口服营养补充在老年胃癌术后辅助化疗患者营养依从性与生活质量间的中介效应分析OA

Objective To explore the mediating effect of oral nutritional supplement(ONS)on the relationship between nutritional compliance and quality of life in elderly patients with gastric cancer undergoing postoperative adjuvant chemotherapy,and to provide a theoretical basis for the optimization of clinical nutritional support strategies.Method A total of 206 elderly patients who underwent radical gastrectomy for gastric cancer and received adjuvant chemotherapy in our hospital from January 2024 to October 2025 were selected as the research subjects.All patients received standardized ONS intervention during the chemotherapy period.Relevant data were collected at baseline(pre-intervention),the 4th week after the intervention,and the 12th week.The score of the baseline ONS compliance rating scale was taken as the independent variable(X),the average ONS intake of patients from the 4th to 12th week was taken as the mediating variable(M),and the score of the European Organization for Research and Treatment of Cancer quality of life questionnaire-core 30(EORTC QLQ-C30)at the 12th week was taken as the dependent variable(Y).Descriptive analysis and Pearson correlation analysis were used to analyze the correlation between variables;the PROCESS macro program was used to test the mediating effect,and the 95%confidence interval of the indirect effect was estimated by the bias-corrected Bootstrap method with 5000 repeated sampling.The effect size was reported as the standardized coefficient.Result At 12 weeks after the intervention,the total score of nutritional compliance of the patients was 82.46±6.73,and the total score of quality of life was 68.34±7.21.Nutritional compliance was significantly positively correlated with quality of life(r=0.562,P＜0.001),and was significantly positively correlated with the functional dimension(r=0.513,P＜0.001),and was significantly negatively correlated with the symptom dimension(r=-0.487,P＜0.001).The mediation effect analysis showed that the partial mediation effect of ONS between nutritional compliance and quality of life was significant,with the indirect effect value being 0.187(95%CI:0.112-0.273),accounting for 34.2%of the total effect;the mediation effect value of ONS between nutritional compliance and the functional dimension was 0.203(95%CI:0.131-0.289),accounting for 38.1%of the total effect;the mediation effect value of ONS between nutritional compliance and the symptom dimension was-0.156(95%CI:-0.238--0.087),accounting for 31.5%of the total effect.Conclusion The nutritional compliance of elderly patients with gastric cancer undergoing postoperative adjuvant chemotherapy plays an important role in predicting their quality of life.It can indirectly affect the quality of life of patients through the partial mediating effect of ONS.Paying attention to the intervention of ONS for such patients is of great significance for improving patients'nutritional compliance and quality of life.