feeling Loneliness (INOSEL): Study Protocol for a Randomized Controlled Trial Journal of holistic nursing : official journal of the American 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Li YH, Tang LL, Mao YP, Zhou GQ, Sun R, Liu X, Guo R, Long GX, Liang SQ, Li L, Huang J, Long JH, Zang J, Liu QD, Zou L, Su QF, Zheng BM, Xiao Y, Guo Y, Han F, Mo HY, Lv JW, Du XJ, Xu C, Liu N, Li YQ, Chua MLK, Xie FY, Sun Y, Ma J (2019) Gemcitabine and Cisplatin Induction Chemotherapy in Nasopharyngeal Carcinoma N Engl J Med 381: 1124-1135 Zhang Y, Monsen KA, Adam TJ, Pieczkiewicz DS, Daman M, Melton GB (2011) Systematic refinement of a health information technology time and motion workflow instrument for inpatient nursing care using a standardized interface terminology AMIA Annual Symposium proceedings AMIA Symposium 2011: 1621-1629 Zhuang C, Wu H, Lin B, An X (2021) The effect of Omaha System-based continuous nursing care on the psychological status, self-esteem, and quality of life in epileptic children American journal of translational research 13: 3435-3442 Tables Tables 1 to 4 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Table1.docx Table2.docx Table3.docx Table4.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6354392","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":464885461,"identity":"68a79780-dd34-46f1-b631-6034f69b97db","order_by":0,"name":"Shuixiu Yang","email":"","orcid":"","institution":"Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College","correspondingAuthor":false,"prefix":"","firstName":"Shuixiu","middleName":"","lastName":"Yang","suffix":""},{"id":464885462,"identity":"c138fe91-7366-4760-9ab6-d00cd7b04395","order_by":1,"name":"Shumin Yu","email":"","orcid":"","institution":"Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College","correspondingAuthor":false,"prefix":"","firstName":"Shumin","middleName":"","lastName":"Yu","suffix":""},{"id":464885463,"identity":"6333a945-f052-4cb5-96e3-faa87836b334","order_by":2,"name":"Qinglin Shen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7UlEQVRIiWNgGAWjYDACZiB+YMDAAESMDxgbQEIJRGhJgGhhNiBOC0wNUAubBFFa+I7zHn6RUHDH3py991g1747DDPzsOQYMP3fg1iJ5mC/NIsHgWeLOnnNpt3nPHGaQ7HljwNh7BrcWg8M8ZgYJBocTDG7kmN3ObTvMAGQYMDO2EdZib3D/jVkxSIs9EVqMHwC1MG64wWPGDLZFgoAWSaAtwEA+nLjhTI6x9N+2dB6JM88KDvbi0cJ3/ozxhw9/gA47fsbw48w2azn+9uSND37i0cJwABgdyHweiCA+cICB+QNeBaNgFIyCUTAKAHQPVDTbMc3BAAAAAElFTkSuQmCC","orcid":"","institution":"Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College","correspondingAuthor":true,"prefix":"","firstName":"Qinglin","middleName":"","lastName":"Shen","suffix":""}],"badges":[],"createdAt":"2025-04-01 15:08:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6354392/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6354392/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":88724254,"identity":"37bedcdb-395e-4e08-a784-c647c12498c2","added_by":"auto","created_at":"2025-08-10 14:31:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":383129,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6354392/v1/12ae28b6-defa-4332-853c-07bdbe790801.pdf"},{"id":83765715,"identity":"2f367fab-2601-4f96-8bb8-aefcbd6f0ba0","added_by":"auto","created_at":"2025-06-02 11:05:43","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":24318,"visible":true,"origin":"","legend":"","description":"","filename":"Table1.docx","url":"https://assets-eu.researchsquare.com/files/rs-6354392/v1/79fe193fb021ce85ad0ed54b.docx"},{"id":83765712,"identity":"93e962ee-0ba3-4c2f-ba17-6da81dab91dc","added_by":"auto","created_at":"2025-06-02 11:05:43","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":26959,"visible":true,"origin":"","legend":"","description":"","filename":"Table2.docx","url":"https://assets-eu.researchsquare.com/files/rs-6354392/v1/e023a5f600ba72db4b555217.docx"},{"id":83765713,"identity":"3fdd2081-7731-451f-ae5b-552b214b0929","added_by":"auto","created_at":"2025-06-02 11:05:43","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":25946,"visible":true,"origin":"","legend":"","description":"","filename":"Table3.docx","url":"https://assets-eu.researchsquare.com/files/rs-6354392/v1/e08b328873d47dc12c1cbf24.docx"},{"id":83765714,"identity":"f989481b-00f1-4e28-883f-41384b147cd2","added_by":"auto","created_at":"2025-06-02 11:05:43","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":23138,"visible":true,"origin":"","legend":"","description":"","filename":"Table4.docx","url":"https://assets-eu.researchsquare.com/files/rs-6354392/v1/0c2fa2588edfa34d66f3c205.