对头颈癌放疗患者实施营养相关症状管理教育的效果研究

Effects of symptom management education on nutrition impact symptoms in head and neck cancer patients undergoing radiotherapy

目的探讨症状管理教育对头颈癌放疗患者营养相关症状水平和营养状况的影响。方法将128例头颈癌放疗患者按不同病区分为对照组与干预组各64例;对照组实施放疗常规护理,干预组在对照组基础上增加分阶段持续性症状管理教育。分别在放疗第1、4、7周和放疗后1个月应用头颈患者症状清单进行营养相关症状评估,同时测量体质量、血清白蛋白及血红蛋白。结果干预组不同时间点营养相关症状总分及疼痛、恶心和抑郁严重程度显著低于对照组,体质量、血清白蛋白、血红蛋白显著高于对照组(干预主效应均P<0.05)。结论分阶段持续性症状管理教育能够提高头颈癌放疗患者的症状管理能力,有效减轻患者营养相关症状负荷,改善患者营养状况。

Objective To investigate the effect of symptom management education on the level of nutrition impact symptoms and nutritional status in head and neck cancer patients undergoing radiotherapy.Methods One hundred and twenty-eight head and neck cancer patients receiving radiotherapy were divided into a control group and an intervention group according to different wards,with 64 in each group.Patients in the control group were given routine radiotherapy nursing,while the intervention group additio-nally received symptom management education.Nutrition impact symptoms were assessed at week 1,week 4,and week 7 after initiation of radiotherapy and at 1 month post-radiotherapy through the Head and Neck Patient Symptom Checklist(HNSC).Body weight,serum albumin and hemoglobin were also measured at these time points.Results The total HNSC score and the severity of pain,nausea and depression were lower,whereas body weight,serum albumin and hemoglobin were higher in the intervention group than those in the control group,showing significant main group effect(all P<0.05).Conclusion Continuous and stage specific symptom management education can improve symptom management ability of head and neck cancer patients undergoing radiotherapy,effectively alleviate the extent of nutrition impact symptoms and improve the nutritional status.