The Effectiveness Of Motivational Interviewing On Oral Nutrition Support(ONS) In Esophageal Cancer Patients Receiving Radiotherapy

Objective:Based on the motivational interviewing,a phased intervention was developed to intervene in the compliance of oral nutritional supplements in esophageal cancer patients receiving radiotherapy,to evaluate its effects on patients’ self-efficacy and compliance,on nutritional status and radiotherapy complications.The intervene promotes the self-management awareness and self-management ability of patients,and provides reference and basis for clinical nursing of oral nutritional supplements in esophageal cancer patients receiving radiotherapy.Methods:This study used a randomized controlled study design.According to the random number table,64 esophageal cancer patients with poor oral nutritional supplementation compliance during radiotherapy in the Department of Thoracic Tumor Radiotherapy,Zhejiang Cancer Hospital were divided into 30 cases in the control group and 34 cases in the observation group.The control group was given routine health education,and the observation group was conducted motivational interviewing based on routine health education.Before and after the intervention,the medication compliance questionnaire,the medication self-efficacy questionnaire and the medication-related belief questionnaire were used to evaluate medication compliance,medication self-efficacy and medication-related beliefs.The nutritional risk and malnutrition rates of the two groups were compared by the European Nutrition Risk Screening Scale(NRS2002)and Body Mass Index(BMI).The incidence of radiation esophagitis of the two groups was compared by the acute radiation injury grading standard(RTOG)and the number pain score(NRS).At the same time,the results of nutrition-related laboratory results at different stages of radiotherapy in the two groups were compared.Results:The compliance,medication compliance confidence and medication-related beliefs of esophageal cancer patient’s receiving radiotherapy are at a moderate level,but the willingness to take medicine is at a lower level.Through motivational interviewing,the oral nutrition supplement compliance,medication self-efficacy,and medication-related belief scores of the observation group were higher than the control group and the difference was statistically significant(p<0.05).The scores of the European Nutritional Risk Screening Scale and the incidence of malnutrition of the two groups in the middle of radiotherapy were statistically significant(p<0.05).The weight loss of observation group was lower than that of the control group in the middle of radiotherapy,and the difference was statistically significant(p<0.05).There was no significant difference in the incidence of radiation esophagitis between the two groups(p>0.05),but the difference of pain scores≥4 points of esophagitis patients in the middle and late stage of radiotherapy was statistically significant(p<0.05).There was no significant difference in serum total protein,albumin,prealbumin and hemoglobin between the two groups(p>0.05).Conclusions:The compliance of oral nutritional supplements,confidence in medication and medication-related beliefs in esophageal cancer patients receiving radiotherapy nee-further improvement.It is meaningful to conduct one-on-one motivational interviewing in oral nutritional supplements for esophageal cancer patients receiving radiotherapy.Compared with the regular health education model,motivational interviewing can improve patients’ medication self-efficacy and drug-related beliefs,thereby improving patients’ compliance with oral nutritional supplements.In addition,through motivational interviewing,it has a certain effect on improving the nutritional risk of patients,delaying the weight loss of patients,and promoting the symptom management of radiation esophagitis,which is worthy of clinical practice and further discussion.