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Improving Quality of Life, Mental Health, and Reducing Complications in Nasopharyngeal Carcinoma Patients Undergoing Chemoradiotherapy: A Randomized Controlled Trial of the Omaha System Nursing Model","fulltext":[{"header":"Introduction","content":"\u003cp\u003eNasopharyngeal carcinoma (NPC) is one of the common malignant tumors in China, and it is prevalent in Guangdong, Jiangxi and other regions, and its incidence has obvious racial and family tendencies [23]. NPC in China accounts for 38.29% and 40.14% of the incidence and death of NPC in the world, which is higher than the world average level [10]. About 60% ~ 87% of patients have cervical lymph nodes, even bone, lung and liver metastasis at the first diagnosis [7]. This not only increases the difficulty of clinical treatment and nursing, but also raise the expenditure of resource and time cost and the family burden of patients [6, 8].\u003c/p\u003e\n\u003cp\u003eNPC originates from the mucous epithelium of the nasopharynx and often occurs in the pharyngeal recess and the top wall of the nasopharynx. With the improvement of medical level, it has entered the era of intensity modulated radiotherapy. In addition, the treatment cycle of NPC is long, and there are many acute injury reactions in the process of radiotherapy, such as skin pruritus, pigmentation, peeling, eczema, blisters and ulceration, redness, erythema, congestion, dry mouth, pain and ulcer of oral mucosa, tinnitus, difficulty opening mouth, limited shoulder and neck movement and other symptoms. Affected by the negative emotion of the disease, patients are prone to poor treatment compliance, which decline the treatment effect and quality of life of patients [9]. In addition, cancer patients have unique medical and psychosocial needs [3, 12]. However, in the past, routine nursing of chemoradiotherapy of NPC mainly started from the implementation of medical orders, diet education, medication education, condition observation, discharge guidance and improvement of service attitude. There was no systematic, complete and continuous evaluation of its existing problems from the perspective of patients, so routine nursing could rarely meet the comprehensive needs of patients.\u0026nbsp;With the continuous improvement of people's demand for health, clinical nursing work is no longer simply nursing diseases in the past, but starting from the patient's body and mind, providing high-quality nursing services for patients, taking patients as the center, establishing a good relationship between doctors and patients, nurses constantly improve their nursing skills and create a good medical environment for patients, Make patients get better care, reduce patients' pain, improve patients' negative psychology, improve patients' quality of life, prolong patients' survival time, and improve nursing satisfaction.\u003c/p\u003e\n\u003cp\u003eOmaha System was founded in the 1970s in the United States. Its purpose is a problem-oriented comprehensive solution system, which is divided into three parts: problem classification system, intervention system and effect evaluation system[5]. It is one of the 12 standardized nursing management systems recognized by the American Nurses Association (ANA) [18], with content validity of 0.863 and Cronbach's alpha coefficient of 0.729 [11]，and has been well applied in the Netherlands, Japan, China and other regions. Many researchers applied Omaha management system in patients with chronic heart failure, diabetes, gastric cancer, patients with elevated myocardial infarction, rheumatoid arthritis, breast cancer, hypertensive cerebral hemorrhage patients, and so on. Patients with dysphagia after radiotherapy of NPC have achieved positive effects. It is confirmed that the nursing management method guided by Omaha management system can better improve patients' disease and quality of life, improve their self-care ability, improve nurse-patient relationship, reduce medical disputes and improve nursing job satisfaction [1, 2, 17]. However, the efficacy and evaluation of Omaha management system in nursing patients with NPC radiotherapy are still lack of large sample retrospective study. The purpose of this study was to explore the application and effect evaluation of Omaha System in nursing patients with NPC after radiotherapy.