| Objectives:Based on the theory of Knowledge-Attitude-Practice,this study constructs a scientific and systematic nutrition education program for colorectal cancer patients undergoing chemotherapy through a questionnaire survey method,qualitative interview,literature analysis method,and Delphi method to provide a reference basis for improving and optimizing the nutrition education program for colorectal cancer chemotherapy patients.Materials and Methods:1.Colorectal cancer patients undergoing chemotherapy who were hospitalized in the oncology departments of five grade 3A hospitals in Sichuan Province from November2021 to May 2022 were selected by convenience sampling,using general information questionnaires,and nutrition knowledge and beliefs of colorectal cancer patients undergoing chemotherapy questionnaires to analyze the current status and influencing factors of nutrition knowledge and opinions of colorectal cancer patients undergoing chemotherapy.2.Using the descriptive phenomenological research method,17 colorectal cancer patients undergoing chemotherapy were interviewed through semi-structured interviews through purposive sampling to deeply understand the nutrition knowledge,belief,practice,and experience of nutrition education of colorectal cancer patients undergoing chemotherapy and to analyze the nutrition education needs of patients.3.Based on a literature analysis and the results of previous quantitative and qualitative studies,the first draft of a nutritional education program for colorectal cancer patients undergoing chemotherapy was initially formulated.The Delphi method was used to conduct a correspondence consultation on the first draft of the program,and the expert comments were summarized and analyzed to form the final draft of the nutrition education program for colorectal cancer patients undergoing chemotherapy.Result:1.Three hundred colorectal cancer patients undergoing chemotherapy in five grade3A hospitals in Sichuan Province were surveyed.The results showed that the scores of the nutrition knowledge,attitude,and practice questionnaire were(59.14±11.37),which was low.The multiple linear regression analysis results showed that insurance type,education level,and whether or not they had received nutrition education influenced nutrition knowledge among colorectal cancer chemotherapy patients(P<0.01,adjusted R~2=0.683).Education level and monthly per capita household income influenced nutritional beliefs(P<0.01,adjusted R~2=0.587).Insurance type,education level,marital status,disease stage,and residence status were influential factors for nutritional behavior(P<0.01,adjusted R~2=0.669).2.Based on qualitative interviews with 17 colorectal cancer patients undergoing chemotherapy,the 5 themes and 15 subthemes,the 5 themes were extracted:incomplete nutrition knowledge,weak nutrition beliefs,irregular nutrition behaviors,poor nutrition education experience,and diversified nutrition education needs.3.A total of 42 articles were included in the search,including 11 guidelines,6 expert consensus articles,18 original studies,1 systematic review,and 6 reviews.The experts in the two rounds of correspondence were from seven grade 3A hospitals in southwest China,and the number of experts in the two rounds of correspondence was 23 and 21,respectively.The effective recall rates of the correspondence questionnaires were 88.46%and 91.30%,the authority coefficient of experts was 0.87 and 0.89,and the Kendall harmony coefficients were 0.147 and 0.224,respectively(P(27)0.001).The final nutrition education program for colorectal cancer patients undergoing chemotherapy was established,including 6 first-level items,15 second-level items,and 72 third-level items.It includes nutrition education staff composition,nutrition screening and assessment,nutrition education content,nutrition education format,nutrition education effect evaluation,and nutrition education follow-up.Conclusions:The nutritional knowledge,beliefs,and practice of colorectal cancer chemotherapy patients need further improvement.Patients face such dilemmas as poor mastery of nutritional knowledge,weak nutritional beliefs,and irregular nutritional behaviors,so it is necessary to carry out targeted and individualized nutritional education to enhance patients’nutritional education experience and meet their diversified needs for nutritional education.This study prepared the preliminary draft of the nutrition education program for colorectal cancer chemotherapy patients based on a questionnaire survey and qualitative interview results combined with literature analysis.The Delphi method was used to form the final draft of the nutrition education program,which is scientific and systematic and can guide the clinical practice of nutrition education for colorectal cancer chemotherapy patients. |
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