"H2H" Nutrition Management Model Based On Internet Platform Application And Research Of Chemotherapy In Patients With Colorectal Cancer Chinese Abstract

Objective:1.To investigate the current nutritional status and nutritional support of colorectal cancer chemotherapy patients,and to provide scientific basis for the implementation of "H2H" nutritional management based on the Internet platform.2.Based on the current situation,we will implement the intervention of "H2H" nutrition management model based on Internet platform for colorectal cancer chemotherapy patients to explore its effects on patients’ nutrition status,quality of life,satisfaction and adherence.3.To understand the impact of the Internet-based "H2H" nutrition management model on colorectal cancer chemotherapy patients,primary caregivers and nutrition management team members,and to provide a reference basis for the subsequent development of patientand primary caregiver-centered "H2H" nutrition management.This study will provide a reference for better implementation of patient-and primary caregiver-centered nutrition management.Method:1.Current situation surveyA convenience sampling method was used to select colorectal cancer chemotherapy patients who were hospitalized in the Department of Medical Oncology of a tertiary hospital in Shanxi Province from November 2021 to March 2022 as the survey subjects,using the general information questionnaire,anthropometric indicators,laboratory indicators,patient subjective overall nutritional assessment(PG-SGA)and nutritional support modalities designed by the investigator as the survey tools to investigate 135 colorectal cancer chemotherapy patients.The survey was conducted to understand the nutritional status and support of patients undergoing chemotherapy for colorectal cancer,and to provide reference for the next application of "H2H" nutritional management.2.Empirical researchUsing the purposive sampling method,74 patients with colorectal cancer chemotherapy who were hospitalized in the Department of Medical Oncology of a tertiary hospital in Shanxi Province from March to October 2022 were selected as the study subjects,and according to the ward where the patients were admitted,patients in the first ward of the Department of Medical Oncology were considered as the intervention group and patients in the second ward were considered as the control group,37 cases each.In the control group,conventional nutrition management was implemented,while in the intervention group,the "H2H" nutrition management model based on the Internet platform was implemented on top of conventional nutrition management for 3 chemotherapy cycles.The anthropometric indexes(weight,BMI),laboratory indexes(serum albumin,prealbumin,hemoglobin),subjective global patient assessment scale(PG-SGA),quality of life scale(EORTC QLQ-C30)Chinese version,patient satisfaction questionnaire and patient compliance were used to compare the nutritional status,quality of life,satisfaction and compliance scores of patients in both groups.The data were statistically analyzed by t-test,chi-square test and Z-test,and the test level α=0.05,and P<0.05 was considered statistically significant difference.3.Qualitative researchA descriptive phenomenological study was used to purposefully select 13 patients receiving nutritional management,5 primary caregivers,and 5 members of the nutritional management team for one-on-one semi-structured interviews,using the Colaizzi seven-step analysis method to distill themes.Results:1.71.85% of 135 colorectal cancer chemotherapy patients had malnutrition,of which34.81% had mild/suspected malnutrition,21.48% had moderate malnutrition,and 5.56%had severe malnutrition.The rate of nutritional support for patients was low,only 45.93%,and in terms of nutritional support modalities,25.19% of patients received oral nutritional supplementation and 9.63% received enteral nutrition,mainly enteral nutrition.2.The results of the class experimental study showed that(1)The samples of control and intervention groups shed a total of 4 cases,and 37 patients were included in each of the two groups.(2)Before the intervention,the general demographic data,nutritional status[anthropometric indicators(weight,BMI),laboratory indicators(serum albumin,prealbumin,hemoglobin),subjective overall patient assessment(PG-SGA)],and quality of life of colorectal cancer patients in the two groups were compared,and the differences were not statistically significant(P > 0.05).(3)After 3 chemotherapy cycles of intervention,there were statistically significant differences(P < 0.05)in the comparison of nutritional status [anthropometric indicators(weight,BMI),laboratory indicators(serum albumin,prealbumin,hemoglobin),subjective overall patient assessment(PG-SGA)],quality of life,patient satisfaction and compliance between the two groups.3.The results of the qualitative study showed that a total of 23 interviewees were included in this study,and the interview data were summarized and refined into 4 themes,11 sub-themes,namely,impact on patients themselves,impact on primary caregivers,impact on nutrition management team members,and areas for improvement,corresponding to the sub-themes of improving nutrition awareness,changing self-concept,and improving psychological status;increasing nutrition care knowledge,improving nutrition care The sub-themes are to increase nutrition awareness,change self-concept,and improve psychological status;increase nutrition care knowledge,improve nutrition care behavior,and reduce the burden of nutrition care;promote self-efficacy and perceive the burden of platform management;combine symptom management and psychological intervention,fully link with community medical care,and accelerate the improvement and promotion of Internet platform.Conclusion:1.This study showed that the incidence of malnutrition in colorectal cancer chemotherapy patients was high,reaching 71.85%.And the nutritional support rate is low,only 45.93%.2.The "H2H" nutrition management model based on the Internet platform can improve the nutritional status of colorectal cancer chemotherapy patients,improve their quality of life,satisfaction and patient compliance.3.The "H2H" nutrition management model based on the Internet platform not only has a positive impact on patients,but also helps to improve the nutrition awareness and ability of patients and their primary caregivers,reduce the care burden of primary caregivers,and improve the ability of nutrition management team members.