The Effect Of Empowerment Based On Food Intolerance On Patients With Ulcerative Colitis

ObjectiveThis study aims to investigate the effect of an empowerment program based on food intolerance on ulcerative colitis patients: disease activity,relapse rate,nutrition condition and quality of life.By summarizing the experience of empowerment based on food intorlerance,more effective dietary nursing intervention was to be provided.Materials and Methods87 patients who were diagnosed of ulcerative colitis(UC)during 2013 September to 2014 August in General Hospital of Tianjin Medical University were included.40 healthy controls were randomly selected from people receiving regular physical examination during 2013 September to 2014 February.The physical information and clinicle data were clected,meanwhile all the participants received food intolerance test and quality of life were investigated.The food intorlerance rate and quality of life was compared and analyzed between healthy controls and UC patients.The UC patients were divided into remission,mild activity and moderate to severe activity groups according to Southerland DAI scoring system;rectum,left sided and pan colitis groups according to the Montreal classification,extraintestinal manifestation and non extraintestinal manifestation group according to the occurrence of extraintestinal manifestation,and difference of food intolerance were analyzed between groups.The UC patients were divided into empowerment group(47participants)and control group(40 participants).According to the result of food intolerance test in the empowerment group the empowerment education was conducted later.While the control group received traditional health education for UC patients.The clinical data and quality of life were investigated after the 6months-intervention.Quality of life,disease characteristics and nutritional index before and after 6 months-intervention between empowerment group and control group were valued.Results1.Food intolerance rate in UC patients was as high as 75.90%,which was significantly higher than healthy controls 37.5%(P<0.05).The intolerance rate ofdifferent food species rank: egg> wheat> milk> corn> tomatoes> crab> rice>soybean> codfish> shrimp> mushrooms> beef,and no intolerance of chicken and pork showed up.No significant difference of food intolerance rate were showed between groups sex and BMI(P>0.05).Compared between each two groups categorized according to age,cod,crab showed statistical significance between groups(P<0.05).The intolerance rate of wheat in the middle-agee group is significant higher than the old group and middle-aged group(P<0.05).The food intolerance rates of different disease activity groups were significant different(P<0.05).Extraintestinal manifestation group had significantly higher food intolerance rate compared to non extraintestinal manifestation group(P<0.05).No significant difference of food intolerance rates were showed between groups of different lesions(P>0.05).2.After 6 months’ empowerment education or traditional health education,the quality of life scores of empowerment group in physical function,social function and mental health dimension were higher than those in the control group(P<0.05),and the difference of mental health was remarkable(P<0.01).At the beginning of the intervention,the mean Southerland DAI of the empowernment group and control group was 2.92±2.35 and 3.44±2.13,between which the defference was not significant(P>0.05).After the intervention the mean Southerland DAI of the empowernment group decreased to 2.02±2.09,significantly inferior to the control group 2.86±3.21(P<0.05).After the intervention patients with extraintestinal manifestations in empowerment group dropped from 13 cases to 4 cases,which was significantly inferior to control group,and the difference was statistically significant(P<0.05).The control group showed higher recurrence rate than the intervention group,but the difference was of no statistically significance(P>0.05).The nutritional indexes were measured before and after the intervention.No significant difference showed in body mass index(BMI),total protein(TP),albumin(ALB),prealbumin(PA)and transferrin(TRF)(P>0.05).Conclusion1.High attention should be paid to food intolerance in patients with UC,especiallythose with high disease activity and extraintestinal manifestations.2.Nurse should improve the communication with UC patients and pay high attention to the physical,mental and social health problems,to offer more targeted guidance and nursing procedures.3.The empowerment education based on food intorlerance which provided targeted nursing intervention and health education showed good results in improving the quality of life,nutritional status and prognosis of the disease in patients with UC.The empowerment education improved quality of life in patients with UC more effective than traditional health education.