[논문]수술 후 보조적 항암화학요법을 받는 대장암 환자의 일상영양관리 순응도에 대한 질적 연구

박희정; 길현선; 조우균

doi:10.5720/kjcn.2020.25.4.303

수술 후 보조적 항암화학요법을 받는 대장암 환자의 일상영양관리 순응도에 대한 질적 연구
Qualitative Study of Compliance with Nutritional Management in Colorectal Cancer Patient Undergoing Chemotherapy 원문보기

대한지역사회영양학회지 = Korean journal of community nutrition, v.25 no.4, 2020년, pp.303 - 316

박희정 (유한대학교 식품영양학과) , 길현선 (가천대학교 특수치료대학원 임상영양학과) , 조우균 (가천대학교 바이오나노대학 식품영양학과)

Abstract ▼ AI-Helper

Objectives: The nutritional status of cancer patients undergoing chemotherapy is closely related to the compliance of nutrition education. However, as chemotherapy is conducted repeatedly, compliance with nutrition management is lowered, leading to malnutrition. Malnutrition is related directly to the quality of life after surgery in cancer patients. Therefore, this study examined the factors related to compliance with nutrition management during chemotherapy. Methods: In this study, five subjects with colorectal cancer undergoing adjuvant chemotherapy were interviewed in-depth using the Giorgi study method. The contents of the nutrition education visits and in-depth interviews were transcribed in the language of the subject after recording, and the appropriateness of the data was improved by reflecting the subject's actions and facial expressions. Results: After conducting the in-depth interviews for each subject, the experience of the subject's diet and adjuvant chemotherapy was drawn into two domains, six elements, and 26 sub-elements. In the cognitive domain, the patients experienced physical and psychological changes, and the need for nutrition management was recognized by analyzing the dietary causes of the diseases. In the domain of practice, a knowing-doing gap was formed, unlike the patient's will. Factors that inhibited compliance with nutritional management included digestive problems, sensory changes, loss of appetite, and social interaction stress. Conclusions: Dietary management is very important for patients receiving periodic anticancer therapy, and step-by-step training and personal monitoring based on the chemotherapy order is necessary to maintain the patient's will and social and environmental support.

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질의응답

핵심어	질문	논문에서 추출한 답변
	대장암의 치료법에는 무엇이 있는가?	대장암의 치료법은 수술, 방사선치료, 항암 화학요법이 있으며, 암세포 부위를 제거하고, 재발을 막거나 다른 조직으로의 전이를 막기 위한 표준치료를 하게 된다. 일반적으로 치료 후에는 출혈, 통증, 근육감소, 심폐기능감소, 만성 피로 등의 증상이 나타나 삶의 질이 낮아지며[4], 특히 항암 화학요법으로 인한 오심과 구토(chemotherapy-induced nausea and vomiting, CINV)가 빈번하게 발생하여, 일상적인 삶의 유지가 힘들다[5].
	대장암 치료의 부작용은 무엇인가?	대장암의 치료법은 수술, 방사선치료, 항암 화학요법이 있으며, 암세포 부위를 제거하고, 재발을 막거나 다른 조직으로의 전이를 막기 위한 표준치료를 하게 된다. 일반적으로 치료 후에는 출혈, 통증, 근육감소, 심폐기능감소, 만성 피로 등의 증상이 나타나 삶의 질이 낮아지며[4], 특히 항암 화학요법으로 인한 오심과 구토(chemotherapy-induced nausea and vomiting, CINV)가 빈번하게 발생하여, 일상적인 삶의 유지가 힘들다[5]. 환자의 80% 이상에서 오심, 구토, 메스꺼움 등의 소화기 증상이 나타남이 보고되었으며, 오심 및 구토가 심할수록 식사 섭취량이 감소하여 영양불량 상태가 나타나는 것으로 확인되었다[6].
	항암치료 중 주요 영양 관리 요인은 무엇인가?	둘째, 실천영역에서 상위요소는 ‘영양교육을 통한 식생활실천 요인’, ‘지식과 실제 섭취의 차이’, ‘적극적인 실천 의지에 대한 장애 요인’으로 도출되었다. 항암치료 중 기본적인 영양 관리 요인으로 ‘식사량 조절 및 체계적 관리’, ‘단백질 섭취량 증가’, ‘균형 있는 식단’, ‘수분 섭취량 증가’에 대한 키워드가 도출되었다. 영양교육 후 규칙적이고 균형 잡힌 식사와 충분한 수분을 섭취하였고, 익히지 않은 음식이나 민간요법에 조심하며 교육받은 대로 식이요법을 실천하기 위해 노력하는 모습을 보였다.

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