飲食衛教方案對口腔癌術後病人營養狀況與生活品質之成效

背景：一般口腔癌治療以手術為主，導致口腔或顏面結構缺損衝擊病人的吞嚥或咀嚼能力，常造成病人營養狀況和生活品質影響。目的；了解口腔癌術後病人營養狀況與生活品質及檢視飲食衛教方案對口腔癌術後病人營養狀況與生活品質之成效。方法；採類實驗設計，手術後可經口喝水時即收案，採隨機分派為實驗組42人與對照組42人。兩組病人均提供吞嚥運動指導及進行一次前測和三次後測共追蹤三個月，實驗組提供飲食評估和飲食衛教方案介入。測量工具為護理營養篩檢表及口腔健康衝擊量表。結果：有營養不良風險者（前測vs. 3個月後測），實驗組47.6% vs. 4.8%，對照組35.7% vs. 42.9%。經廣義估計方程模式顯示，接受飲食衛教方案介入病人營養狀況與生活品質改善成效皆優於對照組（p＜.001）。結論／實務應用：飲食衛教方案可有效改善口腔癌病人術後營養狀況與生活品質，建議於口腔癌治療期間宜提供特製化營養支持，協助維持良好的營養狀態，以提升生活品質。

關鍵字

口腔癌；飲食衛教方案；營養狀況；生活品質

並列摘要

Background: Surgery, the primary treatment for oral cancer, results in oral and facial structural defects that may cause difficulties in swallowing or mastication and thereby affect nutrition status and quality of life. Purpose: This study was designed to understand nutritional status and quality of life in oral cancer patients who had undergone surgery and to examine the effects of a dietary education program on nutritional status and quality of life in these patients. Methods: A quasi-experimental design was conducted. Eligible patients were enrolled immediately after they could sip water after surgery. The participants were randomized into the experimental group (n = 42) and the control group (n = 42). Both groups were provided guidance for swallowing exercise and performed a pre-test (T0) and three posttests (T1-T3) for a total of three months. The experimental group additionally received a diet assessment and dietary education program intervention. The outcome measures included the nursing nutritional risk screening tool (NNRST) and oral health impact profile (OHIP-14T). Results: The level of malnutrition risk (T0 vs. T3) was 47.6% vs. 4.8% in the experimental group and 35.7% vs. 42.9 in the control group. Generalized estimating equation (GEE) statistics were used to assess the effects of the dietary education program on nutritional status. Quality of life was found to be significantly better in the experimental group than in the control group (p ＜ .001). Conclusions/Implications for Practice: A dietary education program may be used to effectively improve the nutritional status and quality of life of patients after oral cancer surgery. We suggest that specialized nutritional support be provided during cancer treatment in order to achieve good nutritional status and improve quality of life.

並列關鍵字

oral cancer ； dietary education program ； nutritional status ； quality of life

參考文獻

呂孟凡（2014）．吞嚥困難個案於飲食質地調整與市售增稠劑之應用狀況．長期照護雜誌，18（3），283–290。[Lu, M. F. (2014). Application of texture modification diet and commercial thickener for patients with dysphagia. The Journal of Long-Term Care, 18(3), 283–290.] https://doi.org/10.6317/LTC.18.283

林韋君、袁素娟、黃秀梨（2010）．營養狀況改變及護理．領導護理，11（3），21–32。[Lin, W. C., Yuan, S. C., & Hwang, S. L. (2010). Nursing care for a patient with altered nutritional status. Leadership Nursing, 11(3), 21–32.] https://doi.org/10.29494/LN.201012.0004

相青琪、胡月娟（2017）．口腔照護方案對口腔癌術後病人吞嚥功能之成效．護理雜誌，64（2），88–98。[Hsiang, C. C., & Hwu, Y. J. (2017). Effects of an oral care program on the swallowing function in post-operative patients with oral cancer. The Journal of Nursing, 64(2), 88–98.] https://doi.org/10.6224/JN.000027

常傳訓、周育如、余璧如、殷秀妙、孫吉珍、董道興…張仙平（2009）．住院癌症病患營養篩檢工具之建立．中華民國癌症醫學會雜誌，25（3），206–215。[Chang, C. H., Chou, Y. R., Yu, P. R., Yin, S. M., Sun, C. C., Tung, T. H., ... Ma, F. C. (2009). A clinical tool for nutrition screening of hospitalized cancer patients. Journal of the Chinese Oncology Society, 25(3), 206–215.] https://doi.org/10.6588/JCOS.2009.25.3.6

郭曉菁、陳人豪、賴辛癸、沈雅春、王震乾、楊奕馨（2013）．台灣簡易七題版口腔健康衝擊量表（OHIP-7T）之發展與驗證．臺灣公共衛生雜誌，32（4），393–402。[Kuo, H. C., Chen, J. H., Lai, S. K., Shen, Y. C., Wang, J. C., & Yang, Y. H. (2013). Development and validation of the Taiwanese short-form of the oral health impact profile (OHIP-7T). Taiwan Journal of Public Health, 32(4), 393–402.] https://doi.org/10.6288/TJPH2013-32-04-11

國際替代計量

飲食衛教方案對口腔癌術後病人營養狀況與生活品質之成效

全文下載

主題瀏覽