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003e\u003cem\u003eParticipants\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA total of 356 patients with NPC treatment in our department from January 2016 to December 2019 were recruited. This study was conducted in accordance with the ethical guidelines of the Declaration of Helsinki and was approved by the Ethics Committee of Jiangxi Provincial People's Hospital (Approval No. 2016-018). Written informed consent was obtained from all participants prior to the study. Clinical trial number is not applicable. All data were kept confidentially by the hospital to ensure their privacy. Inclusion criteria: NPC diagnosed by imaging or pathology with obvious clinical symptoms; Age 18~70 years old; Vital signs are stable and can be completed by themselves. Exclusion criteria: congenital heart disease, acute myocardial infarction or blood disease, liver and kidney dysfunction; Mentally abnormal, or suffering from serious mental illness; Pregnant or lactating female patients. They were equally divided into control group and experimental group according to the number table method. There were 86 males and 92 females in the control group. The age ranged from 18 to 70 years, with an average of (48.63±14.78) years. There were 81 males and 97 females in the experimental group; The age ranged from 19 to 69 years, with an average of (45.76 ± 13.58) years. There was no significant difference in age, sex and other conditions between the two groups (P \u0026gt; 0.05). The details see \u003cstrong\u003eTable 1\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIntervention\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe control group was given routine nursing such as basic nursing, medication guidance, environmental nursing and health education. On this basis, the experimental group adopted OSNM. The specific measures are as follows:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(i) according to Likert scoring method [16], the range is 1 ~ 5 points. The lower the score, the more serious the existing nursing problems. The main problems were mouth opening training and oral care, nasal care, neck functional exercise, negative emotion and social support. Personalized nursing intervention measures were formulated according to nursing problems.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;(ii) Mouth opening training and oral care. Guide patients to brush their teeth with fluoride toothpaste in the morning and evening, gargle with honeysuckle mouthwash, and assist patients in early functional exercises such as mumps, temporomandibular joint massage and tapping; Do mouth opening exercise by biting the cork of the kettle, 3 ~ 5 times a day, 15 ~ 20 minutes each time. Timely adjust the exercise plan according to the patient's own condition.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;(iii) Nasal care. From the beginning of radiotherapy to the third day of radiotherapy, assist the patient in nasal flushing. Before radiotherapy, rinse 1 ~ 2 times a day. The nurse instructs the patient to rinse by himself. After discharge, rinse continuously for 6 months.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;(iv) Neck functional exercise. Assist the patient to rotate the neck left and right 10 ~ 15 times a day to improve the tension of the patient's neck muscle tissue and avoid neck stiffness or muscle fibrosis.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;(v) Health education and psychological nursing. According to the patient's education level, disease characteristics and disease awareness, explain the disease related knowledge for the patient, so that they can fully understand the process and purpose of treatment and nursing. Timely grasp and adjust patients' emotional changes to improve patients' treatment compliance.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;(vi) Social support. After treatment, the survival time of patients with NPC continues to prolong. Family members, relatives and friends need to maintain close communication and communication with patients, strive to create a happy and comfortable living environment, and enable patients to maintain an optimistic and positive attitude, so as to improve their quality of daily life.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eEvaluation tool\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;(i) The anxiety and depression scores of the two groups before and after nursing intervention were stastistisized into comparision. SAS scale[20] was used for anxiety score. The scale contains 20 items, calculated according to grade 4, 3, 2, 1 and 4. The total score is 80 points, and the normal score is less than 50 points; Mild anxiety: 50 ~ 60 points; Moderate anxiety: 61 ~ 70 points, severe anxiety: more than 70 points. SDS scale [20] was used for depression score, including 20 items, which was divided into 4 grades, with a total score of 20 ~ 80. With the increase of scores, the depressive symptoms were more obvious.