| Objective1.To establish a home nutrition management scheme for patients with pancreatic cancer after radical surgery.2.The intervention study of home nutrition management program for patients with pancreatic cancer after radical surgery was conducted to explore the intervention effect of this program on the nutritional status,malnutrition risk and quality of life of patients after discharge.Methods1.Establishment of home nutrition management program for patients with pancreatic cancer after radical surgery: Objective To conduct semi-structured interviews with 15 medical staff,9 patients and caregivers of 5 patients by sampling method.Colaizzi 7 step method was used to collate and analyze the data.To understand the attitude and needs of medical staff towards the construction of this program,and to analyze the influencing factors and needs of patients and their families on home nutrition management.A home nutrition management research group was established to construct the first draft of home nutrition management program for patients with pancreatic cancer after radical surgery through literature review and discussion in the research group,and the final draft of home nutrition management program for patients with pancreatic cancer after radical surgery was formed through expert meeting method and preliminary test.2.Application of home nutrition management program in patients with pancreatic cancer after radical surgery: convenience sampling method was used to select 46 patients after radical resection of pancreatic cancer from January to June 2022(before the implementation of intervention measures)as the control group,and 48 patients after radical resection of pancreatic cancer from July 2022 to December 2022(after the implementation of intervention measures)as the experimental group.Patients in the control group were given routine health education before and after discharge,while patients in the intervention group were given home-based nutrition management program for patients after radical resection of pancreatic cancer on the basis of routine health education.The intervention lasted for 3months.Body weight measurement and biochemical indexes related to body weight nutrition were performed before discharge,1 month after discharge and 3 months after discharge respectively: The data of albumin,hemoglobin and total protein were collected and analyzed.Nutritional Risk Screening 2002(NRS2002)and Cancer Patients Quality of Life Scale(EORTCQLQ-C30)were used to evaluate the intervention effect of this program on the nutritional status and quality of life of patients discharged after radical pancreatic cancer surgery Results1.Establishment of home nutrition management program for patients with pancreatic cancer after radical surgery.(1)Results of semi-structured interview: Through data collation and analysis of semi-structured interviews with medical staff,patients after radical resection of pancreatic cancer and their caregivers,a total of five themes were extracted.From the aspect of medical staff,two themes were extracted:(1)pressure factors of clinical practice implementation.(2)Pressure factors of organization management.Three themes were identified for patients and their caregivers:(1)Dietary stress(2)desire for professional and continuous home nutrition guidance;(3)efforts to cope with nutritional problems.(2)Construction of preliminary scheme: A home-based nutrition management team was established,and the draft of the home-based nutrition management program was constructed after discussion by the research team through literature review and analysis,combined with the results of previous semi-structured interviews.(3)Results of the expert meeting: The draft of the home-based nutrition management program was demonstrated by the expert meeting method(the expert authority index was0.885).Experts suggested that the research team add individualized home nutrition management prescriptions.After the preliminary test confirmed the feasibility of the scheme,the final draft of the home nutrition management scheme was formed.2.Application effect of home nutrition management program for patients with pancreatic cancer after radical surgery.(1)The effects of home nutrition management program on body weight of patients:before discharge,the body weight of the two groups was similar,and the difference was not statistically significant(P(29)0.05);One month after discharge,the body weight of the intervention group(57.75±5.42kg)was higher than that of the control group(56.12±6.13kg),but the difference was not statistically significant(P=0.106).Three months after discharge,the body weight of the intervention group(56.06±5.28kg)was higher than that of the control group(55.53±6.23kg),with statistical significance(P<0.05).(2)Effects of home nutrition management program on nutrition-related indexes of patients:1)The effect of home nutrition management program on the albumin level of patients:before discharge,the albumin level of patients in two groups was similar,and the difference was not statistically significant(P(29)0.05);One month after discharge,the albumin level in the intervention group(34.14±4.30g/L)was higher than that in the control group(33.92±5.20g/L),but the difference was not statistically significant(P=0.840).Three months after discharge,the albumin level in the intervention group(36.56±7.23g/L)was higher than that in the control group(32.29±9.94g/L),with statistical significance(P<0.05).2)Effects of home nutrition management program on total protein level of patients:Before discharge,total protein level of patients in two groups was similar,and there was no statistical significance(P(29)0.05);One month after discharge,the total protein level in the intervention group(55.40±6.41g/L)was higher than that in the control group(55.63±6.85g/L),but the difference was not statistically significant(P=0.248).Three months after discharge,the total protein level of the intervention group(58.21±6.82g/L)was higher than that of the control group(54.32±6.00g/L),and the difference was statistically significant(P<0.05).(3)The effect of home nutrition management program on the risk of malnutrition: two groups of patients before discharge;The frequency of patients with 3 points was similar,but the difference was not statistically significant(P(29)0.05).Although patients in the intervention group 1 month after discharge.Patients with 3 scores(n=29,58%)were more than those in the control group(n=26,52%).3 months after discharge.3 patients(n=36,72%)were more than control group(n=29,58%),but there was no statistical significance(P(29)0.05).(4)The effect of home nutrition management program on the quality of life of patients.The quality of life system was evaluated using the European Tissue Quality of Life Measurement Scale for Cancer Research and Treatment(EORTCQLQ-C30).Before discharge,the health status scores and symptom scores of the two groups were similar,with no statistical significance(P(29)0.05).1)In terms of health scores,One month after discharge,the physical function,emotional function,cognitive function,social function and total health status in the intervention group(67.20±6.98,70.50±6.99,75.00±8.41,74.33±13.97,63.83±8.18)were higher than those in the control group(58.80±5.50,56.50±8).30,68.22±8.62,61.78±7.50,50.83±5.39),the differences were statistically significant(P<0.05).2)In terms of symptom score,one month after discharge,the fatigue score in the intervention group(42.39±10.59)was lower than that in the control group(53.11±6.47),the difference was statistically significant(P<0.05);The economic hardship score of the intervention group(34.00±21.81)was higher than that of the control group(24.66±17.57),and the difference was statistically significant(P<0.05).3)At 3 months after discharge,the role function,emotional function,cognitive function,social function and total health status in the intervention group(93.00±8.31,83.17±5.45,79.66±6.97,83.67±12.37,83.17±5.45)were higher than those in the control group(81.33±10.45,72.17±3).99,74.00±8.35,79.33±7.19,64.33±7.15)were statistically significant(P<0.05);4)3 months after discharge,the fatigue score of the intervention group(14.67±10.63)was lower than that of the control group(26.44±10.74),and the difference was statistically significant(P<0.05);The economic hardship score of the intervention group(25.33±14.38)was higher than that of the control group(16.00±16.82),and the difference was statistically significant(P<0.05).After comprehensive evaluation,the quality of life in the intervention group was significantly better than that in the control group.Conclusions1.Based on semi-structured interviews,literature review,research group discussion,expert meeting demonstration and preliminary experiment,this study established a home-based nutrition management program for patients after radical resection of pancreatic cancer,which has a good scientific quality.2.Through the implementation of scientific,personalized and accurate home nutrition management strategies for patients after radical resection of pancreatic cancer,the nutritional status of patients after radical resection of pancreatic cancer has been improved,helping patients to establish an active lifestyle and improving the quality of life of cancer patients. |
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