目的 探讨胃癌患者营养知信行(KAP)对患者营养状态及生活质量的影响,为胃癌患者临床营养管理及干预方案制订提供循证依据。方法 采用便利抽样法,选取南京医科大学附属淮安第一医院(淮安市第一人民医院)2022年2月至2025年2月的350例胃癌患者为研究对象,通过一般资料问卷、KAP量表、患者主观整体评估(PG-SGA)量表、生活质量核心问卷(QLQ-C30)中GHS/QoL评分对研究对象进行调查。运用Spearman相关性分析探究各变量间的关联关系,并采用多元线性回归分析KAP对患者营养状态与生活质量的影响。结果 家庭所在地、主要照顾者、家庭人均月收入、TNM分期对胃癌患者KAP水平有显著影响(P＜0.05);TNM分期影响患者营养状况(P＜0.05);单因素分析显示TNM分期对生活质量有影响(P<0.05)。Spearman相关性分析显示,KAP评分与PG-SGA评分呈负相关(r=-0.202,P＜0.01),GHS/QoL得分与PG-SGA评分呈负相关(r=-0.964,P＜0.001),KAP评分与GHS/QoL得分呈正相关(r=0.215,P＜0.001)。控制潜在混杂变量后,多元线性回归分析结果显示,PG-SGA评分对患者GHS/QoL得分具有显著独立负向影响(β=-2.744,95%CI=-3.176~-2.313,P<0.001);KAP评分对患者GHS/QoL得分具有显著独立正向影响(β=0.171,95%CI=0.061~0.281,P=0.003)。年龄、性别、家庭所在地、主要照顾者、婚姻状态、家庭人均月收入、TNM分期、手术类型及医保状态等混杂变量,多因素分析均未对生活质量产生显著影响(P均>0.05)。结论 营养状态与生活质量评分呈负相关,KAP与生活质量评分呈正相关,营养状态是影响其生活质量的独立因素,改善营养状态可显著提升患者生活质量。
Abstract
Objective To explore the correlations among nutritional knowledge, attitude, practice (KAP), nutritional status and quality of life in gastric cancer patients, and analyze the independent risk factors affecting quality of life, so as to provide evidence-based basis for clinical nutritional management and intervention. Method A total of 350 gastric cancer patients who underwent radical gastrectomy in Huai'an First People's Hospital from February 2022 to February 2025 were selected by convenience sampling. General information questionnaire, digestive system tumor nutrition KAP scale, Patient-Generated Subjective Global Assessment (PG-SGA) and the Global Health Status/Quality of Life (GHS/QoL) dimension of EORTC QLQ-C30 were used for investigation. Spearman correlation analysis was used to explore the correlations between variables, and multiple linear regression was used to analyze the independent influencing factors of quality of life. Result Place of residence of the family, main caregiver, average monthly family income, and TNM stage had significant effects on the nutritional knowledge, attitude, and practice level of patients with gastric cancer (P<0.05); the TNM stage affected the nutritional status of patients (P<0.05); the univariate analysis of the TNM stage indicated that it had an impact on the quality of life (P<0.05).Spearman correlation analysis showed that the KAP score was negatively correlated with the PG-SGA score (r =-0.202, P<0.01), and the GHS/QoL score was negatively correlated with the PG-SGA score (r=-0.964, P<0.001), and the KAP score was positively correlated with the GHS/QoL score (r=0.215, P<0.001). After controlling for potential confounding variables, the multivariate linear regression results showed that the PG-SGA score had a significant independent negative impact on the GHS/QoL score of patients (β=-2.744, 95%CI: -3.176 to -2.313, P<0.001); the KAP score had a significant independent positive impact on the GHS/QoL score of patients (β=0.171, 95%CI:0.061 to 0.281, P=0.003). The confounding variables such as age, gender, place of residence of the family, main caregiver, marital status, average monthly family income, TNM stage, surgical type, and medical insurance status did not significantly affect the quality of life in the multivariate analysis (all P>0.05). Conclusion Nutritional status is negatively correlated with quality of life scores, while nutritional knowledge, attitude, and practice (KAP) scores are positively correlated with quality of life scores. Nutritional status is a key independent factor influencing quality of life, and improving nutritional status can significantly enhance patients' quality of life.
关键词
胃癌 /
营养知信行 /
营养状况 /
生活质量 /
患者主观整体评估 /
影响因素 /
营养管理 /
胃切除术
Key words
Gastric cancer /
Nutritional knowledge attitude and practice /
Nutritional status /
Quality of life /
Patient-generated subjective global assessment /
Influencing factors /
Nutritional management /
Gastrectomy
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