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(ii) The patients were followed up after 1 month, and the quality of life of the two groups before and after nursing was evaluated according to the quality-of-life rating scale (SF-36) [13]. There are 8 dimensions and 36 items. The dimensions includesemotional function, physiological function, physical pain, physiological function, social function, general health status, vitality and mental health. The higher the score, the better the functional recovery.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStatistical analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe data were statistically analyzed by SPSS 20.0. The Chi-square test was used for paired group comparison of categorical variables. As to the comparison of two independent groups, and the differences of various influencing factors were compared by Chi-square test. P value less than 0.05 was regarded as statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003eComparison of quality-of-life scores between the two groups before and after nursing\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAfter nursing, the scores of physical functions, role function, social function, cognitive function, emotional function and overall quality of life in the experimental group were higher than those in the control group, and the difference was statistically significant (P \u0026lt; 0.05). The details see \u003cstrong\u003eTable 2\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026nbsp;Comparison of mental state scores between the two groups before and after nursing\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAfter nursing, the scores of somatizations, interpersonal sensitivity, depression, anxiety, terror, hostility, compulsion, paranoia and psychotic symptoms in the experimental group were lower than those in the control group, and the difference was statistically significant (P \u0026lt; 0.05). The details see \u003cstrong\u003eTable 3\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eComparison of complications between the two groups before and after nursing\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe incidence of nasal mucosal reaction, oral infection and complications in the experimental group were lower than those in the control group (P \u0026lt; 0.05). The details see \u003cstrong\u003eTable 4\u003c/strong\u003e.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eChemoradiotherapy are essential methods for the treatment of NPC, which is of great significance to improve the condition of patients. However, these methods can not only inhibit the growth of malignant tumor cells, but also destroy normal cells of the body, which \u0026nbsp;are inevitable to lead a variety of complications. Moreover, due to the low awareness of the disease, most patients with NPC will have adverse mental health such as depression and anxiety during the implementation of chemoradiotherapy; it will not only affect the quality of life, but also lead to poor medical compliance of patients, which will seriously lower the treatment effect and prognosis. Therefore, effective nursing intervention should be offered to patients [21]. However, traditional nursing program lacks of systematics, pertinence and integrity. After health education, it is difficult to timely and effectively evaluates the implementation status of patients, and it is reluctant to achieve the final nursing purpose [4, 19]. OSNM is mainly divided into three parts: problem classification, intervention system and outcome evaluation. Giving patients personalized and professional nursing services could effectively \u0026nbsp;recover patients' negative emotions, promote the improvement of treatment effect and restore their health [24].