口服营养支持补充集束化护理方案在胃癌术后患者居家护理中的应用

Effect of oral nutrition supplements cluster care in home care of postoperative patients with gastric cancer

目的构建口服营养支持补充(ONS)集束化护理方案,并探讨其在胃癌术后患者居家护理中的应用效果。方法检索文献回顾胃癌术后患者居家ONS依从性现状,分析目前存在的问题。根据循证证据总结并制订相应的集束化护理方案,建立居家ONS管理团队及流程。采用便利抽样法,选取2020年11月—2021年10月宁波市第一医院胃肠外科需要居家实行ONS的107例胃癌术后患者为研究对象,将2020年11月—2021年4月的胃癌术后患者设为对照组(n=40),将2021年5—10月的胃癌术后患者设为观察组(n=67)。对照组实施常规ONS,观察组在对照组基础上实施居家ONS集束化方案,并评价两组间营养支持依从性、体重增幅、体重指数增幅、随访体验的差异。结果干预6个月后,观察组ONS的依从性、体重增幅、体重指数增幅、随访体验评价得分均较对照组提高,差异有统计学意义(P<0.05)。结论实施集束化方案提高了胃癌术后患者居家ONS的依从性、营养状况及对医护随访的满意度,值得临床推广。

Objective To construct a cluster care of oral nutrition supplements(ONS),and to explore its effect in home care of postoperative patients with gastric cancer.Methods Literature search was conducted to review the status quo of ONS compliance at home in patients with gastric cancer after surgery,and analyze the existing problems.We summarized and formulated the cluster care plan according to the evidence,and established the home ONS management team and process.From November 2020 to October 2021,107 patients with gastric cancer who needed to implement ONS at home in Gastrointestinal Surgery of Ningbo First Hospital were selected as research objects by convenience sampling.Postoperative patients with gastric cancer from November 2020 to April 2021 were set as the control group(n=40),and those from May to October 2021 were set as the observation group(n=67).The control group was treated with conventional ONS,and the observation group was treated with home ONS cluster care plan on the basis of the control group.The compliance of nutritional support,weight gain,body mass index increase and follow-up experience between the two groups were evaluated.Results After six months of intervention,the scores of ONS compliance,weight gain,body mass index increase and follow-up experience in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions The cluster care plan improves the ONS compliance at home,nutritional status and satisfaction with the follow-up by medical and nursing staff in patients with gastric cancer after surgery,which is worthy of clinical promotion.