| Objective:1.In the early stage of this study,a semi-structured interview was conducted on lung cancer chemotherapy patients to clarify their understanding of gastrointestinal symptoms and their demand and suggestions for a We Chat management platform for gastrointestinal symptom groups.2.Based on the theory of symptom management,by reading relevant literature at home and abroad and conducting semi-structured interviews with lung cancer chemotherapy patients,we extract and analyze their digestive tract symptom group information management needs,and construct an evidence-based digestive tract symptom group information management plan for lung cancer chemotherapy patients.Through relevant module theme education,we provide professional information acquisition channels and medical information guidance platforms for them,And verify the effectiveness of this intervention plan on patient self-efficacy and symptom burden,explore more effective and standardized medical care service models,improve the quality and job satisfaction of medical care services,and provide reference for remote management of lung cancer chemotherapy patients.Methods:1.Part Ⅰ: Analysis of the management needs of the digestive tract symptom cluster of lung cancer patients undergoing chemotherapy: Using the objective sampling method,16 lung cancer patients receiving chemotherapy in the respiratory department of a third grade-A hospital in a city from October to November 2021 were selected as the research objects,and semi-structured in-depth interviews were conducted,and phenomenology analysis was used for data analysis.Explore the needs of lung cancer chemotherapy patients for the gastrointestinal symptom group information platform and the information acquisition needs of nutritional diet,providing reference for the construction of later intervention plans.2.Part Ⅱ : Module content and intervention implementation of We Chat platform: Convenient sampling method was used to select lung cancer chemotherapy patients in the respiratory department of a tertiary hospital in Jiangxi from April 2022 to December 2022 as the research subjects,with 42 cases in the experimental group and 42 cases in the control group.The control group received routine care,while the experimental group established a nursing team for the digestive tract symptom group information management platform for lung cancer chemotherapy patients based on it.The digestive tract symptom group information management plan was implemented,which was determined by group experts through discussion and was practical and effective.It can expand the patient’s access to information and improve the cognitive level of symptom groups.Relying on the department’s wechat public account +popular science management small assistant(Small procedures)to build the management content of digestive tract symptom group,regularly push text and video popular science and diet management knowledge,and output symptom group management information.The duration of intervention was 8 weeks.The primary outcome measures were symptom burden and self-management efficacy,while the secondary outcome measures were nutritional risk level,quality of life for lung cancer,and nursing job satisfaction.Use SPSS 25.0 software to conduct statistical analysis of the data.Results:1.Part Ⅰ: Through the interview of 16 patients with lung cancer treated with chemotherapy,the information management needs of digestive tract symptom group were explored in depth,and three topics were summarized,the results showed that the patients with lung cancer who received chemotherapy generally had symptoms of digestive tract but lacked multi-channel positive behavior,and the patients with lung cancer who received chemotherapy had a high demand for information management platform of digestive tract symptom group When the patients with lung cancer have digestive tract discomfort,they need more information about nutrition and diet.2.Part Ⅱ:(1)The research team carries out the information management of digestive tract symptom groups through the department’s We Chat official account+science popularization management assistant.The module content includes four main modules: homepage,article push,video sharing,and personal information.Each main module corresponds to other modules below.Patients can self manage and obtain corresponding health and dietary nutrition knowledge according to their needs.(2)comparison of the general data of the two groups: the baseline data of the two groups were compared.The results showed that there was no significant difference in the baseline data between the two groups(P > 0.05).(3)①comparison of nutritional risk score between two groupsBefore and after intervention,there was no significant difference in the nutritional risk score of the control group(P > 0.05),but there was significant difference in the nutritional risk score of the intervention group(P > 0.05).There was no significant difference in nutrition risk score between groups after intervention(P > 0.05).②comparison of the scores of symptom assessment scale between the two groupsBefore and after intervention,there were significant differences in the total score and the scores of each dimension between the two groups(p < 0.05).After intervention,there were significant differences in the total score of Scl-90 and the score of the disturbance of daily life between groups(p < 0.05),there was no significant difference(P > 0.05).③comparison of the scores of quality of life scale for lung cancer between the two groupsBefore and after intervention,the total scores,physiological dimensions,social and family dimensions and functional dimensions of quality of life scale in the control group were significantly different(p < 0.05),there was no significant difference between the two groups in the scores of emotional dimension and additional condition dimension(p > 0.05),but the total scores of Qol and scores of each dimension in the intervention group were significantly different,the difference was statistically significant(p < 0.05).After intervention,there were significant differences in the total scores,social and family dimensions,emotional dimensions,functional dimensions and additional dimensions between the two groups(p < 0.05)There was no significant difference in scores of physiological dimensions between groups(P > 0.05).④comparison of the scores of self-management efficacy scale between the two groupsBefore and after intervention,the total scores of self-management efficacy scale,self-decompression and positive attitude in the control group were significantly different(p < 0.05),there was no significant difference between the two groups(P >0.05),but there was significant difference between the intervention group and the control group(p < 0.05)After intervention,the total scores and the scores of each dimension of the self-management efficacy scale were significantly different between groups(p <0.05).⑤comparison of nursing satisfaction scores between the two groupsAfter intervention,the scores of nursing job satisfaction and the scores of each dimension were significantly different between groups(p < 0.05).Conclusions:Lung cancer chemotherapy patients lack health awareness of gastrointestinal symptom group information,and due to the impact of disease treatment and spatial time,they lack proactive self-management behavior,which seriously affects their quality of life.This study obtained the management needs of patients’ gastrointestinal symptom group through qualitative interviews and proposed targeted solutions,In the hope that medical staff can accurately evaluate patients’ cognitive status of digestive tract symptoms and dietary and nutritional management needs in medical practice,achieve scientific management,improve patients’ self-management level,and reduce the burden of patients’ symptoms.Most of the patients lack the access to knowledge of symptom management,and they are optimistic about wechat management platform.Some of them put forward suggestions on the form and function of wechat management platform,according to the qualitative research results and referring to the literature at home and abroad,the management module of digestive tract symptom group based on wechat platform was constructed and applied to clinical practice,the scheme of intervention group can significantly improve the symptom burden and self-management efficacy of lung cancer patients undergoing chemotherapy,and the patients in the intervention group are more satisfied with the content of each module of wechat platform and have higher satisfaction with nursing as a whole.Meeting the health management needs of patients with digestive tract symptoms through We Chat platform proves the effectiveness of this plan in improving the self-management efficiency of such populations and reducing the burden of symptoms,providing practical reference for the management of digestive tract symptoms in lung cancer chemotherapy patients. |
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