| Objective:To analyze the intervention effect of nutrition education on dietary knowledge,attitude and behavior of patients with liver cirrhosis admitted to our hospital from September 2017 to September 2018,and provide evidence for nutrition education for patients with cirrhosis.Methods:Self-designed questionnaires on dietary knowledge,attitudes,and behaviors of patients with liver cirrhosis,including knowledge about cirrhosis diet,dietary attitudes,eating behaviors,and lifestyle habits.We randomly selected 200 hospitalized patients with liver cirrhosis and explained the purpose and significance of the survey to them.After getting informed consent,we told them how to fill in the questionnaire.The first questionnaire survey was conducted in the form of face-to-face or self-filling.After the mission,the second questionnaire was filled out at the time of discharge.The contents were the same as the first one.Combined with the exclusion criteria,a total of 186 valid questionnaires were collected.The education includes explanations of reasonable diet,nutritional value of different foods,dietary considerations,individualized nutrition knowledge and reasonable lifestyle.The educational methods include individual dietary guidance,group dietary education and group classroom dietary explanation.SPSS21.0 software was used for statistical analysis of the effective questionnaires.Counting data of the two groups were compared by chi-square test and chi-sum test.The score of dietary knowledge of liver cirrhosis of each subject was calculated(50 questions in total,2 points for each question,the total of 100 points),and the score was divided into high grade(scores>80 points),medium grade(scores from 60 points to 80 points)and low grade(scores < 60 points).The intervention effect on the dietary behavior and attitude of patients with liver cirrhosis was analyzed and evaluated according to the appropriate diet and lifestyle of patients with liver cirrhosis in those three groups.Results:1.General demographic characteristics:Number of respondents: 186 cases,104 males(55.9%)and 82 females(44.1%).Age: average age(54.3 ± 13.2)years old.2.Dietary knowledge level of patients with liver cirrhosis can be improved through nutrition education.The rate of universal acknowledged dietary knowledge before propaganda was three items: "quit smoking and drinking","eat slowly and chew slowly" and "not the more you eat,the better your physical condition will be".That is the reason why there was no significant difference before and after propaganda in that part(P>0.05).For the other 47 items,the rate of those awareness was significantly improved(P<0.001).As can be seen from the scoring results of dietary knowledge of patients with cirrhosis,the proportion of respondents with low scores after education decreased from 84.9% to 4.3%,while the proportion of respondents with high scores increased from 3.2% to over 70%.3.Nutrition education can significantly improve the attitudes of dietary and lifestyle of patients with liver cirrhosis.The results showed that after nutrition education,patients with cirrhosis were more willing to learn the dietary knowledge of cirrhosis,to "quit smoking and drinking",to adhere to diet treatment,to eat a variety of foods,to eat eggs,milk,soy or its products every day,to change the bad eating habits in the past,to eat light and less salty meals,and to invest a certain amount of time and money on nutritional therapy.After the education,those willness listed aboved was significantly increased(P<0.001).Before the publicity and education,the main channels for cirrhosis patients want to obtain nutrition and dietary knowledge of cirrhosis were formal lectures and consultation,radio,television,Internet,etc.After the publicity and education,the majority of patients hoped to obtain nutrition knowledge through medical professional channels such as nutrition clinic and medical staff(P<0.001).At the same time,patients with liver cirrhosis have high learning enthusiasm and initiative for knowledge related to reasonable diet and matters needing attention on diet,and more patients have urgent needs for knowledge related to diet after education.Before the education,the rules of patients with cirrhosis chosen food based on habit and taste.After the mission,the number of patients with cirrhosis chosen food based on nutritional value was significantly increased,and the proportion of patients chosen food with price was significantly decreased(P<0.001).4.Dietary behaviors of patients with liver cirrhosis were corrected after nutritional education.Types of daily food intake: before the mission,patients with daily food intake of less than 5 types and 5 ~ 10 types were a large proportion,while patients with daily food intake of 11 ~ 15 types and 16 ~ 20 types were significantly increased after the education(P<0.001).There was no significant change in patients who consumed more than 20 kinds of food per day.High quality protein diet: after the education,the frequency of liver cirrhosis patients' intake of high quality protein foods such as poultry,fish,shrimp and crab,beans and soy products,eggs,milk and so on increased significantly,while the frequency of livestock meat decreased.The frequency of daily fruit intake showed that before education,the majority of patients with cirrhosis consumed fruit 4-6 times per week,while after education,more than half of the patients could eat fruit every day.The results of daily vegetable intake showed that after the education,the number of respondents with daily intake of 400 ~ 499 g increased significantly,and the number of respondents with daily intake of 200 g and 200 ~ 299 g decreased significantly(P<0.001).The number of respondents with daily intake of the 300 ~ 399 g decreased,and the number of respondents with daily intake of 500 g and above increased(0.001<P<0.05).Eating habits: after education,the proportion of patients with liver cirrhosis who had good eating habits such as having more meals a day but less food at each,chewing carefully and swallowing slowly,late evening snack increased significantly,while the proportion of patients who had bad eating habits such as overeating,eating two or three meals a day and eating fast decreased significantly(P<0.001).After the education,the dietary habits of patients with liver cirrhosis,such as preference to greasy food,high-salt diet,preference to fat meat,meat consumption of livestock more than poultry and fish and shrimp,and partial food picky significantly decreased.The number of respondents with light taste significantly increased(P<0.001).Fewer people prefer western fast food(P=0.001).It can be seen that nutrition education plays a positive role in the diversification of food intake,the correction of unhealthy dietary habits and the improvement of dietary structure of patients with liver cirrhosis.5.Nutrition education can promote the compliance of patients with liver cirrhosis for healthy lifestyle.Before education,about 36% of patients with liver cirrhosis drank alcohol every day or 3-4 times per week,which was significantly reduced after education,and the number of patients who did not drink or abstain from alcohol was significantly increased(P<0.001).After education,the number of patients with cirrhosis who did not smoke or quit smoking or less than 6 cigarettes per week increased significantly,and the number of patients with 10-19 cigarettes per day and at least 20 cigarettes per day decreased significantly(P<0.001).The proportion of patients with 1 to 9 cigarettes per day did not change significantly.Conclusion:1.The individualized dietary guidance,the group type diet on education,group class mode,and other comprehensive nutrition education,which can improve the diet of the patients with cirrhosis,obviously improve the knowledge level,enhance the lifestyle of the positive attitude of patients with liver cirrhosis,correct the diet behavior of patients with cirrhosis,promote patients with cirrhosis to comply for healthy lifestyle.2.Nutrition education can significantly improve the dietary knowledge,attitude and behavior of patients with liver cirrhosis and should be applied in clinical practice as a treatment.3.Patients with liver cirrhosis have a strong demand for correct diet,especially in dietary matters needing attention and knowledges of healthy diets.Dietary behaviors are urgently needed to improve. |
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