\u003c/p\u003e\n\u003cp\u003eIn this study, OSNM was implemented in the experimental group. The results showed that the incidence of complications in the experimental group was lower than that in the control group (P \u0026lt; 0.05). It indicates that the implementation of OSNM can significantly reduce the incidence of complications. The main reason is that after chemoradiotherapy, patients with NPC not only kill tumor cells, but also cause damage to normal tissues and organs, resulting in a significant increase in the incidence of complications. In this nursing intervention, guiding patients to wash nasopharynx correctly can effectively alleviate the symptoms of adhesion and scab of nasal endocrine substances, so as to completely remove nasal secretions, reduce the incidence of mucosal inflammation and edema; Oral mucositis is a high incidence complication in patients with NPC. Nurses guide patients to carry out correct oral care and gargle with gargle containing important components, so as to effectively avoid oral infection; Nurses can significantly improve the blood circulation in the mouth and nose, improve the tension of tongue and masticatory muscles, and significantly reduce the incidence of radiation mouth opening difficulties by allowing patients to open their mouth and knock their teeth [14].\u003c/p\u003e\n\u003cp\u003eIn this study, the scores of somatizations, interpersonal sensitivity, depression, anxiety, terror, hostility, compulsion, paranoia and psychotic symptoms in the experimental group were lower than those in the control group (P \u0026lt; 0.05). It demonstratesthat OSNM for patients with NPC undergoing concurrent chemoradiotherapy can effectively upgrade their mental status. The main reason is that through effective psychological nursing, patients can master the correct way to vent their bad emotions, so as to alleviate their negative emotions such as anxiety and depression; Provide sufficient care and help to patients through family members and social support, so that patients can enhance their confidence in treating diseases, and finally significantly improve their mental status [22]. The scores of physical function, role function, social function, cognitive function, emotional function and overall quality of life in the experimental group were higher than those in the control group( P＜0.05). It shows that the implementation of OSNM can effectively improve the quality of life of patients. The factors affecting the quality of life of patients are not only physiological conditions, but also psychological, social and spiritual factors. OSNM intervention can effectively evaluate the psychological and physiological conditions of patients, give patients personalized nursing intervention measures, and finally significantly raise the quality of life\u0026nbsp;[15, 25].\u003c/p\u003e\n\u003cp\u003eTo sum up, this study uses the three systems of Omaha management system to evaluate each NPC patient undergoing radiotherapy or chemoradiotherapy, formulate nursing plans and observe nursing effects, and finally form a NPC nursing plan based on the theoretical framework of Omaha management system, so as to reduce patients' pain and improve their negative psychological state, improve their quality of life and satisfaction, reduce the cost of disease treatment and rehabilitation, refresh the relationship between nurses and patients, and avoid the waste of health resources; It can also improve the medical staff's sense of social responsibility and the noble pursuit of life first, and improve the nursing staff's awareness, skills and nursing level of treatment and nursing management for patients with NPC. OSNM can improve the quality of life, improve mental state and reduce the incidence of complications in patients with NPC undergoing concurrent chemoradiotherapy. This nursing model has obvious advantages and is worth popularizing in clinical nursing work.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQ. S. conceived the project, and provided funding. Q.S. and S.Y. wrote the manuscript. All authors edited and commented on the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of conflicting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there is no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by a grant from the Science and technology project of Jiangxi Province Health Commission (Grant No. 202130003).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to express their gratitude to all participants who were committed to this study during this critical period.