原发性肝癌患者饮食治疗依从性及其影响因素的纵向研究  

Longitudinal study on adherence to dietary treatment and its influencing factors in patients with primary hepatic cancer

作　　者：王苗苗 余慧茜[1] 傅凌雪[1] 马元锦 王兆洪[2] 姚红响 WANG Miaomiao;YU Huixi;FU Lingxue;MA Yuanjin;WANG Zhaohong;YAO Hongxiang(Interventional Medicine of Vascular Surgery Department,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第二医院血管外科介入医学科,浙江温州325000 [2]温州医科大学附属第二医院肝胆胰外科

出　　处：《中华全科医学》2024年第8期1328-1331,1358,共5页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2019PY048);温州市科技局计划项目(Y20210541)。

摘　　要：目的随访观察原发性肝癌患者饮食治疗依从性的变化轨迹,并分析其影响因素。方法采用方便抽样法于2021年3月—2022年4月选取在温州医科大学附属第二医院住院首次治疗的243例肝癌患者为研究对象。出院前(T0)完成第1次问卷调查,首次治疗后1个月(T1)、3个月(T2)及6个月(T3)随访完成依从性量表调查。结果肝癌患者在T0、T1、T2和T3时点的饮食治疗依从性得分分别为(37.62±6.53)分、(37.82±6.34)分、(37.12±6.10)分和(34.43±5.76)分,T0-T1、T0-T2和T1-T2间的差异无统计学意义(P>0.05),而T0-T3、T1-T3、T2-T3间的差异有统计学意义(P<0.05)。使用潜类别增长模型可识别3个潜在轨迹类别:“紧紧跟随组”占比30.87%(75例),“放松警惕组”占比33.33%(81例),“重视不足组”占比35.80%(87例)。宗教信仰、营养不良风险、独居和健康信念是肝癌患者饮食治疗依从性潜在轨迹类别的影响因素。结论医护人员应尊重患者的宗教信仰,帮助重度营养不良风险的患者形成正确的疾病认知,配合社区开展独居患者精准关爱服务,准确评估患者的健康信念状况,提高饮食治疗的依从性。Objective To explore the change track of dietary treatment adherence of primary hepatic cancer patients and its influencing factors.Methods A convenience sample of 243 hepatic cancer patients undergoing their first treatment in the Second Affiliated Hospital of Wenzhou Medical University between March 2021 and April 2022 was selected.The initial data collection was completed before discharge(T0),followed by collecting data on dietary treatment adherence scale at 1 month(T1),3 months(T2)and 6 months(T3)after the first treatment.Results The dietary treatment adherence scores at points T0,T1,T2 and T3 were(37.62±6.53)points,(37.82±6.34)points,(37.12±6.10)points and(34.43±5.76)points.The differences between T0-T1,T0-T2 and T1-T2 were not statistically significant(P>0.05),while the differences between T0-T3,T1-T3 and T2-T3 were statistically significant(P<0.05).Three potential trajectory categories could be identified by the potential category growth model:"closely follow group"accounted for 30.87%(75 cases),"relaxed group"accounted for 33.33%(81 cases)and"underappreciated group"accounted for 35.80%(87 cases).Religious beliefs,risk of malnutrition,living alone and health beliefs were the influencing factors in determining the potential trajectory category of dietary treatment adherence.Conclusion Medical staff should respect patients'religious beliefs,assist patients at risk of severe malnutrition in developing a correct understanding of the disease,cooperate with the community to provide accurate care services for patients living alone,accurately assess their health beliefs,and improve the diet treatment adherence.

关 键 词：原发性肝癌 饮食治疗依从性 纵向研究 

分 类 号：R735.7[医药卫生—肿瘤]