Roxburghe House, Aberdeen, UK.
J Hum Nutr Diet. 2011 Oct;24(5):470-8. doi: 10.1111/j.1365-277X.2011.01182.x. Epub 2011 Jul 7.
The National Health Servive (NHS) Quality Improvement Scotland developed nutritional Clinical Standards to address the problem of malnutrition in hospitals. NHS palliative care units are obliged to incorporate these standards into nutritional aspects of care. The nutritional needs of this patient population are under-researched. The present study aimed to explore patients' views of nutrition, to begin to understand their concerns and to determine whether such standards meet the needs of patients in the palliative care setting.
A qualitative study was conducted in 2009 in an NHS Palliative Care Unit. Six inpatients were involved in one-to-one interviews, which were audiotaped and transcribed verbatim. The transcripts were subject to qualitative data analysis in accordance with a previous framework.
A recurring theme that emerged was that of change and uncertainty. Four main areas subject to change were: disease state, symptoms, oral dietary intake and weight. Each change could exert control over, or be controlled by, the patient. When patients were eventually unable to exert control, they accepted the change, either willingly or enforced, thereby unintentionally setting their own targets.
The present study enables a deeper understanding of the concerns that palliative care patients have regarding their oral dietary intake and weight. Their 'malnutrition' not only refers to physical malnutrition alone, but also incorporates psychological and social 'malnutrition'. When applying standards or protocols regarding nutritional care, these wider issues must be taken into account to meet patients' nutritional needs.
英国国家医疗服务体系（NHS）苏格兰质量改进部制定了营养临床标准，以解决医院营养不良问题。NHS 姑息治疗病房有义务将这些标准纳入护理的营养方面。该患者群体的营养需求研究不足。本研究旨在探讨患者对营养的看法，开始了解他们的关注点，并确定这些标准是否满足姑息治疗环境中患者的需求。
2009 年在 NHS 姑息治疗病房进行了一项定性研究。6 名住院患者参与了一对一访谈，访谈内容进行了录音并逐字转录。根据先前的框架，对转录本进行了定性数据分析。
反复出现的主题是变化和不确定性。有四个主要变化领域：疾病状态、症状、口服饮食摄入和体重。每个变化都可以控制或被患者控制。当患者最终无法控制时，他们要么自愿接受，要么被迫接受变化，从而无意中设定了自己的目标。
本研究使我们能够更深入地了解姑息治疗患者对口服饮食摄入和体重的关注。他们的“营养不良”不仅指身体营养不良，还包括心理和社会“营养不良”。在应用营养护理标准或协议时，必须考虑到这些更广泛的问题，以满足患者的营养需求。
