TTM-Based Self-Nutrition Management Program Applied To Advanced Gastric Cancer Patients Received Chemotherapy

Objective(s):(1)To construct a self-nutrition management program based on literature research and Expert Meeting method.(2)To investigate the effect of self-nutrition management program based on TTM and provide guidance for advanced gastric cancer patients received chemotherapy.Methods:(1)The preliminary self-nutrition management program was established based on systematically reviewed articles about nutrition management in advanced gastric cancer patients.Appraisal of the selected literature was done using appropriate quality evaluation methods and the contents of literature was extracted.Then the first draft of the intervention plan was formed.9 experts took part in Expert Meeting Method to revise the first draft.(2)Used the quasi-experimental research method,59 cases with advanced gastric cancer hospitalized in our hospital from June to November 2022 were selected.According to the order of enrollment time,all the patients from June to August 2022 were divided into the control group(n=29),and the patients admitted from September to November 2022 were divided into the study group(n=30).The control group was given routine nursing care while the study group was given TTM-Based self-nutrition management program.The differences of behavior,self-management efficacy,PG-SGA score,QLO-STO22 score,blood biochemical indexes(albumin,prealbumin,total protein,hemoglobin)and anthropometric indexes(triceps skinfold thickness,upper arm circumference,lower leg circumference,grip strength)were compared before intervention,1,3 months after intervention.Results:(1)The coefficient of expert meeting method is 0.90,the coefficient of familiarity is 0.81,and the authoritative coefficient of expert familiarity is 0.855.The final draft of self-nutrition management program for patients with advanced gastric cancer received chemotherapy included 4 first-level items,21 second-level items and35 third-level items.(2)There were no significant differences in general information,population distribution at behavioral change stage,PG-SGA score,self-management efficacy,QLO-STO22 score,blood biochemical indexes(albumin,prealbumin,total protein,hemoglobin),and anthropometric indexes(triceps skin pleat thickness,upper arm circumference,calf circumference,and grip strength)between 2 groups(P > 0.05).The data of the two groups were comparable.(3)Behavioral change stage: After 1 month,there was no significant difference between the two groups in population distribution at behavioral change stage(P >0.05).After 3 month intervention,there was significant difference in the number distribution of patients in behavioral change stage between the two groups(P < 0.05).(4)Self-management efficacy score: After 1 month intervention,there was no significant difference in self-management efficacy score between the 2 groups(P >0.05).After 3 months intervention,the self-management efficacy score of the control group was lower than that of the study group,and the difference was statistically significant(P < 0.05).(5)PG-SGA score: After 1 month intervention,there was no statistical significance in PG-SGA score between the 2 groups(P > 0.05).After 3 months intervention,PG-SGA score in the control group was higher than that in the study group,and the difference was statistically significant(P < 0.05).(6)QLO-STO22 score: After 1 month intervention,there was no significant difference in the quality of life between the two groups(P > 0.05).After 3 months intervention,the quality of life in the control group was lower than that in the study group,and the difference was statistically significant(P < 0.05).(7)Blood biochemical indexes: There was no significant difference in blood biochemical indexes(albumin,prealbumin,total protein and hemoglobin)between the two groups after 1,3 months intervention(all P> 0.05).(8)Anthropological indicators: there was no significant difference in Anthropological indicators(weight,triceps skin-fold thickness,upper arm circumference,calf circumference and handgrip strength)between the two groups after 1,3 month intervention(all P> 0.05).Conclusion(s):(1)The nutrition management program based on literature research and expert meeting method is scientific and practical,can be used to guide the self-nutrition management of patients with advanced gastric cancer received chemotherapy.(2)TTM-Based Self-nutrition management program can help advanced gastric cancer patients to develop healthy behavior habits,improve their self-management efficacy and quality of life,and thus better improve their self-nutrition management ability.