Harm H. J. van Noort, MSc, RN, is from the Departments of Nutrition, Physical Activity and Sports, and Surgery, Gelderse Vallei Hospital, Ede, The Netherlands; and Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
Carlijn R. Lamers, MD, is from the Department of Gastroenterology and Hepatology, Gelderse Vallei Hospital, Ede, The Netherlands; and Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
Gastroenterol Nurs. 2022;45(5):342-353. doi: 10.1097/SGA.0000000000000678. Epub 2022 Jul 20.
This study evaluated the applicability and efficacy of patient education regarding fasting recommendations to shorten fasting times in patients undergoing esophagogastroduodenoscopy (EGD). A prospective nonrandomized controlled pilot study was performed. The intervention group (IG) was educated by nurses to eat until 6 hours and drink until 2 hours before EGD. The control group (CG) received usual care. Outcomes were applicability as perceived by patients, adherence to fasting recommendations, gastric visibility, and patients' comfort. A total of 109 patients were included of whom 42 were IG patients (37%). Patients' perspectives on fasting, their experienced discomfort, professional support, and circadian rhythm influenced application of fasting recommendations. Adherence to length of fasting from foods improved with 3:14 hours ( p < .001) and from liquids with 5:22 hours ( p < .001) in the IG compared with the CG. Gastric visibility during EGD was better in the IG than in the CG. The IG patients experienced significant less thirst, hunger, headache, and anxiety. To successfully reduce fasting times, fasting education should include positive, individual instructions, which help patients apply the fasting recommendations within their biorhythm. Positive, concrete instructions by nurses shortened fasting times before EGD, which improved gastric visibility and reduced patient discomfort.
本研究评估了针对接受食管胃十二指肠镜检查（EGD）的患者进行禁食建议相关教育以缩短禁食时间的适用性和效果。进行了一项前瞻性非随机对照试点研究。干预组（IG）由护士进行教育，告知患者在 EGD 前 6 小时进食，2 小时内可饮水。对照组（CG）接受常规护理。观察指标为患者对禁食建议的感知适用性、对禁食建议的遵守情况、胃的可视性和患者的舒适度。共纳入 109 例患者，其中 IG 患者 42 例（37%）。患者对禁食的看法、不适感、专业支持和昼夜节律影响了禁食建议的应用。与 CG 相比，IG 患者从食物中禁食的时间延长了 3:14 小时（p<0.001），从液体中禁食的时间延长了 5:22 小时（p<0.001）。IG 患者的胃可视性优于 CG 患者。IG 患者口渴、饥饿、头痛和焦虑的发生率明显较低。为了成功缩短禁食时间，禁食教育应包括积极的个体化指导，帮助患者在生理节律内遵守禁食建议。护士提供的积极、具体的指导可缩短 EGD 前的禁食时间，提高胃的可视性并减轻患者的不适。
