| Objective:Based on the family nurse diet theory(FNDT),a set of local and universal family nurse diet plan was constructed.Through short-term intervention,the auxiliary effect of the program on weight loss and blood lipid regulation in patients with coronary heart disease and its influence on daily eating behavior were evaluated.Methods:This study took FNDT as the framework,improved the Mediterranean diet strategy,systematically reviewed,collated and analyzed relevant literature by using literature research method,and obtained the research progress of nutritional support treatment and nursing of CHD,obesity and dyslipidemia as well as the effects of Tartary buckwheat on reducing the "three high",regulating metabolism,antioxidant and anti-inflammatory,etc.,which laid the knowledge foundation for the construction of diet regimen.After three rounds of expert meetings and team brainstorming,the content of the scheme was modified and improved to ensure the scientific nature of the scheme.Before the intervention,the subjects and their agents were informed of the plan in detail in the form of wechat video,and the plan was experimented for 1 week,so as to understand the demands of the subjects,modify the plan according to the actual situation,and develop a personalized diet nursing plan to ensure the applicability of the plan.Finally,according to the principle of randomization and assignment concealment,72 subjects were divided equally into diet group and Tartary buckwheat group for mutual control.After 6 weeks of intervention,the four indexes of blood lipids and body weight of the subjects were observed to evaluate the therapeutic effect.t test,2 test or rank sum test were performed by SPSS 26.0 software.Results:1.Construction of the protocol: The framework and basic content of the program were preliminarily formulated through the literature research method and the expert meeting method.Clinical dietitians,physicians with senior titles in cardiovascular medicine and clinical nursing experts discussed the draft plan,and put forward predictions and doubts.The researchers integrated the contents of the meeting based on evidence and opinions,and finally formed a family nurse diet program with a total of 26 items including 4 items such as diet principles,calculation methods,implementation process and meal list guidance.All the experts were present at the three rounds of meetings,and the positive degree of experts was high,Cr=0.83,and the research results were reliable.2.Empirical evidence of the scheme:(1)There was no significant difference in baseline body mass index between the two groups(P > 0.05).Comparison within the6-week intervention group: Body weight of subjects in both groups decreased to different degrees,with statistical difference(P < 0.05).After 6 weeks of intervention,the weight loss in diet + Tartary buckwheat group was significantly higher than that in Tartary buckwheat group(3.52 kg and 1.00kg),and the difference was statistically significant(P < 0.05).(2)There was no significant difference in baseline blood biochemical indexes between the two groups(P > 0.05).Comparison within the 6-week intervention group: serum triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FPG),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)of subjects in 2 groups were decreased to different degrees,with statistical differences(P < 0.05);High density lipoprotein cholesterol(HDL-C),blood urea nitrogen(BUN),serum creatinine(Scr)and serum uric acid(UA)were decreased in diet + Tartary buckwheat group,and there were statistical differences(P < 0.05).There were statistical differences in HDL-C increase in Tartary buckwheat group(P < 0.05),but there were no statistical differences in BUN,Scr and UA levels(P > 0.05).After 6 weeks of intervention,the reduction of serum TG in diet + Tartary buckwheat group was better than that in Tartary buckwheat group(0.53mmol/L and 0.14mmol/L),and the difference was statistically significant(P < 0.05).The serum HDL-C increase effect of Tartary buckwheat group was better than that of diet + Tartary buckwheat group(0.06mmol/L and-0.08mmol/L),and the difference was statistically significant(P < 0.05).There were no significant differences in the levels of FPG,ALT,AST,BUN,Scr and UA between 2 groups(P > 0.05).(3)There were no significant differences in daily dietary energy and main nutrients intake between the two groups at baseline(P > 0.05).After 6 weeks of intervention,the intake of dietary energy and carbohydrate in diet +Tartary buckwheat group was significantly decreased,and the intake of protein was increased,with statistical differences(P < 0.05),but there was no statistical difference in fat intake(P > 0.05).There were no significant differences in dietary energy and nutrient intake in Tartary buckwheat groups(P > 0.05).Comparison between groups after 6 weeks of intervention: there were statistically significant differences in daily intake of dietary energy,protein and carbohydrate between the two groups(P < 0.05).There was no significant difference in fat intake(P > 0.05).The subjects in diet + Tartary buckwheat group had a high overall dietary compliance(78.13%).Visual simulation score showed that 6-week diet could guarantee moderate satiety,tolerable mild hunger 2 hours after meals,and basic dietary satisfaction.Conclusion:In this study,under the guidance of FNDT,a set of universal family nurse diet program for north China residents was proposed.The scheme is simple and practicable,and the subjects have good compliance.A 6-week single-blind randomized controlled trial confirmed that the regimen was more effective in reducing body weight and serum TG in patients with CHD and had a positive effect on dietary behavior in patients with CHD.The successful practice of the scheme verifies the applicability and effectiveness of FNDT and can be used to guide nursing practice.Follow-up studies can increase the sample size and prolong the intervention time to observe the long-term effects of family nurse diet on CHD metabolism. |
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