互助小组式同伴支持饮食管理对胃癌术后患者营养状况的影响

Effects of peer support groups-based dietary intervention on nutritional status among patients with gastrectomy

目的探讨互助小组式同伴支持饮食管理对胃癌术后营养状况的改善效果。方法采用便利抽样法,选取2018年3月至2019年8月山西白求恩医院胃肠外科进行手术的胃癌患者82例为研究对象。按照随机数字表法分为试验组和对照组,每组41例。对照组给予常规护理和饮食指导,试验组在此基础上实施互助小组式同伴支持饮食管理。在出院前1 d和出院后4、12周检测患者血清总蛋白、白蛋白和BMI,采用患者整体营养主观评估量表(PG-SGA)、饮食相关症状量表和饮食依从性量表评价干预效果。结果最终试验组纳入38例,对照组纳入39例。出院后4、12周,试验组饮食相关症状量表得分分别为(10.61±2.37)、(8.61±1.64)分,明显低于对照组的(12.05±1.49)、(11.46±2.44)分,差异有统计学意义(t=3.20、6.05,均<0.05);试验组饮食依从性量表得分分别为(63.87±4.60)、(64.92±6.39)分,明显高于对照组的(60.90±4.94)、(62.18±5.07)分,差异有统计学意义(t=2.73、2.09,均P<0.05)。出院后4、12周,试验组PG-SGA得分分别为(4.11±0.86)、(3.53±1.13)分,明显低于对照组的(5.15±1.46)、(4.28±1.62)分,差异有统计学意义(t=3.85、2.38,均P<0.05);出院后12周,试验组血清总蛋白、白蛋白分别为(57.79±3.95)、(36.68±3.11)g/L,明显高于对照组的(55.26±3.66)、(34.74±2.41)g/L,差异有统计学意义(t=2.92、3.06,均P<0.05);2组不同时间点BMI比较差异无统计学意义(P>0.05)。结论互助小组式同伴支持饮食管理可提高胃癌术后患者自我饮食管理,改善患者术后营养状况。

Objective To explore the effects of peer support groups-based dietary intervention on nutritional status among patients with gastrectomy.Methods Eighty-two patients with gastrectomy from March 2018 to August 2019 in Gastrointestinal Surgery of Shanxi Bethune Hospital were assigned to the experimental group and control group with 41 cases in each group by random digits table method.Patients in the control group were recieved routine nursing care and dietary guidance,basis on the control group,the experimental group provided peer support groups-based dietary intervention as well.BMI,total serum protein,albumin were recorded at 1 day before discharge,4 weeks and 12 weeks after discharge,the intervention effect was assessed by Patient-Generated Subjective Global Assessment(PG-SGA),diet related symptoms scale and diet compliance scale.Results At 4,12 weeks after discharge,diet related symptoms scale scores were(10.61±2.37),(8.61±1.64)points in the experimental group,significantly lower than(12.05±1.49),(11.46±2.44)points in the control group,the differences were statistically significant(t=3.20,6.05,both P<0.05).At 4,12 weeks after discharge,diet compliance scale scores were(63.87±4.60),(64.92±6.394)points in the experimental group,significantly higher than(60.90±4.94),(62.18±5.07)points in the control group,the differences were statistically significant(t=2.73,2.09,both P<0.05).At 4,12 weeks after discharge,PG-SGA scores were(4.11±0.86),(3.53±1.13)points in the experimental group,significantly lower than(5.15±1.46),(4.28±1.62)points in the control group,the differences were statistically significant(t=3.85,2.38,both P<0.05).At 12 weeks after discharge,the levels of total serum protein,albumin were(57.79±3.95),(36.68±3.11)g/L in the experimental group,significantly higher than(55.26±3.66),(34.74±2.41)g/L in the control group,the differences were statistically significant(t=2.92,3.06,both P<0.05).There was no significant difference in BMI in different time between the two groups(P>0.05).Conclusions Peer support groups-based dietary intervention can promote self catering management and nutritional status of patients with gastrectomy.