Effects Of Enteral Nutrition In Combination With Psychological Intervention On The Health Status Of Patients With Gastrointestinal Malignant Tumor Undergoing Postoperative Chemotherapy

BackgroundGastrointestinal malignant tumors are one of the most common malignant tumors in clinical practice and its morbidity are raising in recent years. The therapeutic methods includes surgical therapy, radiotherapy, chemotherapy and molecular targeted therapy etc. However, every therapy brings some side-effects in the process of treatment, including malnutrition and mental problem. Meanwhile,these side-effects would influence the implement of therapeutic methods and drugs’ effect, which would influence the quality of life. It is very necessary to improve the nutrition status, upregulate the immunity, release the mental burden and alleviate the side-effects of chemotherapy and augment the tolerance. Our research will implement nutritional intervention combined with psychological nursing to increase the therapeutic effect and improve the health status of patients with gastrointestinal malignant tumor undergoing postoperative chemotherapy.ObjectiveTo explore the efficacy of therapeutic nutritional intervention combined with relaxation therapy, musical therapy or cognitive-behavioral therapy were used to relieve side effects, anxiety and depression as well as improve nutritional and mental health status in patients undergoing post-operation chemotherapy for their gastrointestinal malignant tumors.MethodsBased on nutritional screening and patients’information consent,130 patients were included in our research and randomly divided into observation group(OG n= 63) cases and control group (CG n= 67). All patients received standard chemotherapy. Patients in CG were received routine nursing and common health educations only, whereas the patients in the OG were given extra therapeutic nutritional intervention and psychological nursing before chemotherapy procedures.8 patients were excluded because of disobeying the doctor’s advice. Nutritional and mental health status, clinical symptoms, and the severity of depression and anxiety were evaluated before and after chemotherapy treatment in each patient. SPSS 18.0 was used to statistics analyze the data.Results1. After three cycles of chemotherapy, there were significant increases in body weight, body mass index, HGB, ALB, GLB and TP in patients of OG compared with those of CG (all P<0.05) while no significant differences in peripheral lymphocyte count and triceps skin-fold thickness.2. Enteral nutrition index were decreased after three cycles of chemotherapy which is significantly differences (P<0.01). Apart from body weight and body mass index, the other nutrition index were decreased in OG with significantly differences (P<0.01). The descending curve of OG is more obviously more flat than that of CG, the comparison has statistically significance (P<0.05)3. After three cycles of chemotherapy, SCL-90 showed that apart from Psychoticism, other factors are statistically significant lower in OG than those in CG(P<0.05). SAS and SDS statistics showed that scores of anxiety and depression are lower than the condition before chemotherapy in OG while the condition in CG is not as obvious as OG, which is statistically different (P<0.05).4. Among the three cycles of therapeutic nutritional intervention and psychological nursing, the incidence of nausea and vomiting, inappetence and abdominal distension diarrhoea was dramatically lower in OG than in CG, with significant difference(P<0.01). The differences of alopecia and oral ulcer in two groups had no statistically significance (P>0.05). The grade of myelosuppression showed no statistically different in two group after three cycles of chemotherapy (P>0.05)Conclusion1. Enteral nutrition combined with relaxation therapy, cognitive behavioral therapy and music therapy can effectively improve the nutritional and mental health status of patients with gastrointestinal malignant tumor undergoing postoperative chemotherapy.what’s more, it can reduce anxiety and depression levels and improve the ability to cope with illness and treatment.2. Enteral nutrition support combined with psychological intervention can improve the patients with gastrointestinal malignant tumor undergoing postoperative chemotherapy chemotherapy tolerance, reduce the incidence of adverse reaction of chemotherapy and improve the quality of life in patients, what’s more,it can improve the curative effect of malignant tumor and have positive clinical significance.