基于共享决策理念的健康教育联合个体化营养支持在肺癌根治术后康复中的应用  

Application of shared decision-making concept based health education combined with personalized nutritional support in the rehabilitation of lung cancer patients after radical surgery

作　　者：梁亭亭 顾磊[1] 羊波[1] 张萍[1] 夏文佳[2] Liang Tingting;Gu Lei;Yang Bo;Zhang Ping;Xia Wenjia(Department of Thoracic Surgery,Jiangsu Cancer Hospital,Nanjing Jiangsu 210009,China;Department of Thoracic Surgery,Cancer Hospital Affiliated to Nanjing Medical University,Nanjing Jiangsu 210009,China)

机构地区：[1]江苏省肿瘤医院胸外科,江苏南京210009 [2]南京医科大学附属肿瘤医院胸外科,江苏南京210009

出　　处：《中国医刊》2024年第4期460-463,共4页Chinese Journal of Medicine

基　　金：国家自然科学基金(81802907)。

摘　　要：目的探讨基于共享决策理念的健康教育联合个体化营养支持在肺癌根治术后康复中的应用效果。方法选取2022年1月至2023年1月在江苏省肿瘤医院接受肺癌根治术后康复治疗的患者430例,在组间基线特征可比的原则上,采用随机数字表法将其分为观察组和对照组,去除脱落病例后最终纳入观察组196例、对照组204例,共计400例患者。对照组在康复治疗过程中应用个体化营养支持,观察组在个体化营养支持的基础上联合应用基于共享决策理念的健康教育。比较康复治疗前及康复治疗3个月后两组患者肺功能指标、营养状况指标、自我管理效能和生活质量的差异。结果康复治疗前两组患者的第1秒用力呼气容积(FEV1)和用力肺活量(FVC)比较差异无统计学意义(P>0.05);康复治疗3个月后两组患者的FEV1和FVC均明显高于治疗前,且观察组明显高于对照组,差异有统计学意义(P<0.05)。康复治疗前两组患者的血红蛋白(Hb)、白蛋白(ALB)、总蛋白(TP)水平及癌症自我管理效能量表(SUPPH)评分比较差异无统计学意义(P>0.05);康复治疗3个月后两组患者的Hb、ALB、TP水平及SUPPH评分均明显高于治疗前,且观察组明显高于对照组,差异有统计学意义(P<0.05)。康复治疗前两组患者中文版癌症患者生命质量测定量表(EROTC-QLQ-C30)的情绪、认知、角色、躯体、社会功能维度得分比较差异无统计学意义(P>0.05);康复治疗3个月后两组患者EROTC-QLQ-C30量表各维度得分均明显高于治疗前,且观察组明显高于对照组,差异有统计学意义(P<0.05)。结论基于共享决策理念的健康教育联合个体化营养支持可有效提升肺癌根治术后康复患者的自我管理效能,改善肺功能和营养状况,提高生活质量。Objective To explore the application of shared decision-making concept based health education combined with personalized nutritional support in the rehabilitation of lung cancer patients after radical surgery.Method A total of 430 lung cancer patients who underwent postoperative rehabilitation treatment in Jiangsu Cancer Hospital from January 2022 to January 2023 were collected.They were randomly separated into a reference group and an observation group using a random number table method.After removing dropout cases,196 patients were included in the observation group and 204 patients in the reference group,totaling 400 patients.The reference group received personalized nutritional support,while the observation group received health education based on shared decision-making concept.The lung function indicators,nutritional status indicators,self-management efficiency,and quality of life of the two groups were compared.Result After 3 months of nursing care,the first second forced end expiratory volume(FEV1)and forced vital capacity(FVC)of both groups increased,but the increases in the reference group were not as obvious as those in the observation group(P<0.05);the levels of hemoglobin(Hb),albumin(ALB),and total protein(TP)in both groups increased after 3 months of care,and the observation group showed a more obvious increase(P<0.05);the scores of the Strategies Used by People to Promote Health(SUPPH)increased in both groups after nursing care,and the observation group showed a more obvious increase than reference group(P<0.05);the scores of the Quality of Life Scale(EROTC-QLQ-C30)for cancer patients in terms of emotion,cognition,role,body,and social function increased in both groups after 3 months of nursing care,and the observation group had obviously higher scores than the reference group(P<0.05).Conclusion Shared decision-making concept based health education combined with personalized nutritional support can effectively help lung cancer patients after radical surgery improve their postoperative self-management

关 键 词：共享决策理念 健康教育 个体化营养支持 肺癌根治术 术后康复 

分 类 号：R493[医药卫生—康复医学]