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口服营养补充剂的依从性及其对消化道肿瘤术后患者的影响因素:一项横断面研究。

Adherence with oral nutritional supplements and influencing factors in postoperative patients with digestive tract tumors: a cross-sectional study.

机构信息

Shanghai Jiao Tong University, School of Nursing, No.227, Chongqing South Road, Huangpu District, Shanghai, 200025, China.

Department of Nursing, Shanghai General Hospital, No.650, Xin Song Jiang Road, Songjiang District, Shanghai, 201620, China.

出版信息

Support Care Cancer. 2024 Jul 10;32(8):501. doi: 10.1007/s00520-024-08711-z.

Abstract

OBJECTIVE

This study aims to use structural equation modeling to explore the pathways and effect sizes of factors influencing the adherence of postoperative patients with digestive tract tumor to oral nutritional supplements, providing a theoretical basis for future nursing intervention measures.

METHODS

A total of 300 postoperative patients with digestive tract tumor within 30 days after surgery were conveniently sampled. Surveys were conducted using a General Information Questionnaire, Morisky Medication Adherence Scale, Digestive System Tumor Patient Nutrition Knowledge-Attitude-Behavior Questionnaire, Multidimensional Social Perception Scale, Beliefs about Medical Questionnaire, and General Self-Efficacy Scale. Structural equation modeling was employed to analyze the factors and pathways affecting adherence with oral nutritional supplements.

RESULTS

The adherence score of postoperative patients with digestive tract tumor to oral nutritional supplements was 1.61 ± 1.38. The structural equation model had a good fit (χ/df = 2.685, GFI = 0.930, CFI = 0.913, AGFI = 0.887, IFI = 0.915, and RMSEA = 0.075). Nutrition knowledge, social support, medication beliefs, and self-efficacy were found to be factors influencing adherence with oral nutritional supplements in postoperative patients with digestive tract tumor, with total effects of 0.539, 0.264, 0.215, and 0.180, respectively. Nutrition knowledge indirectly affected adherence through self-efficacy and medication beliefs, while social support indirectly affected adherence through self-efficacy.

CONCLUSION

Adherence with oral nutritional supplements in postoperative patients with digestive tract tumor is at a low level. Improving social support, enhancing patients nutrition knowledge, increasing self-efficacy, and strengthening medication beliefs are effective ways to improve patient adherence.

摘要

目的

本研究旨在运用结构方程模型探讨影响消化道肿瘤术后患者口服营养补充剂依从性的因素及其作用路径和效应大小,为今后护理干预措施提供理论依据。

方法

便利抽取术后 30 天内的 300 例消化道肿瘤患者,采用一般资料问卷、Morisky 服药依从性量表、消化系统肿瘤患者营养知识-态度-行为问卷、多维社会感知量表、医疗信念量表和一般自我效能感量表进行调查,采用结构方程模型分析影响口服营养补充剂依从性的因素及其作用路径。

结果

消化道肿瘤术后患者口服营养补充剂的依从性评分为(1.61±1.38)分。结构方程模型拟合度较好(χ/df=2.685,GFI=0.930,CFI=0.913,AGFI=0.887,IFI=0.915,RMSEA=0.075)。营养知识、社会支持、用药信念和自我效能是影响消化道肿瘤术后患者口服营养补充剂依从性的因素,总效应分别为 0.539、0.264、0.215、0.180。营养知识通过自我效能和用药信念间接影响患者的依从性,社会支持通过自我效能间接影响患者的依从性。

结论

消化道肿瘤术后患者口服营养补充剂的依从性处于较低水平。提高社会支持、增强患者营养知识、提升自我效能、强化用药信念是提高患者依从性的有效途径。

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