The Effect Of Nutritional Interventions Outside The Hospital On Nutritional Status And Life Quality Of The Patients With Gastric Cancer Having Received Gastrectomy

Objective: The study aims to investigate the effect of nutritional interventions,conducted out of hospital,on the nutritional status and life quality of patients recovering from gastrectomy,so as to provide scientific evidence for offering reasonable nutritional interventions to the patients by medical workers.Methods: 101 participants,having received gastrectomy,the operations for gastric cancer,were enrolled in the study.Simple randomization was adopted in the study,and participants were divided into control group(with regular guidance)and trial group(with individualized nutritional interventions)according to randomized digit table.Follow-up visits were conducted in both groups.Basic information of the patients was collected before their leaving hospital.Nutritional risk screening(NRS2002),Patient-Generated Subjective Global Assessment(PG-SGA),total protein(TP),albumin(ALB),prealbumin(PA),lymphocytes(LYM),hemoglobin(HB),height,body weight(BW),body mass index(BMI),mid-arm circumference(MAC),triceps skin-fold thickness(TSF),mid-arm muscle circumference(MAMC),European Organization for Research and Treatment of Cancer QLQ-C30(EORTC QLQ-C30),European Organization for Research and Treatment of Cancer QLQ-STO22(EORTC QLQ-STO22)were utilized to assess the nutritional status and life quality of the patients at different time,namely before discharge,after one months,two months and three months from discharge,and the analysis,based on the collected data,aimed to indicate the differences between the two groups at different time for data collection mentioned above.The enumeration data was analyzed by chi-square test.The normal measurement data was analyzed by independent sample t test and repeated measures anlysis of variance,but non-normal measurement data was analyzed byMann-Whitney U test and Friedman test.Results: 1.There is no statistical difference between the control group and trial group in age,gender,nationality,marriage,career,education or history of alcohol consumption,smoking,chronic diseases,allergy,as well as clinical stages(P>0.05).2.Assessment Result of NRS2002:The two groups patients of nutritional risks was reduced in the NRS2002 results and the patients with nutritional risks in the trial group was lower than those in control group after intervention,and the differences were statistically significant(P<0.05).3.Assessment Result of PG-SGA:The two groups patients that the degree of malnutrition was decreased in the PG-SGA results and the degree of malnutrition in the trial group was lower than those in control group after intervention,and the differences were statistically significant(P<0.05).4.Laboratory indexes: The total protein,albumin,prealbumin,total lymphocyte count,and hemoglobin,after intervention,raise in both control and trial group compared with those before intervention,and the difference is statistically significant(P<0.05).Meanwhile,it mentioned above tend to show a statistical significance in two groups after intervention(P<0.05),which trial group has higher than control group.5.Results of anthropometric measurement:The BMI,MAC,TSF and MAMC,after intervention,reduce in both control and trial group compared with those before intervention,and the difference is statistically significant(P<0.05).But,only BMI mentioned above tend to show a statistical significance in two groups after intervention(P<0.05),which trial group has higher than control group.6.Results of life quality:(1)Assessment Result of EORTC QLQ-C30(V3.0):The assessment scores of general health status,after intervention,raise in both control and trial group compared with those before intervention,and the difference is statistically significant(P<0.05).Meanwhile,the assessment scores mentioned above tend to show a statistical significance in two groups after intervention(P<0.05),which trial group has higher scores than control group.In addition,the assessment scores of physical function,role function,cognitive function,emotional function and social function,after intervention,raise in both control and trial group compared with those before intervention,and the difference is statistically significant(P < 0.05).Meanwhile,the assessment scores mentioned above tend to show a statisticalsignificance in two groups after intervention(P<0.05),which trial group has higher scores than control group.Moreover,the scores of exhaustion and pain tend to decline while the scores of nausea and vomiting increase in two groups after intervention from leaving hospital,which is statistically significant(P<0.05).Compared with those in control group,participants in trial group have lower scores in the assessment of exhaustion,pain,nausea and vomiting after intervention,and the difference was statistically significant except for the nausea and vomiting score after one month from discharge(P<0.05).Last but not the least,participants in both control group and trial group have lower scores of the conditions of breathlessness,insomnia,constipation,diarrhea and higher scores of the sufferings of anorexia and economic hardship after intervention,and the difference was statistically significant except for the insomnia and diarrhea score(P<0.05).When it comes to the comparison of two groups,the assessment scores of the conditions of breathlessness,anorexia,constipation,insomnia and diarrhea in trial group are lower than those in control group,while economic hardship of trial group are worse than control group.Only the difference of breathlessness and anorexia scores between the two groups after two month and three month from discharge is statistically significant(P<0.05).(2)Assessment Result of EORTC QLQ-STO22:The assessment scores of the conditions of dysphagia,pain,reflux symptoms,restrictions in eating,xerostomia and physical changes indicate a gradual decreasing of participants in both control group and trial group after interventions,while those of the conditions of anxiety and taste changes and hair loss increase in two groups,and the difference was statistically significant except for the xerostomia,hair loss and physical changes of control group score(P<0.05).The dysphagia,pain,reflux,eating disorders,anxiety,dry mouth,taste changes,body image,hair loss score were lower in trial group after discharge,but the differences were statistically significant except for dry mouth,body image,hair loss score,anxiety and taste change score one month after discharge(P<0.05).Conclusion: 1.Nutritional interventions conducted out of hospital can reduce the nutritional risk,malnutrition,and BMI reduction of patients recovering from gastrectomy.2.Nutritional interventions conducted out of hospital can boost the totalprotein,albumin,prealbumin,total lymphocyte count and hemoglobin of patients recovering from gastrectomy.3.Nutritional interventions conducted out of hospital can improve the life quality of the patients recovering from gastrectomy.