基于体验的护患协同设计在头颈部肿瘤术后患者家庭肠内营养中的应用

Application of experience-based co-design in home enteral nutrition for patients with head and neck cancer after operation

目的:探讨基于体验的护患协同设计(experience-based co-design,EBCD)在头颈部肿瘤术后患者家庭肠内营养中的应用效果。方法:选取上海交通大学医学院附属第九人民医院2021年5月—9月治疗的41例头颈部肿瘤患者为对照组,采用常规肠内营养健康教育和出院指导;2021年10月—2022年3月治疗的41例头颈部肿瘤患者为试验组,在对照组基础上实施基于EBCD的家庭肠内营养护理服务,比较2组患者出院前及出院1个月、3个月的营养状况、自我管理效能及生活质量。采用SPSS 20.0软件包对数据进行统计学分析。结果:出院3个月后,试验组患者主观整体评估量表(PG-SGA)评分优于对照组,血红蛋白、血清白蛋白、血清总蛋白水平显著高于对照组(P<0.05)。出院1个月、3个月,试验组患者自我管理效能及生活质量评分优于对照组;2组比较,干预效应、时间效应、交互效应均有统计学差异(P<0.05)。结论:基于EBCD的家庭肠内营养护理以头颈部肿瘤患者体验为触点,改进家庭肠内营养护理服务质量,有效改善了患者营养状况、生活质量及自我管理效能。

PURPOSE:To explore the effect of experience-based co-design(EBCD)in home enteral nutrition(HEN)for patients with head and neck cancer(HNC)after operation.METHODS:A total of 41 patients with HNC collected in our hospital from May to September 2021 were selected as the control group,and provided with routine enteral nutrition health education and discharge instruction.Meanwhile,another 41 patients with HNC collected from October 2021 to March 2022 were included in the experimental group,and were given EBCD-based HEN as the basis of the scheme in the control group.The nutritional status,self-management efficacy and quality of life of patients in the two groups were compared before discharge as well as 1 month and 3 months after discharge.SPSS 20.0 software package was used for data analysis.RESULTS:Three months after discharge,the PG-SGA score of the patients in the experimental group was better than that of the patients in the control group,and the levels of hemoglobin,serum albumin and total serum protein were significantly higher in the experimental group than those of the control group(P<0.05).Furthermore,the self-management efficacy and quality of life scores of the patients in the experimental group were better than those in the control group at 1 month and 3 months after discharge.There were significant differences in the intervention effect,time effect and interaction effect between the two groups(P<0.05).CONCLUSIONS:HEN based on EBCD contributes to the improvement of the service quality of HEN according to the experience of HEN patients,which effectively improves the nutritional status,quality of life and self-management efficiency of these patients.