营养健康教育对造血干细胞移植术后患者健康素养及营养状况的影响效果

The effect of nutrition health education on health literacy and nutritional status among patients after hematopoietic stem cell transplantation

目的探讨营养健康教育对造血干细胞移植术后患者健康素养及营养状况的影响。方法将营养师加入到血液病患者传统的健康教育中,通过发放指导手册和食物模型、观看讲座幻灯、术后由营养师全程督导饮食6个月等多种形式作为干预措施,研究其对移植术后患者健康素养以及人体测量指标、血液指标的影响。结果移植术后6个月,实验组所有健康素养问题的正确率均显著高于其移植术前(P<0.05),且除了饮食禁忌问题之外,其余所有问题的正确率均显著高于对照组;移植术后,对照组的体重、上臂围、小腿围、髂部皮褶厚度与自身移植前比较,均显著下降,其中平均体重下降了3.7 kg,上臂围减小了1.28 cm,小腿围减小了3.36 cm,髂部皮褶厚度减小了3 mm;实验组移植术后的体重、上臂围、小腿围、髂部皮褶厚度与自身移植前比较有轻度下降,但下降幅度小于对照组,差异有统计学意义(P<0.05);所有研究对象在移植术后,均出现了血红蛋白的显著下降,血清白蛋白、血清铁在实验组未见显著下降,在对照组有显著下降;实验组经健康教育后,血清白蛋白、血清铁的下降程度均小于对照组,差异有统计学意义(P<0.05)。结论营养健康教育能有效改善造血干细胞移植患者的健康素养水平和营养状况;在传统的移植前健康教育团队中,应该加入营养专业人员,以更好地开展此类患者的健康教育工作。

Objective To explore the effect of nutrition health education on health literacy and nutritional status among patients after hematopoietic stem cell transplantation.Methods Dietitians were added to the traditional health education for patients with blood diseases.And the influence on health literacy,anthropometric indicators and blood indicators of patients after transplantation was studied after various forms of intervention measures such as distributing instruction manuals and food models,watching lecture slides,and supervising diet by dietitians for 6 months after the operation.Results Six months after the transplantation,the correct rates of all nutritional literacy problems in the experimental group were significantly higher than that before health education(P<0.05),and the correct rates of all questions except for dietary contraindications were significantly higher than that of the control group.After transplantation,the body weight,upper arm circumference,calf circumference and iliac skin fold thickness of the control group were significantly reduced.Compared to before,the average body weight dropped by 3.7 kg,the upper arm circumference was reduced by 1.28 cm,and the calf circumference was reduced.Which was 3.36 cm smaller,and the thickness of the iliac skinfold was reduced by 3 mm.The weight,upper arm circumference,calf circumference,and iliac skinfold thickness of the experimental group after transplantation were slightly decreased compared to before transplantation,but the decline was smaller than that of the control group,and the difference was significant(P<0.05).All subjects showed a significant decrease in hemoglobin after transplantation.Serum albumin and serum iron were not significantly decreased in the experimental group but significantly decreased in the control group.After health education,the decrease degree of serum albumin and serum iron in the experimental group was lower than that in the control group,and the difference was significant(P<0.05).Conclusion nutrition health education can effectively improve the health literacy level and nutritional status of patients with hematopoietic stem cell transplantation.In the traditional preoperative health education team,nutrition professionals should be added in order to better carry out the health education of such patients.