继发性气道消化道瘘住院患者营养运动认知行为的横断面研究

A cross-sectional study of knowledge and behavior of dietary and physical exercise in patients with secondary respiratory-digestive fistulas

【目的】调查继发性气道消化道瘘住院患者营养及运动的认知现状、营养状况及疾病治疗的选择意愿,为医护人员对患者进行营养运动宣教、疾病综合治疗提供依据。【方法】选择53例继发性气道消化道瘘住院患者进行横断面调查研究,内容包括患者问卷调查、医生及营养师进行营养风险筛查、膳食回顾、运动情况评估,计算并比较患者能量及蛋白质的每日实际需要量及目标需要量。【结果】继发性气道消化道瘘住院患者对营养支持和运动的重要性认识不足、营养知识欠缺并且存在营养知识误区。实际上83.02%的患者有营养风险(NRS2002≥3分),实际每日摄入能量为(1231.67±586.36)kcal,显著低于目标需求量(1861.67±265.21)kcal(P=0.037),仅达目标需要量的66.16%;实际每日蛋白质摄入量为(54.17±13.57)g,显著性低于目标需求量(89.83±13.61)g(P=0.017),仅达目标需要量的60.30%。仅有26.42%的患者可达到中等运动强度要求,39.62%的患者接受过运动教育指导。经鼻营养管及经皮造瘘对患者心理健康有负面影响。【结论】继发性气道消化道瘘患者对科学的营养及运动认知情况差、接受规范教育比例低、实际能量及蛋白摄入量偏低并且运动不足。因此,有针对性地对患者进行营养运动宣教、营养方式宣讲,将对改善患者营养、治疗原发病、控制感染、减少医疗支出起到重要作用。

【Objective】To investigate the current cognitive status of knowledge of dietary and physical exercise,nutrition and willingness for the treatment in the inpatients with secondary respiratory-digestive fistulas,and provide basis for medical staff to carry out nutrition education and comprehensive treatment of diseases.【Methods】A total of 53 inpatients with secondary respiratorydigestive fistulas were investigated by a self-made questionnaire composed of dietary and exercise knowledge,willingness for the treatment,nutrition risk screening,24 h dietary recalls and exercise evaluation.Then dietitians and physicians conducted to calculate the patients’energy and protein daily intake and target requirements,compared with the actual intake and target intake.【Results】According to the questionnaire,the patients with secondary respiratory-digestive fistulas had insufficient understanding of the importance and knowledge of nutrition and exercise.Most patients misunderstood dietary knowledge.According to the nutrition analysis,83.02%of the participants had nutritional risk(NRS 2002≥3 scores).The actual daily energy intake was(1231.67±586.36)kcal,which was significantly less than the target energy intake(1861.67±265.21)kcal(P=0.037),amounting to 66.16%of the target requirements.Actual daily protein intake was(54.17±13.57)g,which was significantly less than the target energy intake(89.83±13.61)g(P=0.017),amounting to 60.30%of the target requirements.Besides,only 26.42%of participants achieved moderate exercise and 39.62%received exercise education guidance.The measurement of nutrition tube and gastrointestinal fistulation would affect the psychology of patients negatively.【Conclusion】The survey indicated that patients with secondary respiratory-digestive fistulas had poor understanding of the rational nutrition and physical exercise,as well as insufficient education.Daily dietary intake of energy and protein did not meet the target need.The measurement of nutrition would affect the psychology and quality of life of the patients.Therefore,it is necessary to enhance the health awareness of patients,in order to improve the nutrition status of patients,better treatment of primary disease,control of infection,and reduction of medical expenses.