College of Nursing, Shandong Second Medical University, Weifang, China; College of Nursing, Chungnam National University, Daejeon, Republic of Korea.
College of Nursing, Shandong Second Medical University, Weifang, China.
Int J Nurs Stud. 2024 Nov;159:104873. doi: 10.1016/j.ijnurstu.2024.104873. Epub 2024 Aug 8.
Dietary education and modification interventions are valuable and feasible strategies for enhancing nutritional status and managing symptoms in patients with gastric cancer following gastrectomy. In alignment with administrative policies prioritizing shorter hospital stays and enhanced postoperative self-management, the provision of a simplified nutritional management approach following gastrectomy holds promise for preventing weight loss and expanding resources for monitoring both the nutritional and symptomatic aspects of these patients.
This study evaluated the effectiveness of an integrative approach involving the five sequential steps of Conversation, Assessment, Nutrition plan, Complications, Evaluation, and Reassurance or Removal (CANCER) into Altering Intake and Managing Symptoms (AIMS), with specific focus on enhancing nutritional status and symptom management.
A single-blind, two-arm, randomized controlled trial.
This study was conducted at a tertiary hospital in Shandong province, China.
Patients with total or subtotal gastrectomy for gastric cancer.
The participants were randomly assigned to either the intervention or control group in a 1:1 ratio. The intervention group received a 16-week CANCER-AIMS intervention program. The control group received usual routine care dietary guidance. Questionnaires and electronic medical records of each patient were used to assess dietary intake, dietary symptoms, and subjective and objective nutritional status. Outcomes were assessed at four specific time points: the day before discharge and at 4-, 8-, and 16-weeks following hospital discharge.
Thirty-eight participants completed the study. The findings revealed significant interaction effects between group and time for dietary intake, dietary symptoms, and nutritional status between intervention and control groups (P < 0.001). The intervention group had significantly higher dietary intake, fewer dietary symptoms, and better nutritional status post-intervention than the control group (P < 0.001). Moreover, there were significant differences in dietary intake, dietary symptoms, and nutritional status according to time in both the intervention and control groups.
The CANCER-AIMS intervention for patients with gastric cancer following gastrectomy may be efficient at enhancing nutritional intake, reducing negative dietary symptoms, and thus improving both their subjective and objective nutritional status.
饮食教育和调整干预是有价值且可行的策略，可以改善胃癌患者胃切除术后的营养状况和管理症状。为了配合行政政策，优先考虑缩短住院时间和增强术后自我管理，简化胃切除术后的营养管理方法有望防止体重减轻，并为监测这些患者的营养和症状方面提供更多资源。
本研究评估了将连续五个步骤的对话、评估、营养计划、并发症、评估和再保证或消除（CANCER）纳入改变摄入和管理症状（AIMS）的综合方法的有效性，重点是增强营养状况和管理症状。
单盲、双臂、随机对照试验。
本研究在中国山东省的一家三级医院进行。
接受胃癌全胃或胃大部切除术的患者。
患者以 1:1 的比例随机分配到干预组或对照组。干预组接受 16 周的 CANCER-AIMS 干预计划。对照组接受常规的常规饮食指导。使用问卷和每位患者的电子病历评估饮食摄入、饮食症状以及主观和客观的营养状况。在四个特定时间点评估结果：出院前一天和出院后 4、8 和 16 周。
38 名患者完成了研究。结果显示，干预组和对照组之间在饮食摄入、饮食症状和营养状况方面，组间和时间之间存在显著的交互效应（P<0.001）。干预组在干预后饮食摄入更高、饮食症状更少、营养状况更好，与对照组相比差异具有统计学意义（P<0.001）。此外，干预组和对照组的饮食摄入、饮食症状和营养状况均随时间变化而显著变化。
针对胃切除术后胃癌患者的 CANCER-AIMS 干预可能能够有效增加营养摄入，减少负面饮食症状，从而改善患者的主观和客观营养状况。
