基于全方位营养指导的延续性护理在食管癌术后患者居家康复中的应用效果评估

Application Effect Evaluation of Continuous Nursing Based on Comprehensive Nutrition Guidance in Home Rehabilitation of Patients with Esophageal Cancer after Surgery

目的:探究基于全方位营养指导的延续性护理在食管癌术后患者居家康复中的应用效果。方法:选取2018年6月-2019年6月本院收治80例食管癌患者,按照随机数表法将其分为干预组和对照组,每组40例。对照组给予常规护理干预,干预组在对照组基础上给予基于全方位营养指导的延续性护理干预。比较两组干预前后的营养指标(上臂中点围、三头肌皮褶厚度、平均小腿围)、知信行水平(食管癌术后患者营养知信行调查问卷)、自我护理能力、生存质量;比较两组患者居家肠内营养支持不良并发症发生情况。结果:干预前,两组上臂中点围、三头肌皮褶厚度、平均小腿围及营养知识、营养态度、营养行为、食管癌生存质量测定量表(QLQ-OES18)、自我护理能力测量量表(ESCA)评分比较,差异均无统计学意义(P>0.05);干预后,两组上臂中点围、三头肌皮褶厚度、平均小腿围及营养知识、营养态度、营养行为、QLQ-OES18、ESCA评分均高于干预前,且干预组均高于对照组,差异均有统计学意义(P<0.05)。干预组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:基于全方位营养指导的延续性护理干预可改善患者营养状况,提高其知信行能力和自护能力,提高生存质量,值得在临床推广使用。

Objective:To explore the application effect of continuous nursing based on comprehensive nutrition guidance in home rehabilitation of patients with esophageal cancer after surgery.Method:A total of 80 patients with esophageal cancer admitted to our hospital from June 2018 to June 2019 were selected,and they were divided into intervention group and control group according to random number table method,40 cases in each group.The control group was given routine nursing intervention,and the intervention group was given continuous nursing based on comprehensive nutrition guidance on the basis of the control group.Nutritional indicators(upper arm midpoint circumference,triceps skin fold thickness,average calf circumference),knowledge,confidence and behavior level(nutrition knowledge,confidence and behavior adjustment questionnaire for patients after esophageal cancer),self-care ability,quality of life before and after intervention were compared between two groups;the incidence of complications of poor home enteral nutritional support was compared between two groups.Result:Before intervention,there were no significant differences in upper arm midpoint circumference,triceps skin fold thickness,average calf circumference and nutritional knowledge,nutritional attitude,nutritional behavior,QLQ-OES18 and exercise of self-care agency scale(ESCA)scores between two groups(P>0.05);after intervention,upper arm midpoint circumference,triceps skin fold thickness,average calf circumference and nutritional knowledge,nutritional attitude,nutritional behavior,QLQ-OES18 and ESCA scores in both groups were higher than those before intervention,and those of the intervention group were higher than those of the control group,the differences were statistically significant(P<0.05).The incidence of complications of the intervention group was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Continuous nursing based on comprehensive nutrition guidance can improve the nutritional status of patients,improve their cognitive competence,trust and carry out self-care,and improve the quality of life,which is worth promoting in clinical use.