Study On The Correlation Between Nutritional Cognition Level And Quality Of Care In Family Caregivers Of Patients With Esophageal Cancer

Objective1.Understand the changes of nutritional cognition level and different time points in the care of patients with esophageal cancer after operation and their influencing factors.2.ABC-X model was used to explore the relationship between various factors and to analyze the correlation between nutritional cognition level of family caregivers and patient care quality.To provide the basis for carrying out targeted nutrition cognitive health education and developing health education methods in which patients and caregivers participate together.MethodsTaking the convenient sampling method,from October 2018 to June 2019,the patients and their main caregivers in thoracic surgery of a Grade 3A tumor specialist hospital were selected,and 149 cases were investigated at three time points:1 day before operation?T₁?;2 day after operatio?T₂?;1 day after admission review one month after operation?T₃?.The survey tool includes two parts:caregiver and patient.Caregiver survey tools include: general data questionnaire,post-operative esophageal cancer patient caregiver nutrition care knowledge and practice questionnaire,Xiao Shuiyuan social support assessment scale?SSRS?.Patient survey tools include: general data and disease-related data questionnaire,patient subjective overall nutritional status assessment scale?Scored Patient Generated Subjective Global Assessment,PG-SGA?score,cancer patient quality of life core questionnaire 3.0?QLQ-C30?.Using Epidata3.1 to establish a database,using SPSS18.0 for data analysis.The counting data are expressed by frequency and percentage,and the measurement data are described statistically by mean and standard deviation.independent sample T test,univariate analysis of variance,multiple stepwise regression analysis to analyze the influencing factors of nutritional cognition in family caregivers.Single factor ANOVA and chi-square test were used to analyze the changes of nutritional cognition and nutritional status of family caregivers at different time points,and to analyze the influence of nutritional cognition of family caregivers on nutritional status of patients.By means of Person correlation analysis and multiple stepwise regression analysis.Results1.Nutritional cognition of family caregivers in patients with 1.esophageal cancer scored at T₁?T₂?T₃ three time points?35.99�4.05?,?39.07�4.27?,?38.01�3.93?.At three time points,the nutritional cognitive score of caregivers showed an upward trend,and the difference was statistically significant?P?0.05?.2.The social support scores of family caregivers at T₁?T₂?T₃three time points were?28.16�2.98?,?30.14�3.13?,?30.03�3.16?.Compared with the scores of each dimension,the total social support score of caregivers was statistically significant?P?0.05?.3 The total score of nutrition cognition and the scores of each dimension were positively correlated with the total score of social support and the scores of each dimension?P?0.05?.4.Univariate analysis of nutritional cognition level of family caregivers in patients with esophageal cancer the difference of nutritional knowledge scores of caregivers with different age,education and employment status in T₁ and T₃ time points was statistically significant?P?0.05?.In addition to the above three factors,the difference in nutritional knowledge scores of family caregivers with or without chronic diseases was statistically significant?P?0.05?.5.Multivariate stepwise regression analysis of nutritional cognitive level of family caregivers in patients with esophageal cancer showed that the main factors affecting nutritional cognitive level were caregivers age,education,work,objective support.6.Nutritional status of patients with esophageal cancer: the BMI values at the three time points were?22.10�2.64?,?21.72�2.62?,?21.01�2.63?;and the PG-SGA scores were?3.23�1.32?,?3.78�1.17?,?3.45�1.08?.Malnutrition T₁:31.5%,T₂:56.4 % and T₃:36.9 %.7.Quality of life scores at three time points in patients with esophageal cancer: somatic function was?75.39�7.40?,?70.39�7.01?,?73.31�7.34?;role function was?47.85�8.72?,?44.79�9.25?,?46.51�8.61?;emotional function was?73.13�5.48?,?67.83�7.85?,?71.83�7.90?;The cognitive functions were?71.35�4.80?,69.09�5.02),?72.07�4.76?;The social functions were?53.02�7.65?,?48.79�7.61?,?49.41�7.70?and the overall health status was?58.97�6.61?,?56.64�6.23?,?58.64�6.580?,with statistically significant differences in quality of life scores between the three time points?P?0.05?.8.The effect of nutritional cognitive level of family caregivers in patients with esophageal cancer on the nutritional status of patients: according to the PG-SGA nutritional risk screening system rating criteria,the patient PG-SGA score was divided into two groups;among them ?4 was divided into malnutrition group,? 4 was divided into nutrition good group.The results of single factor ANOVA showed that the scores of nutrition cognition and questionnaire scores were higher than those of malnutrition group in T₂ time group?P?0.05?,and the scores of nutrition behavior and nutrition questionnaire in T₃ time group were higher than those in malnutrition group,significant difference?P?0.05?.9.At three time points,the total nutritional cognitive score of caregivers was positively correlated with the total health assessment score of patients?P ? 0.01?,and the correlation coefficient values were 0.653,0.397,0.169 respectively.10.The results showed that the total score of nutritional cognition of family caregivers at three time points explained the variation of 24.5%,26.9% and 20.2% of the patients' overall health status.Conclusions1.The nutritional cognition level of family caregivers of patients with esophageal cancer increased gradually with the time of care,but the score of nutritional attitude and behavior was not significant.2.The nutritional cognitive level of family caregivers is mainly affected by age,education,work situation and social support,objective support in social support is the main positive influence factor of their nutritional cognitive level.3.Applied the ABC-X model to this study,we found that the nutritional cognition of family caregivers was positively correlated with social support and care quality,that is,the higher the social support level of caregivers,the higher the nutritional cognition level and the better the care quality.