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eORCID ID\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQinglin Shen http://orcid.org/0000-0002-1658-2768\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBayuo J, Wong FKY, Agyei FB (2020) \u0026quot;On the Recovery Journey:\u0026quot; An Integrative Review of the Needs of Burn Patients From Immediate Pre-Discharge to Post-Discharge Period Using the Omaha System J Nurs Scholarsh 52: 360-368\u003c/li\u003e\n\u003cli\u003eChan RJ, Teleni L, McDonald S, Kelly J, Mahony J, Ernst K, Patford K, Townsend J, Singh M, Yates P (2020) Breast cancer nursing interventions and clinical effectiveness: a systematic review BMJ Support Palliat Care 10: 276-286\u003c/li\u003e\n\u003cli\u003eFles R, Bos A, Supriyati, Rachmawati D, Waliyanti E, Tan IB, Haryana SM, Schmidt MK, Dewi FST (2017) The role of Indonesian patients\u0026apos; health behaviors in delaying the diagnosis of nasopharyngeal carcinoma BMC Public Health 17: 510\u003c/li\u003e\n\u003cli\u003eIlgaz A, G\u0026ouml;z\u0026uuml;m S (2021) Integrative Nursing and Omaha System-Based Nursing Care Interventions in Older Women Feeling Loneliness (INOSEL): Study Protocol for a Randomized Controlled Trial Journal of holistic nursing : official journal of the American Holistic Nurses\u0026apos; Association 39: 225-238\u003c/li\u003e\n\u003cli\u003eKerr MJ, Gargantua-Aguila SDR, Glavin K, Honey MLL, Nahcivan NO, Secginli S, Martin KS, Monsen KA (2019) Feasibility of describing community strengths relative to Omaha system concepts Public Health Nurs 36: 245-253\u003c/li\u003e\n\u003cli\u003eLee AW, Ma BB, Ng WT, Chan AT (2015) Management of Nasopharyngeal Carcinoma: Current Practice and Future Perspective J Clin Oncol 33: 3356-3364\u003c/li\u003e\n\u003cli\u003eLee AWM, Ng WT, Chan JYW, Corry J, Makitie A, Mendenhall WM, Rinaldo A, Rodrigo JP, Saba NF, Strojan P, Suarez C, Vermorken JB, Yom SS, Ferlito A (2019) Management of locally recurrent nasopharyngeal carcinoma Cancer Treat Rev 79: 101890\u003c/li\u003e\n\u003cli\u003eLee HM, Okuda KS, Gonzalez FE, Patel V (2019) Current Perspectives on Nasopharyngeal Carcinoma Adv Exp Med Biol 1164: 11-34\u003c/li\u003e\n\u003cli\u003eLi C, Duan J (2021) Effect of high-quality nursing intervention on psychological emotion, life quality and nursing satisfaction of patients with nasopharyngeal carcinoma undergoing radiotherapy American journal of translational research 13: 4928-4938\u003c/li\u003e\n\u003cli\u003eLovlie A, Vestrheim DF, Aaberge IS, Steens A (2020) Changes in pneumococcal carriage prevalence and factors associated with carriage in Norwegian children, four years after introduction of PCV13 BMC Infect Dis 20: 29\u003c/li\u003e\n\u003cli\u003eMerola A, Torres-Russotto DR, Stebbins GT, Vizcarra JA, Shukla AW, Hassan A, Marsili L, Krauss JK, Elble RJ, Deuschl G, Espay AJ (2020) Development and Validation of the Orthostatic Tremor Severity and Disability Scale (OT-10) Mov Disord 35: 1796-1801\u003c/li\u003e\n\u003cli\u003eMiller KD, Nogueira L, Mariotto AB, Rowland JH, Yabroff KR, Alfano CM, Jemal A, Kramer JL, Siegel RL (2019) Cancer treatment and survivorship statistics, 2019 CA Cancer J Clin 69: 363-385\u003c/li\u003e\n\u003cli\u003eNilsson E, Festin K, Lowen M, Kristenson M (2020) SF-36 predicts 13-year CHD incidence in a middle-aged Swedish general population Qual Life Res 29: 971-975\u003c/li\u003e\n\u003cli\u003eNing L, Yuan C, Li Y, Wang L, Chen Y, Tang A, Feng H (2021) Effect of continuous nursing based on the Omaha System on cancer-related fatigue in patients with lung cancer undergoing chemotherapy: a randomized controlled trial Ann Palliat Med 10: 323-332\u003c/li\u003e\n\u003cli\u003ePeng L, Gao Y, Lu R, Zhou R (2020) Efficacy of Omaha system-based nursing management on nutritional status in patients undergoing peritoneal dialysis: A randomized controlled trial protocol Medicine (Baltimore) 99: e23572\u003c/li\u003e\n\u003cli\u003eShin T, Smyth TB, Ukimura O, Ahmadi N, de Castro Abreu AL, Ohe C, Oishi M, Mimata H, Gill IS (2018) Diagnostic accuracy of a five-point Likert scoring system for magnetic resonance imaging (MRI) evaluated according to results of MRI/ultrasonography image-fusion targeted biopsy of the prostate BJU international 121: 77-83\u003c/li\u003e\n\u003cli\u003eSlipka AF, Monsen KA (2018) Toward Improving Quality of End-of-Life Care: Encoding Clinical Guidelines and Standing Orders Using the Omaha System Worldviews on evidence-based nursing 15: 26-37\u003c/li\u003e\n\u003cli\u003eTopaz M, Golfenshtein N, Bowles KH (2014) The Omaha System: a systematic review of the recent literature J Am Med Inform Assoc 21: 163-170\u003c/li\u003e\n\u003cli\u003eWarren JN, Luctkar-Flude M, Godfrey C, Lukewich J (2016) A systematic review of the effectiveness of simulation-based education on satisfaction and learning outcomes in nurse practitioner programs Nurse Educ Today 46: 99-108\u003c/li\u003e\n\u003cli\u003eYang J, Tang