Nutrition Education And Nursing Program Based On Trans-theoretical Model In Application Of Chemotherapy In Patients With Lung Cancer

Objective:Based on the trans-theoretical model,the nursing plan of nutrition education for patients with lung cancer chemotherapy was developed and its effect on patients with lung cancer chemotherapy was evaluated,providing new ideas and references for clinical health education.Methods:A total of 78 lung cancer chemotherapy patients who met the inclusion and exclusion criteria in the oncology department of a Grade-III hospital in Shanxi Province from July to December 2022 were selected as the study objects by convenience sampling method.The patients were divided into control group and intervention group by coin toss.The control group received conventional nutrition education,and the intervention group received nutrition education based on trans-theoretical model.After a total of 3 months of intervention,the behavioral change stage,subjective overall nutritional status of cancer patients,nutritional knowledge and practice level of cancer chemotherapy patients,general self-efficacy and quality of life of cancer patients were compared between the two groups before intervention,one month after intervention and three months after intervention.Results:(1)A total of 78 patients were included in this study,three cases fell off during the study,and 75 patients finally completed the study.(2)Before intervention,there was no difference in the data between the two groups(P>0.05).(3)Comparison of subjective global nutrition assessment table in tumor patients:Before intervention,there was no significant difference in scores between the two groups(P>0.05).After 1 month of intervention,there was no statistical significance in the nutritional status of the two groups(P>0.05).After 3 months of intervention,the nutritional status of the two groups was compared,and the score of the intervention group was lower than that of the control group,with significant difference(P<0.001).The results of repeated measurement analysis of variance showed that the time effect,intergroup effect and interaction were statistically significant(P<0.05).Pairwise comparison within the group:There was no statistical significance between the intervention group and the control group except the score difference at T1 and T2 time points(P>0.05),and the score difference between the other pairwise pairs was statistically significant(P<0.05).(4)Comparison of nutritional knowledge and practice questionnaire scores in patients with malignant tumor chemotherapy: Before intervention,there was no statistical significance in the nutritional knowledge,nutritional attitude,nutritional behavior and total score between the two groups(P>0.05);After 1 month and 3 months of intervention,the scores of the intervention group were higher than those of the control group,and the difference was statistically significant(P<0.05).The total scores of nutritional knowledge and practice level in 2 groups were statistically significant in time effect,intergroup effect and interaction effect(P<0.05).Pairwise comparison within the group:there were statistically significant differences in scores between the two groups in pairwise comparison(P<0.05).(5)Comparison of general self-efficacy scores: Before intervention,there was no statistical significance in total scores between the two groups(P>0.05);After 1 month and 3 months of intervention,the score of the intervention group was better than that of the control group,with significant difference(P<0.001).The timing,intergroup effect and interaction of GSES scores in the two groups were statistically significant(P<0.05).Pairwise comparison within the group: there were statistically significant differences in scores between the two groups(P<0.05).(6)Comparison of quality of life assessment of cancer patients: Before intervention,there was no statistical significance in scores of all dimensions of quality of life between the two groups(P>0.05);Although there was no significant difference in the scores of 13 mixed items such as body,emotion,social function,fatigue,pain,shortness of breath,insomnia,loss of appetite,and economic difficulties between the two groups after 1month of intervention(P>0.05),there were statistically significant differences in the scores of 2 symptom items such as constipation and diarrhea(P<0.05).After 3 months of intervention,the two groups of patients had different scores except for other items Except for no statistical significance(P>0.05),there were statistically significant differences in the scores of body,nausea and vomiting,decreased appetite,constipation and diarrhea(P<0.05).The functional dimension of EORTC QLQ-C30,overall health status and symptom dimension were statistically significant in time,intergroup effect and interaction between the two groups(P<0.05).Pairings within groups: there were statistically significant differences in body,social function,decreased appetite,nausea and vomiting,constipation and diarrhea in the intervention group at T1 and T2(P<0.05),but no statistically significant differences in other scores(P>0.05).At T1 and T3,there were no significant differences in scores of emotional function,shortness of breath and insomnia(P>0.05),but there were significant differences in scores of other items(P<0.05).There were no significant differences in scores of cognition,emotional function,shortness of breath,insomnia and constipation at T2 and T3(P>0.05),while there were significant differences in scores of other items(P<0.05).There was no significant difference in scores of other items at T1 and T2 in the control group except for nausea,vomiting and pain(P<0.05).At T1 and T3,there were no statistically significant differences in the scores of general health status,shortness of breath,decreased appetite,constipation and diarrhea(P>0.05),but there were statistically significant differences in the scores of other items(P<0.05).There were no significant differences in the scores of body function,shortness of breath,insomnia and decreased appetite at T2 and T3(P>0.05),but there were significant differences in the scores of other items(P<0.05).(7)Comparison of behavioral stages: there was no statistically significant difference between the two groups before intervention(P>0.05),but there was statistically significant difference between the two groups after 1 month and 3 months of intervention(P<0.05).Conclusion:The nutrition education and nursing program based on the trans-theoretical model can improve the nutritional knowledge and practice level of patients with lung cancer chemotherapy,and achieve the purpose of improving the nutritional status,but the short-term nutritional status improvement is slightly not significant.It can promote patient behavior initiative,help patients change from the initial stage to the action or maintenance stage,and better improve self-efficacy.There was an overall effect on the quality of life,but no improvement on the emotional function of patients.