| Objective To observe the effect of fatty acid ratio based feedback method diet intervention on blood lipid level and quality of life in patients with hyperlipidemia,and to obtain feedback from participants on the process of nursing intervention.On this basis,the application effect of collaborative nursing combined with dietary intervention based on the feedback method of fatty acid proportion in patients with hyperlipidemia was further explored.Methods This study is divided into two parts.Part I: 66 patients with hyperlipidemia were selected from the endocrine outpatient department of a tertiary care hospital and various communities in Wuxi,and were divided into control group,intervention group and fatty acid intervention group.The control group received routine diet nursing for hyperlipidemia;The intervention group received feedback diet nursing;The fatty acid intervention group received a dietary intervention based on the proportion of fatty acids.The feedback method based on the proportion of fatty acids should try not to limit the fat intake of patients.n-3polyunsaturated fatty acid(n-3 PUFA)has the properties of inhibiting the synthesis of lipids and lipoproteins in the liver.In the protocol,patients were advised to give priority to n-3PUFA rich foods in their daily diet,reduce the ratio of n-6/n-3 PUFA in their diet,and use the feedback method for health education and diet management.The level of lipid metabolism and quality of life of the three groups were monitored at 0 and 2 months.At the end of the intervention,some patients were randomly selected to participate in the return visit.Part II: Through the analysis of the results of the first part of the study,it was found that there was a lack of family support in elderly patients with hyperlipidemia.The elderly patients had a particularly urgent need for family caregivers,so the researchers optimized the nursing program.The feedback method based on fatty acid ratio was used as a whole and combined with collaborative nursing model.Family members of patients were encouraged to participate in diet nursing together.Nursing staff provided multiple dietary guidance and health education for patients and their families through the feedback method based on fatty acid ratio,and jointly supervised and assisted the diet management of patients with their families,in order to better improve the lipid metabolism and quality of life of patients.A total of 116 patients with hyperlipidemia were selected from the endocrine outpatient department of a tertiary care hospital and various communities in Wuxi,and they were divided into routine group,collaborative group,optimized feedback group and combined nursing group by random number table method.The routine group received routine hyperlipidemia diet nursing.The collaborative group received collaborative care;The optimized feedback group received dietary intervention based on the fatty acid proportion feedback method.The combined nursing group received collaborative nursing combined with dietary guidance based on fatty acid proportion,emphasized the importance of shared nursing to family members,formulated dietary nursing intervention programs for patients,and let family members of patients assist in supervising dietary nursing to ensure patients’ daily intake of adequate n-3 PUFA.The lipid metabolism levels of the two groups were monitored at 0 and 2 months,respectively.the Mos36-item Short Form Health Survey(SF-36),Self-Rating Anxiety Scale(SAS)and diet compliance survey were used to evaluate the quality of life of patients.Results The results of the first part of the study showed as follows: 1.Baseline evaluation: the general information,anthropometric measurements and blood biochemical parameters of the control group,the intervention group and the fatty acid intervention group were basically the same before the intervention(0 month),and there were no statistically significant differences among the groups(P > 0.05).2.Anthropometric Index evaluation: After the intervention,all the anthropometric indexes in the intervention group and the fatty acid intervention group were lower than those in the control group,and the Body Mass Index(BMI)and body weight were significantly reduced compared with before the intervention(P < 0.05).3.Lipid metabolism indexes evaluation: After the intervention,the levels of total cholesterol(TC)and high density lipoprotein cholesterol(HDL-c)in the three groups were of statistical significance(P < 0.05).A pair-to-pair comparison between the intervention group and the fatty acid intervention group showed significant improvement in the HDL-c level of patients in the fatty acid intervention group(P < 0.05).4.Quality of life and anxiety scale evaluation: In terms of quality of life,all dimensions of quality of life in the three groups were improved to varying degrees after intervention,and scores of energy dimension and mental health dimension were significantly improved after intervention in the intervention group and optimal feedback method(P < 0.05).There was no statistical significance in the comparison of anxiety between groups(P > 0.05).5.Follow-up stage: 10 patients were interviewed,and the final results showed 3 themes and 8 sub-themes:(1)the negative effects of hyperlipidemia: physical discomfort,psychological pressure,and social activities;(2)Recognition of dietary intervention based on fatty acid response: good nursing experience,improvement of blood lipid and change of health behavior;(3)Problems existing in dietary intervention based on fatty acid feedback method and dietary care needs: insufficient popularity and convenience to be improved,hope to get assistance from family members,continuity of dietary care.The results of the second part of the study showed that: 1.Baseline evaluation: The basic information,anthropometry and blood biochemical indexes of the conventional group,the collaborative group,the optimal response group and the collaborative care group were basically the same at month 0,and there was no statistical difference between the groups(P> 0.05).2.Anthropometric Index evaluation: After the intervention,all the anthropometric indexes in the intervention group and the fatty acid intervention group were lower than those in the control group,and the Body Mass Index(BMI)and body weight were significantly reduced compared with before the intervention(P < 0.05),Body weight,BMI,and body Fat percentage(Fat mass,FM)were significantly improved in the combined care group in the intergroup comparison(P < 0.05).Factorial analysis showed that collaborative nursing combined with dietary intervention based on fatty acid ratio had no interaction on anthropometric indicators.3.Lipid metabolism index evaluation: After the intervention,the levels of TC,triglyceride(TG)and HDL-c in the four groups were statistically significant(P < 0.05).Compared with the combined nursing group,the TG and HDL-c levels of the collaborative group were statistically significant(P < 0.05),the TC level of the optimal response group was statistically significant compared with that of the combined nursing group(P < 0.05).The results of factorial analysis showed that collaborative nursing combined with dietary intervention based on fatty acid ratio feedback had an interactive effect on the changes of TC and TG concentrations(TG:P = 0.046,TC:P = 0.027).4.Quality of life and anxiety scale evaluation: After intervention,inter-group comparison showed that physiological function,energy dimension and total score improved(physiological function:P = 0.013,energy:P = 0.035,total score:P = 0.001),combined care significantly improved patients’ quality of life.The results of factorial analysis showed that the synergistic nursing combined with the dietary intervention based on fatty acid ratio had an interactive effect on the change value of quality of life score(P = 0.034).Anxiety was not statistically significant(P > 0.05).Conclusions1.The dietary feedback method based on fatty acid proportion can reduce the blood lipid level and improve the quality of life in patients with hyperlipidemia.2.The collaborative nursing combined with the response method based on the proportion of fatty acids further promoted the effect of dietary nursing on the improvement of lipid metabolism and quality of life in patients with hyperlipidemia,and improved the patients’ dietary control ability.3.This study combined nursing in patients with hyperlipidemia diet intervention,the scheme will be the first part of feedback method based on proportion of fatty acids diet intervention and collaborative nursing combination,encourage patients increased n-3 PUFA in diet intake,reduce the proportion of n-6 / n-3 PUFA,At the same time,the patient’s family support system was mobilized to assist clinical professionals to participate in the care.The results showed that the combined nursing diet intervention improved the blood lipid level of patients with hyperlipidemia on the one hand,improved the health awareness of patients on the other hand,consolidated the relationship between patients and family caregivers,and further enhanced the confidence of patients with hyperlipidemia in the treatment of diseases.Finally,the lipid metabolism,quality of life and nursing compliance of patients were improved. |
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