S, Zhou W (2018) Effect of Mindfulness-Based Stress Reduction Therapy on Work Stress and Mental Health of Psychiatric Nurses Psychiatr Danub 30: 189-196\u003c/li\u003e\n\u003cli\u003eYang XL, Li HH, Hong MH, Kao HS (2010) The effects of Chinese calligraphy handwriting and relaxation training in Chinese Nasopharyngeal Carcinoma patients: a randomized controlled trial Int J Nurs Stud 47: 550-559\u003c/li\u003e\n\u003cli\u003eZhang P, Hu YD, Xing FM, Li CZ, Lan WF, Zhang XL (2017) Effects of a nurse-led transitional care program on clinical outcomes, health-related knowledge, physical and mental health status among Chinese patients with coronary artery disease: A randomized controlled trial Int J Nurs Stud 74: 34-43\u003c/li\u003e\n\u003cli\u003eZhang Y, Chen L, Hu GQ, Zhang N, Zhu XD, Yang KY, Jin F, Shi M, Chen YP, Hu WH, Cheng ZB, Wang SY, Tian Y, Wang XC, Sun Y, Li JG, Li WF, Li YH, Tang LL, Mao YP, Zhou GQ, Sun R, Liu X, Guo R, Long GX, Liang SQ, Li L, Huang J, Long JH, Zang J, Liu QD, Zou L, Su QF, Zheng BM, Xiao Y, Guo Y, Han F, Mo HY, Lv JW, Du XJ, Xu C, Liu N, Li YQ, Chua MLK, Xie FY, Sun Y, Ma J (2019) Gemcitabine and Cisplatin Induction Chemotherapy in Nasopharyngeal Carcinoma N Engl J Med 381: 1124-1135\u003c/li\u003e\n\u003cli\u003eZhang Y, Monsen KA, Adam TJ, Pieczkiewicz DS, Daman M, Melton GB (2011) Systematic refinement of a health information technology time and motion workflow instrument for inpatient nursing care using a standardized interface terminology AMIA Annual Symposium proceedings AMIA Symposium 2011: 1621-1629\u003c/li\u003e\n\u003cli\u003eZhuang C, Wu H, Lin B, An X (2021) The effect of Omaha System-based continuous nursing care on the psychological status, self-esteem, and quality of life in epileptic children American journal of translational research 13: 3435-3442\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 4 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Omaha System nursing model, Nasopharyngeal carcinoma, Chemoradiotherapy, Quality of life, Mental status, Complication","lastPublishedDoi":"10.21203/rs.3.rs-6354392/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6354392/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eTo explore the effect of Omaha System nursing model (OSNM) on the quality of life, mental status and complications of patients with nasopharyngeal carcinoma (NPC) undergoing chemoradiotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A total of 356 patients with NPC were randomly divided into experimental group and control group by random number grouping method, and there are 178 cases in each group. The control group received routine nursing and the experimental group received OSNM; The scores of qualities of life, mental status and the incidence of complications were compared and analyzed between the two groups before and after nursing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The scores of physical function, role function, social function, cognitive function, emotional function and overall quality of life in the experimental group were significantly higher than those in the control group (P\u0026lt;0.05); Whereas, the scores of somatization, interpersonal sensitivity, depression, anxiety, terror, hostility, compulsion, paranoia and psychotic symptoms in the experimental group were obviously lower than those in the control group (P \u0026lt; 0.05); In addtion, the incidence of nasal mucosal reaction, oral infection and complications in the experimental group were also significantly lower than those in the control group (P \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: OSNM demonstrates obvious advantages and deserves the expansion of its popularization in routine clinical nursing work.\u003c/p\u003e","manuscriptTitle":"Improving Quality of Life, Mental Health, and Reducing Complications in Nasopharyngeal Carcinoma Patients Undergoing Chemoradiotherapy: A Randomized Controlled Trial of the Omaha System Nursing Model","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-02 11:05:38","doi":"10.21203/rs.3.rs-6354392/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6c75ac79-00e8-4774-972a-544667e47190","owner":[],"postedDate":"June 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-08-10T14:23:35+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-02 11:05:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6354392","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6354392","identity":"rs-6354392","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}