Effect of Nurse-Led Swallowing Rehabilitation on Swallowing Function, Quality of Life, and Adherence in Patients with Oral Cancer: A Single Center Randomized Controlled Trial

Abstract

Objective: Oral cancer patients frequently experience high rates of dysphagia, multiple complications, and poor rehabilitation compliance post-surgery. This study aims to evaluate the effectiveness of specialized nurse-led dysphagia rehabilitation program in improving patients’ swallowing function, quality of life, adherence, and nutritional status. Methods: A single center randomized controlled trial design was employed. 89 patients admitted to the Department of Oral and Maxillofacial Surgery at Zhejiang Cancer Hospital between July 17, 2025, and October 20, 2025, were randomly assigned to an intervention group (n=45) or a usual care group (n=44). The intervention group received a comprehensive rehabilitation program (diagnostic phase, perioperative phase, pre-discharge preparation phase, adjustment and adaptation phase) implemented by a multidisciplinary team led by specialized nurses, supported by a WeChat mini-program. The usual care group received a standard rehabilitation program. Outcome measures included functional oral intake scale, swallowing-related quality of life scale, swallowing function exercise compliance scale, and body mass index. Assessments were conducted at baseline (T0), 1 week post-surgery (T1), 2 weeks (T2), and 4 weeks (T3). Generalized estimating equations were used to analyze changes in outcomes over time. Results: Post-intervention, the intervention group demonstrated significantly superior scores compared to the usual care group in swallowing function (at T2 and T3), quality of life (at T1, T2, and T3), and adherence (at T1, T2, and T3). Nutritional status was also significantly better in the intervention group at T1 and T2. Generalized estimating equations analysis revealed statistically significant group-by-time interaction effects for swallowing function, quality of life, adherence, and nutritional status. Conclusion: Compared with conventional rehabilitation protocols, a swallowing rehabilitation program led by specialized nurses effectively improves swallowing function, quality of life, adherence, and early nutritional status in patients after oral cancer surgery.