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一项针对成年囊性纤维化患者的新型居家行为营养教育项目“CF健康饮食”的随机对照试验。

A randomized controlled trial of a new behavioral home-based nutrition education program, "Eat Well with CF," in adults with cystic fibrosis.

作者信息

Watson Helen, Bilton Diana, Truby Helen

机构信息

Department of Nutrition and Dietetics, Papworth Hospital, Papworth Everard, Cambridge, CB3 8RE, UK.

出版信息

J Am Diet Assoc. 2008 May;108(5):847-52. doi: 10.1016/j.jada.2008.02.017.

Abstract

Cystic fibrosis (CF) remains the most common genetically inherited disease in the white population and its prognosis is affected by nutritional status. Adults with the disease are now surviving longer and new strategies are required to ensure that they maintain optimal nutrition. This article reports preliminary data from a randomized controlled trial of a 10-week home-based behavioral nutrition intervention, "Eat Well with CF." Outcome measures of weight change over 6 and 12 months and changes in CF-specific nutrition knowledge score, self-efficacy score, reported dietary fat intake and health-related quality-of-life score were compared between the intervention group (n=34) and a standard care control group (n=34). The hypotheses to be tested were that adults with CF completing "Eat Well with CF" would have an improved nutritional status, improvement in specific nutrition knowledge, and an improvement in self-efficacy regarding their ability to cope with a special diet, compared to those receiving standard care. There were substantial improvements in the intervention group's specific CF nutrition knowledge score, self-efficacy score, and reported fat intake compared to control, but no substantial change in body mass index or health-related quality of life over time. Home-based nutrition education incorporating behavioral strategies can be an effective way to support adults with CF, enabling improvement in self-management skills in relation to diet and pancreatic enzyme replacement therapy. This study revealed gaps in basic nutrition knowledge and skills, inadequate knowledge of diet-disease links and pancreatic enzyme replacement therapy. These need to be identified when subjects progress from pediatric to adult care, and programs such as "Eat Well with CF" are a useful adjunct for registered dietitians trying to manage this diverse but growing population.

摘要

囊性纤维化(CF)仍是白种人群中最常见的基因遗传性疾病,其预后受营养状况影响。患有该疾病的成年人现在存活时间更长,需要新的策略来确保他们保持最佳营养状态。本文报告了一项为期10周的居家行为营养干预“CF健康饮食”随机对照试验的初步数据。比较了干预组(n = 34)和标准护理对照组(n = 34)在6个月和12个月内体重变化的结果指标,以及CF特异性营养知识得分、自我效能得分、报告的膳食脂肪摄入量和健康相关生活质量得分的变化。要检验的假设是,与接受标准护理的成年人相比,完成“CF健康饮食”的CF成年患者营养状况会得到改善,特定营养知识会有所提高,应对特殊饮食能力的自我效能也会得到改善。与对照组相比,干预组的CF特异性营养知识得分、自我效能得分和报告的脂肪摄入量有显著改善,但随着时间推移,体重指数或健康相关生活质量没有显著变化。纳入行为策略进行居家营养教育是支持CF成年患者的有效方式,能够提高他们在饮食和胰酶替代疗法方面的自我管理技能。本研究揭示了基本营养知识和技能方面的差距,对饮食与疾病关联以及胰酶替代疗法的了解不足。当患者从儿科护理过渡到成人护理时,需要识别这些问题,而“CF健康饮食”等项目对于试图管理这一多样化但不断增长的人群的注册营养师来说是一种有用的辅助手段。

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