胃癌胃大部切除术后病人营养知识需求的质性研究

Nutritional knowledge requirements in patients with gastric cancer after subtotal gastrectomy:a qualitative study

目的:结合病人及医护人员不同的视角,深入探讨胃癌胃大部切除术后病人的营养知识需求,为其营养教育的实施提供依据和建议。方法:采用现象学研究方法,对云南省某三级甲等肿瘤专科医院19名医护人员和8例胃大部切除术后胃癌病人进行半结构访谈。结果:根据知信行理论对主题进行归纳总结,共提炼出3个类别11个主题。1)知识。营养知识缺乏;营养知识传播受限。2)态度。营养认知不一致;病人自我感觉负担重;病人术后营养教育需要高。3)行为。医院工作强度大;宣教方式单一;病人饮食依从性差;疾病原因困扰进食;家庭支持不足,阻碍健康饮食行为的形成。结论:胃癌胃大部切除术后病人的营养教育需求受到多重因素影响,术后病人对营养教育的需求高,但其营养认知水平及行为有待提高,迫切需要加强营养教育。因此,要提高医护和病人的营养知识水平及能力、加强护患沟通,促进知识的传播,提高胃癌术后病人的营养认知,同时要加强胃癌术后病人的心理支持和规范医院营养教育的流程优化这4个方面,针对病人实际需求,为病人提供个性化的营养宣教,解决胃癌术后病人实际营养需求,提高病人营养认知能力和水平,并为其提供合理的营养支持治疗,促进健康。

Objective:To investigate the nutritional knowledge requirements of patients with gastric cancer after subtotal gastrectomy,and to provide basis and suggestions for the implementation of nutritional education combining with different perspectives of patients and medical staff.Methods:Semi-structured interviews were conducted with 19 medical staff and 8 patients with gastric cancer after subtotal gastrectomy in a third A oncology hospital in Yunnan province by phenomenological methods.Results:According to the theory of knowledge,belief and action,the themes were summarized,and a total of 11 themes were extracted from 3 categories.Knowledge:Lack of nutritional knowledge;limited dissemination of nutritional knowledge.Attitude:inconsistent nutritional cognition;patients self-perceived heavy burden;the need for postoperative nutrition education was high.Behavior:hospital work intensity;the mode of mission teaching is single;the patients had poor dietary compliance;disease cause trouble eating;Insufficient family support hinders the development of healthy eating behaviors.Conclusions:The nutritional education needs of patients with gastric cancer after subtotal gastrectomy are affected by multiple factors.The postoperative patients have a high demand for nutritional education,but their nutritional cognition level and behavior need to be improved,and it is urgent to strengthen nutritional education.Therefore,it is necessary to improve the nutritional knowledge level and ability of medical staff and patients,strengthen the communication between nurses and patients,promote the dissemination of knowledge,improve the nutritional cognition of patients after gastric cancer surgery,strengthen the psychological support of patients after gastric cancer surgery,standardize the process optimization of hospital nutrition education,and provide patients with personalized nutrition education according to the actual needs of patients.To solve the actual nutritional needs of patients with gastric cancer after surgery,improve the nutritional cognitive ability and level of patients,and provide them with reasonable nutritional support treatment to promote health.