An Action Study In Diet Management Of Patients With Liver Cirrhosis Based On Experience-based Co-design

Objectives1.Understand the current status of dietary compliance of patients with liver cirrhosis,and conduct qualitative interviews with patients with poor dietary compliance with liver cirrhosis,and further analyze the factors that affect patients’ dietary compliance,and provide realistic basis for follow-up research.2.Explore the application effect of diet management based on Experience-based Co-design on patients with liver cirrhosis with poor dietary compliance,in order to improve the dietary compliance and self-management ability of patients,improve their nutritional status,improve their self-efficacy and quality of life.MethodsThis study is divided into three parts:1.Survey of dietary compliance status of patients with liver cirrhosisFrom April 2019 to May 2019,a self-designed dietary compliance questionnaire for patients with liver cirrhosis was used to interview 120 patients with liver cirrhosis who were admitted to the Department of Infectious Diseases of a tertiary hospital in Suzhou.The status of dietary compliance of patients with cirrhosis was investigated to understand the status of dietary compliance scores of patients with liver cirrhosis,and single factor analysis and multiple stepwise linear regression analysis were used to analyze the factors affecting dietary compliance of patients with liver cirrhosis.2.A qualitative study on the factors affecting poor dietary compliance in patients with liver cirrhosisFrom May 2019 to June 2019,using the method of purpose sampling,a semi-structured interview was conducted for patients with liver cirrhosis who were admitted to the Department of Infectious Diseases of a tertiary hospital in Suzhou with poor dietary compliance,and analyzed the interview data according to the Colaizzi analysis method.Refine topics related to factors affecting dietary compliance in patients with liver cirrhosis.3.An action research on the dietary management of patients with liver cirrhosis based on Experience-based Co-designConvenience sampling was used to select 60 patients with liver cirrhosis with poor dietary compliance who were admitted from June to October 2019 in a tertiary hospital in Suzhou City,of which 30 were admitted from June to July as the control group,and from September to October.Thirty people admitted to the hospital served as the intervention group.The control group implemented regular diet health education,and the intervention group adopted the experience-nursing-patient cooperation method to implement diet management.Through six stages including setting up a research team,focus discussion of the research group,patient group meeting,nurse-patient cooperation group meeting,practice and improvement,review and summary.Plan,act,observe,and reflect on dietary management,and compare the nutritional risk scores,self-management scores,self-efficacy scores,and dietary compliance scores of the two groups of patients at admission,one month after discharge,and three months after discharge.Results1.Survey of dietary compliance status of patients with liver cirrhosisThe dietary compliance of patients with liver cirrhosis is at a moderate level,and their compliance with dietary management methods is relatively poor,most patients are young and middle-aged rural men,high nutritional risk,decompensated liver cirrhosis,junior high school education,number of years of illness 11-15.The total dietary compliance scores of patients with liver cirrhosis have statistically significant differences in occupation,payment method,and Child-Pugh classification(P<0.05),and there were no statistical significance differences in age,gender,education level,diagnosis,years of illness,and RFH-NPT score.2.Qualitative study on the influencing factors of poor dietary compliance in patients with liver cirrhosisQualitative research has extracted three topics that affect poor dietary compliance in patients with liver cirrhosis:(1)insufficient or biased dietary awareness: including personal factors,erroneous experiences that have not yet triggered adverse outcomes,and self-defined dietary control standards;(2)negative dietary attitudes Emotional and emotional effects: including negative dietary adjustment attitudes and stigma;(3)insufficient self-efficacy: including the inability to integrate knowledge and behavior,lack of self-management initiative,temporary needs and special preferences.3.An action research on the dietary management of patients with liver cirrhosis based on Experience-based Co-designThe two groups of patients had no statistically significant differences in general information such as gender,age,occupation,payment method,education level,BMI value,liver disease course,hospitalization time,and past history(all P>0.05),and they were comparable.The nutritional risk score of the intervention group was lower than that of the control group at three months after discharge.The total score of self-management,diet management,daily life management,disease monitoring management,and self-management in the self-management ability of the intervention group for one month and three months after discharge Efficacy scores and diet compliance scores were higher than those of the control group,and the difference was statistically significant(both P<0.01);the nutrition risk scores of the intervention group were lower than those at admission,diet management dimensions,daily life The management dimensions,medication management dimensions,disease monitoring management dimensions,self-management total scores,self-efficacy and diet compliance scores were all higher than those at admission,and the difference was statistically significant(P<0.05).Conclusions1.The dietary compliance of patients with liver cirrhosis is at a moderate level,and its low compliance with dietary management methods is particularly prominent.Therefore,it is necessary to implement strategies to improve patients’ dietary compliance.2.There are many influencing factors that lead to poor dietary compliance in patients with liver cirrhosis,and individual differences are large.The nurse-patient cooperation model should be strengthened and scientific dietary management programs should be explored in order to improve the nutritional status of patients and improve the quality of life.3.Dietary management based on Experience-based Co-design can improve the dietary compliance of patients with liver cirrhosis with poor dietary compliance,improve their nutritional risk,self-management level and self-efficacy,and help patients enhance their health beliefs and adhere to healthy behaviors,improve the quality of life.