基于MTM模型的饮食指导对胃肠道恶性肿瘤化疗患者味觉改变的影响

Effect of diet guidance based on the MTM model on taste change in patients with gastrointestinal cancer undergoing chemotherapy

目的探讨基于健康行为改变多理论模型(multi-theory model,MTM)的饮食指导对胃肠道恶性肿瘤化疗患者味觉改变的影响。方法选取2021年1—12月在重庆市某三级甲等医院肿瘤科就诊的125例胃肠道恶性肿瘤患者为研究对象,其中1例患者中途退出(病情恶化),2例患者出院后失访,最终入选胃肠道恶性肿瘤患者122例,按照组间基本资料具有可比性的原则分为对照组59例和观察组63例。对照组采用肿瘤科常规饮食指导,观察组在对照组基础上采用基于MTM模型的饮食指导策略。于干预后第8周采用Kano化疗相关味觉改变量表(CiTAS)和生活质量核心问卷(QLQ-C30)评估两组患者味觉改变情况和生活质量的差异。结果干预后,对照组和观察组患者CiTAS总分分别为5.27±1.39分和4.53±0.64分,两组比较差异有统计学意义(P<0.05);观察组患者在整体味觉改变维度、味幻觉和味觉异常维度、基本味觉改变维度得分均低于对照组(P<0.05)。干预后,对照组总体健康状况维度得分为61.58±14.84分,观察组总体健康状况维度得分为72.08±14.67分,两组比较差异有统计学意义(P<0.05);功能维度中除社会功能外,观察组患者躯体功能、角色功能、情绪功能和认知功能得分均高于对照组,两组比较差异均有统计学意义(P<0.05);症状维度和单条目维度中,观察组患者各项目得分均低于对照组,两组比较差异均有统计学意义(P<0.05)。结论基于MTM模型的饮食指导可降低胃肠道恶性肿瘤患者化疗相关味觉改变发生率,改善患者味觉障碍,提高患者生活质量,促进患者康复。

Objective To explore the effect of diet guidance based on the multi-theory model(MTM)of health behavior change on taste change in patients with gastrointestinal cancer undergoing chemotherapy.Methods A total of 125 patients with gastrointestinal malignant tumors who were treated in the oncology department of a third class A hospital in Chongqing from January to December 2021,were selected as the study subjects,among them,one patient withdrew midway(the condition worsened),and two patients lost follow-up after discharge.Finally,122 patients with gastrointestinal malignant tumors were selected.According to the principle of comparability of basic data between groups,they were divided into a control group(59 cases)and an observation group(63 cases).The control group adopted the routine diet guidance of oncology department,and the observation group adopted the diet guidance strategy based on MTM model on the basis of the control group.At the 8th week after intervention,Kano chemotherapy-induced taste alteration scale(CiTAS)and the core quality of life questionnaire(QLQ-C30)were used to assess the diff erence between the two groups in taste change and quality of life.Results After the intervention,the total CiTAS scores of the patients in the control group and the observation group were 5.27±1.39 points and 4.53±0.64 points respectively,the diff erence between the two groups was statistically signifi cant(P<0.05).The scores of patients in the observation group in the overall dimension of taste change,the dimension of taste hallucination and abnormal taste,and the dimension of basic taste change were lower than those in the control group(P<0.05).After intervention,the overall health dimension score of the control group was 61.58±14.84 points,and the overall health dimension score of the observation group was 72.08±14.67 points,the difference between the two groups was statistically significant(P<0.05).Besides social function,the scores of physical function,role function,emotional function and cognitive function in the observation group were higher than those in the control group,and the diff erences between the two groups were statistically signifi cant(P<0.05);in the symptom dimension and single item dimension,the scores of patients in the observation group were lower than those in the control group,and the diff erences between the two groups were statistically signifi cant(P<0.05).Conclusion The diet guidance based on MTM model can reduce the incidence of chemotherapy-related taste changes in patients with gastrointestinal cancer,improve their taste disorders,improve their quality of life,and promote their rehabilitation.