| Objective1.To explore the effect of group visits on nutritional status and quality of life of gastric cancer patients by implementing group visits strategy for gastric cancer patients in the intervention group.2.Through this study,an intervention program was established to improve the nutritional status and quality of life of patients with gastric cancer,and a new health education model was established.Method1.Gastric cancer patients admitted to the first and second ward of gastrointestinal surgery department of The First Affiliated Hospital of Zhengzhou University from August 2017 to November 2018 were selected.Patients admitted to the first ward of gastrointestinal surgery were divided into control group and patients admitted to the second ward of gastrointestinal surgery were divided into control group.2.The control group implemented routine nursing,and the intervention group implemented group visits on the basis of routine nursing,including group visits in the hospital and WeChat group outside the hospital,to explain relevant knowledge of disease and rehabilitation to patients.3.The nutritional status and quality of life of patients were evaluated and monitored by general information questionnaire,subjective overall nutritional status assessment scale of patients(PG-SGA),nutritional knowledge,attitude and behavior questionnaire of patients with digestive system cancer(KAP),quality of life scale of patients with gastric cancer(QLQ-STO22),nutrition-related indicators and complications.Patients were followed up and questionnaires were filled out before surgery,before discharge,1 month after discharge and 3 months after discharge,and data collection was completed.Result1.A total of 79 patients were included in this study,including 40 patients in the intervention group and 39 patients in the control group.Two groups of patients with general data show that the average age of the patients was 55.18±5.474 years old.Male patients accounted for about 60.8%(48/79).The junior middle school and the following education accounts for about 54.4% of patients(43/79).Disease in phase Ⅰ accounted for about 10.1% of the patients(8/79),Ⅱ period accounted for about 44.3% of patients(35/79),Ⅲ period accounted for about 45.6% of patients(36/79).Surgical procedure for patients with stomach full cut accounted for about 26.58%(21/79).About 40.51%(32/79)of the patients received the first chemotherapy(oxaliplatin,5-fluorouracil,calcium folic acid),and 59.49%(47/79)of the patients received the second chemotherapy(oxaliplatin,giorgio).Patients who had meals three times a day accounted for about 77.2%(61/79),and patients who had meals actively accounted for about 67.1%(53/79).T test,rank sum test and χ2 test were used to compare the general data of patients in the two groups and the differences were not statistically significant(P>0.05).2.The PG-SGA scores of the intervention group and the control group were: preoperative(7.00±1.78 vs 6.67±1.03,P>0.05)and before discharge(6.38±1.23 vs 6.28±1.24,P>0.05).There was no significant difference in scores.One month after discharge(3.70±0.69 vs 4.05±0.86,P<0.05),3 months after discharge(4.25±0.90 vs 5.13±0.80,P<0.05),the difference was statistically significant.The time effect of PG-SGA score was statistically significant(P < 0.001);the grouping effect was statistically significant(P < 0.001);there was an interaction between time effect and grouping effect(P < 0.05).3.Nutrition-related indicators in the intervention group and the control group: hemoglobin:before surgery(118.73±9.13 vs 121.85±9.47)g/L,P>0.05.The difference was not statistically significant.Before discharge(102.50±6.73 vs 98.92±4.81)g/L,P<0.05.One month after discharge(115.75±7.30 vs 110.49±6.54)g/L,P<0.05.3 months after discharge(105.90±7.51 vs 101.44±5.62)g/L,P<0.05.The difference was statistically significant.Albumin:before surgery(36.09±4.88 vs 35.47±4.69)g/L,P>0.05.The difference was not statistically significant.Before discharge(30.94±5.12 vs 28.00±4.82)g/L,P<0.05.One month after discharge(38.99±5.02 vs 35.91±4.62)g/L,P<0.05.3 months after discharge(34.54±5.65 vs 31.32±4.59)g/L,P<0.05.The difference was statistically significant.Total protein: before surgery(56.17±6.07 vs 56.44±5.47)g/L,P>0.05.Before discharge(46.43±5.73 vs 44.99±5.29)g/L,P>0.05.The difference was not statistically significant.1 month after discharged(57.68±7.83 vs 54.10±6.46)g/L,P<0.05.3 months after discharge(53.31±6.88 vs 48.28±6.49)g/L,P<0.05.The difference was statistically significant.The number of malnourished cases was 19 in the preoperative intervention group and 21 in the control group,25 patients in the intervention group before discharge and 26 in the control group,8 patients in the intervention group at 1 month after discharge and 14 patients in the control group.13 patients in the intervention group and 20 patients in the control group at 3 months after discharge.The difference was not statistically significant(P>0.05).4.The incidence of complications in the two groups was a total of 4 cases in the intervention group,including 2 cases of gastric emptying disorder,1 case of incision infection and 1 case of postoperative bleeding.A total of 9 cases occurred in the control group,including 3 cases of gastric emptying disorder,2 cases of incision infection,1 case of urinary tract infection,1 case of anastomotic fistula,1 case of pulmonary infection and 1 case of postoperative bleeding.χ2 test was used to compare the complications between the two groups,and it was found that the difference was not statistically significant(P>0.05).5.The results of nutrition knowledge,attitude and behavior questionnaires in the intervention group and the control group showed that the total score of the questionnaire before operation was(35.53±10.80 vs 36.21±9.69,P>0.05).The knowledge dimension was(6.83±2.98 vs 7.05±2.98,P>0.05).The attitude dimension was(12.45±3.83 vs 12.54±3.17,P>0.05).The behavioral dimension was(16.25±4.24 vs 16.62±4.00,P>0.05).The difference was not statistically significant.The total questionnaire in 3 months after discharge was(49.58±10.20 vs 43.67±10.07,P<0.05).The knowledge dimension was(11.28±2.52 vs 9.26±3.43,P<0.05).The attitude dimension was(15.00±3.64 vs 13.36±3.51,P<0.05).The behavioral dimension was(23.30±5.35 vs 21.05±4.08,P<0.05),and the differences were statistically significant.6.The scores of the quality of life questionnaires in the intervention group and the control group were:(39.95±15.97 vs 43.38±16.01,P>0.05)before the operation,and(42.62±16.83 vs 47.45±17.09,P>0.05)before discharge.The scores were not statistically different.After 1 month of discharge(29.68±11.67 vs 35.97±15.45,P<0.05).3 months after discharge(25.78±11.52 vs 32.05±14.80,P<0.05),the difference was statistically significant.The time-effect of patients’ quality of life scores was statistically significant(P < 0.001);grouping effect was statistically significant between group(P < 0.001);interaction between time effect and grouping effect(P < 0.001).7.The dimensions in the two groups of patients before surgery had no difference(P>0.05).Before discharge in patients after the intervention,reflux symptoms and limited feeding symptoms exist differences between two groups(P<0.05).1 month after discharge from hospital,in addition to pain,body image,hair loss,the rest of the dimension differences were statistically significant(P<0.05).3 months after discharge from hospital,in addition to changes in taste,body image,the rest of the dimension differences were statistically significant(P < 0.05).Conclusion1.Compared with routine nursing,group visits can improve the nutritional status of patients with gastric cancer.The score of PG-SGA scale decreases,the level of hemoglobin,albumin and total protein increases,the number of related complications decreases,and the level of nutritional knowledge,attitude and behavior increases.2.Group visits can improve the quality of life of patients with gastric cancer,and symptoms of dysphagia,pain,reflux,restricted eating,anxiety,dry mouth,change in taste,body image,hair loss and other areas have been improved. |
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