| ObjectiveTo explore the status of health promoting lifestyle,cancer related fatigue,anxiety,depression and quality of life in colorectal cancer patients and their relationships.Through a randomized controlled trials to explore the effect of a changing lifestyle on the healthy outcome of the patients with colorectal cancer,so that we can enrich the oncologic nursing theory,improve the healthy outcome of the patients with colorectal cancer,and provide an empirical basis for clinical and community nursing.Methods1.A total of 334 patients with colorectal cancer in three tertiary grade-A hospital in Taian-city were investigated with cross-sectional survey by using the Health Promoting Lifestyle Profile II(HPLP II),cancer-related fatigue questionnaire(CFS),hospital anxiety and Depression Scale(HADS)and colorectal cancer quality of life questionnaire(FACT-C)),to test the health promoting lifestyle,fatigue,anxiety and depression,quality of life and so on.Data were processed using SPSS(Statistical Package for the Social Sciences)18.0 software.Pearson correlation techniques were used to examine the relationship between quality of life,the health promoting lifestyle,fatigue,anxiety and depression.Hierarchical regression analysis were used to explore the factors influencing the quality of life of patients with colorectal cancer;Structural equation model was used to analyze the effect of health promoting lifestyle on the quality of life of patients with colorectal cancer;And Amos was used to analyze the mediating effect of the health promoting lifestyle on quality of life in colorectal cancer patients.2.A total of 120 colorectal cancer patients from one tertiary grade-A hospital in Tai’an were recruited for study.Participants were divided into experimental group and control group by random,7 of them were lost to visit,the final control group was 57 cases,and the intervention group was 56 cases.The health promotion mode,quality of life and some physiological indexes of two groups of patients were evaluated before discharge.Only the patients in the intervention group were followed up by telephone and WeChat after discharge.At the 3 and 6 months after intervention,the health promotion lifestyle and quality of life of the two groups were reevaluated,and blood lipids,fasting blood glucose,BMI,SOD and tumor markers were collected.SPSS 18 was used for data sorting and analysis,including descriptive analysis,t test,x~2 test,repeated measurement analysis of variance,multiple stepwise regression analysis,hierarchical regression analysis,etc.ResultsQuantitative study results:Firstly,the total score of health promoting lifestyle in patients with colorectal cancer was 118.86±17.12;The total score of cancer related fatigue was 23.94±6.77;The total score of anxiety and depression was 12.66±5.97;The total score of quality of life was 77.57±14.98.Secondly,patients’s quality of life was positive co-rrelated with the health promoting lifestyle(r=r=0.385,p<0.01),and it was negative correlated with the fatigue(r=-0.226,P<0.01)and anxiety and depression(r=-0.567,P<0.01).Thirdly,the main factors affecting the quality of life of the patients with colorectal cancer are the degree of culture,the state of occupation,the monthly income of the family,the course of the disease and the progress of the disease.Fourthly,the multiple dependent variables can impact of the quality of life of patients with colorectal cancer,and the total explanation of relevant variables on the quality of life had reached 52.2%;The demographic and disease characteristics explained 18.2%;The health promoting lifestyle explained 23%;The explanatory power of cancer dependent fatigue variables was 8.5%;The explanatory power of the anxiety and depression variables was 2.5%;The mediated effect of anxiety during the health promoting lifestyle and quality of life accounted for17.26%of the total effects.Fifthly,health promoting lifestyle directly positive effect quality of life,while anxiety directly negative effect quality of life,meanwhile Health promoting lifestyle can through the intermediary role of anxiety indirectly affect the quality of life,the mediated effect accounted for 17.26%of the total effects.Intervention research results:A total of 120 patients were included in the study standard,of which 7 cases were lost.Finally,there were 57 patients for control group and56 patients for experimental group.Before the intervention,there were no significant differences between the intervention groups and the control group in the scores of the studying variables.Both experimental group and control group in timepoints of at discharge,3 months after hospital discharge and 6 months after hospital discharge within the same group data was analysed by repeated measures analysis of variance showed that:Colorectal cancer patients’level of quality of life(F=115.544,P<0.01),level of lifestyle(F=26.319,P<0.01)were all gradually increased along with the extension of time after discharge in intervention groups and the control group.Analysis of the effect of lifestyle intervention:Firstly,quality of life:The comparison of t test between the intervention group and the control group showed that 3 months after discharge,the total score and emotional status of the patients in the intervention group were significantly higher than those in the control group(P<0.05);In the intervention group,the total score of life quality,social/family status and emotional state of patients in the 6 months after intervention were significantly higher than those in the control group(P<0.01).Secondly,health promoting lifestyle:The analysis of repeated measurements of variance showed that the level of health promoting lifestyle in the intervention group and the control group gradually increased with the prolongation of discharge time;The comparison of t test between the intervention group and the control group showed that the health responsibility and exercise dimension of the intervention group were significantly higher than the control group at 3 months after discharge(P<0.05),and the effect of intervention on the nutrition latitudes was significant 6 months after discharge(P<0.01);Thirdly,physiological indicators:The analysis of repeated measurements of variance showed that the level of fasting blood glucose(FB),total cholesterol(TC)and low density lipoprotein(LDL)in the patients of the intervention group and the control group were reduced with the prolongation of the discharge time;The comparison of t test between the intervention group and the control group showed that the lifestyle intervention significantly reduced the FB,TC and LDL-C levels of the patients for 3 months and 6 months(P<0.01);The TC level of the patient decreased in 3 months(P<0.05),a significant reduction in 6months(P<0.01);There was no significant difference in leukocyte,carcinoembryonic antigen(CEA)and sugar antigen(CA19-9)between the intervention group and the control group for 3 months and 6 months after discharge.Conclusions1.The level of health promoting lifestyle and quality of life in patients with colorectal cancer were lower,and there are mild cancer-related fatigue and anxiety and depression.2.The main influencing factors of quality of life in colorectal cancer patients are:education level,occupation status,family monthly income and disease duration.There is a positive correlation between self health promotion lifestyle and quality of life,and cancer related fatigue and anxiety and depression are negatively correlated with their quality of life.3.In the discharge of patients with colorectal cancer after nursing intervention based on information technology by the relevant professional nursing nurse,can relieve patients from non promoting healthy lifestyles to the health trend change,lower level of total cholesterol,blood glucose and LDL,so as to improve the quality of life in patients. |
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