| ObjectivesTo explore the intervention effect of gastrointestinal symptom cluster management program based on the three core concepts of “education-skill-support” on patients with gastric cancer adjuvant chemotherapy.MethodsThe research is a quasi-experimental study.76 patients with adjuvant chemotherapy for gastric cancer after surgery in a third grade class-A hospital in Zhengzhou were selected.Among them,38 patients with adjuvant chemotherapy for gastric cancer from October 2017 to April 2018 served as the control group,38 patients with gastric cancer from June 2018 to December 2018 served as intervention group.The control group received routine care and antiemetic measures.On the basis of the control group,the intervention group implemented the management of digestive tract symptom groups from three modules: knowledge education,skill training and supportive communication.Before the intervention,the first chemotherapy,the third chemotherapy,and the sixth chemotherapy,the general data questionnaire,the Cartesian function scale,the disease knowledge questionnaire,the MASCC antiemetic evaluation tool,and the general self-efficacy scale were used for investigation and evaluation.Statistical analysis was performed using EpiData 3.1 for data entry and IBM SPSS Statistics 21.0.Statistical methods include: statistical description,chi-square test,two independent sample t-test,non-parametric test,generalized estimating equation,generalized linear mixed-effects model,and the test level is α = 0.05.Results1.The final 66 patients were enrolled in the study.There were 33 patients in the control group and 33 patients in the intervention group.The mean age was(56.77±11.82)years,male patients accounted for 65.2%,and female patients accounted for 34.8%.The proportion of patients with stage III~IV gastric cancer was 68.2%,and the pathological type was mainly gastric adenocarcinoma,accounting for 84.8%.The chemotherapy regimen was mainly oxaliplatin,accounting for 78.7%.The KPS score was(78.79±5.999)in the control group and(79.09±6.307)in the intervention group.The difference was not statistically significant(P>0.05).Disease knowledge scores,the difference between the two groups was not statistically significant(P>0.05).The difference was not statistically significant(P>0.05).The general self-efficacy score was(2.17±0.298)in the control group and(2.18±0.291)in the intervention group.2.During the third chemotherapy period,the total knowledge of the two groups of patients was(8.76±1.437)points in the control group and(9.42±1.871)points in the intervention group.The control group was(9.24±1.501)points during the sixth chemotherapy period.Results(11.6 ± 1.868)points,the difference was statistically significant(P<0.05).3.The results of the generalized estimation equation showed that the incidence of nausea and vomiting in the intervention group was better than that in the control group.The generalized linear mixed-mix effect model fitting results showed that the acute phase vomiting.There was no statistically significant difference between the two groups.The control of nausea and the frequency of vomiting in the delayed phase were better than those of the control group.4.During the third chemotherapy period,the average scores of general self-efficacy of the two groups were small,and the difference was not statistically significant(P>0.05);the sixth chemotherapy showed that the control group was divided into(2.20±0.259).In intervention group the score is(2.53±0.212),the difference was statistically significant(P<0.05).ConclusionsThe symptom group management program based on the three core concepts of “education-skill-support” can reduce the incidence of acute and delayed gastrointestinal symptoms.The three modules of the digestive tract symptom group intervention program can increase the knowledge of gastric cancer in patients,alleviate the digestive tract symptoms of patients with gastric cancer adjuvant chemotherapy,and improve self-efficacy.It can be used as a train of thoughts for the management of digestive tract symptoms to provide ideas and references for the future implementation of symptom management. |
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