The Relationship Between The Prognosis In Colorectal Cancer And Nutrition,social Support

PurposeTo understand the nutritional status, social support and prognosis status of the patients with colorectal cancer half a year after operation, and evaluate the role of the nutrition, social support of the patients with colorectal cancer in prognosis quantitatively.To provide theoretical basis for prolonging the survival time and improving the quality of life of the patients with colorectal cancer.Methods Selecting 251 cases with contact information in June 2013 to December 2013 and 133 in June 2012 to November 2013 operated at a tertiary hospital and diagnosed with contacted details of postoperative patients with colorectal cancer as the research objects from medical insurance information system in Fujian Province. All patients were investigated in the nutritional status,social support,quality of life etc.After six months of operation,133 cases of colorectal cancer were investigated in the living conditions again after two years. The association of nutrition status,social support and survival time was analyzed by binary logistic regression; The association of nutrition status,social support and quality of life was analyzed by ordered logistic regression. The relationship between three dimensions of social support(subjective support, objective support, support utilization degree) and six dimensions of quality of life(physical function, role function, emotional function, cognitive function, social function and symptoms of side effects) was analyzed by canonical correlation analysis.The results1 There is an association between nutritional status,social support, survival time of colorectal cancer patients half a year of operation. The poorer nutritional status, the lower two years of survival rate. The worse social support, the lower two years of survival rate. Two years of survival rate of 133 cases colorectal patients is 79.7%.Theresult of the analysis of influence factors of survival time shows, the influence factors of the survival time of the postoperative patients with colorectal cancer are age(OR=21.720,95%CI:4.221~112.029),activity(OR=0.453,95%CI:0.215~0.925), nutritional status(OR = 0.117, 95% CI: 0.040 ~ 0.336), social support(OR = 0.235, 95% CI: 0.067 ~ 0.822), and chemotherapy(OR = 4.510, 95% CI: 1.116 ~ 18.226). 2 There are relations between nutritional status and the quality of life in colorectal cancer patients with postoperative after half a year of operation.The poorer nutritional status, the worse quality of life. The worse social support condition, the worse the quality of life. The result of multiple factor analysis about the influence factors of the quality of life shows, the score of the quality of life have correlation with age(OR = 1.036, 95% CI: 1.012 ~ 1.059), gender(OR = 1.881, 95% CI: 1.142 ~ 3.098), activity(OR = 0.805, 95% CI: 0.805 ~ 1014), the nursing staff(OR = 0.785, 95% CI: 0.719 ~ 0.909), the nutritional situation(OR = 0.100, 95% CI: 0.064 ~ 0.157), the condition of social support(OR = 0.597, 95% CI: 0.386 ~ 0.922), and family economic situation(OR = 1.642, 95% CI: 1.166 ~ 2.314).Among them, the longer the activity time of postoperative patients every day, the higher the paramedics intimate degree and the better the nutritional situation, the better social supports status, the better quality of life. The older, the women, the worse family economic situation, the worse quality of life. 3 The nutritional status of colorectal cancer patients after half a year of operation have correlation with age, the method of operation, working condition, and chemotherapy. The nutrition al status of younger patients, the patients who had radical operation, and didn’t have chemotherapy are better than those patients who are older, had received palliative operation, and chemotherapy. 4 There are correlations between the social support of colorectal cancer patients who had the operation and the patients’ age, gender, nursing staff, working condition, the method of operation, the situation of chemotherapy, and clinical stage. The patients who are older, male, single, retired, terminal, had chemotherapy have less social support especially the subjective support. 5 The canonical correlation analysis of social support and survival quality in colorectal cancer patients shows that the correlation coefficient of first canonical correlation variable is 0.367296(P<0.05), the second is 0.304768(P<0.05). The effectsof social support in quality of life are on emotion, role, social function.ConclusionThere is a close relationship between nutritional status,social support of patients with colorectal cancer and their survival,quality of life.Improving the nutritional status of patients and more social support after surgery would help prolong the survival time and improve the quality of life.We should pay more attention to improving the nutritional condition for older people,receiving palliative resection and chemotherapy patients.Society and family should give more concern and spiritual support to male patients who were older people,no spouse,retired and given chemotherapy.