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食物照顾者对住院血液恶性肿瘤患者营养摄入的影响 - 一项前瞻性研究。

Food caregivers influence on nutritional intake among admitted haematological cancer patients - a prospective study.

机构信息

Department of Haematology, Centre of Cancer and Inflammation, Aarhus University Hospital, Tage-Hansens Gade 2, DK-8000 Aarhus C, Denmark.

出版信息

Eur J Oncol Nurs. 2013 Dec;17(6):827-34. doi: 10.1016/j.ejon.2013.06.010. Epub 2013 Sep 5.

Abstract

PURPOSE

Haematological cancer patients have an increased risk of undernourishment due to their malignancy, treatment toxicity and severe infections. This study examines whether kitchen assistants working as food caregivers increase nutritional intake and knowledge among haematological cancer patients.

METHODS

Comparison of two cross-sectional studies with dietary assessment of patients with haematological malignancies before (N = 42) and after (N = 45) implementation of food caregivers. Secondly, a questionnaire concerning dietary counselling performed before (N = 74) and after (N = 78) the implementation.

RESULTS

The energy requirements were fulfilled with 76.2% (CI 95% 64.6-87.9) and 93.3% (CI 95% 82.3-104.3) of the calculated need in the before-group and the after-group, respectively (p = 0.03). The improvement was mainly due to increased energy intake through between meal snacks served by the food caregivers. There was no difference in protein intake between the two groups. The study showed that more than two-thirds of the patients in both groups had side effects like fatigue, loss of appetite, vomiting, xerostomia or taste disorder to a degree that affected nutritional intake. When adjusted for side effects, patients in the after-group increased energy intake by 22% (CI 95% 6.1-38.0) (p = 0.007). After implementation of food caregivers significantly more patients stated that they were informed about their nutritional needs, 41% in the before-group and 67% in the after-group (p = 0.001).

CONCLUSIONS

Educated and trained food caregivers working at the wards increase nutritional intake and knowledge among haematological cancer patients and play an important role in the multi professional nutritional management.

摘要

目的

由于恶性肿瘤、治疗毒性和严重感染,血液系统癌症患者存在营养不足的风险增加。本研究旨在探讨在病房工作的厨房助理作为饮食护理者是否能增加血液系统癌症患者的营养摄入和知识。

方法

比较了两项横断面研究,一项是在实施饮食护理者之前(n=42),另一项是之后(n=45)对血液恶性肿瘤患者进行饮食评估。其次,在实施前后(n=74 和 n=78),通过问卷调查了解有关饮食咨询的情况。

结果

计算得出的能量需求,在前组中分别有 76.2%(95%CI95%64.6-87.9)和 93.3%(95%CI82.3-104.3)得到满足,在后组中则分别有 76.2%(95%CI95%64.6-87.9)和 93.3%(95%CI82.3-104.3)得到满足(p=0.03)。这种改善主要是由于饮食护理者提供的额外间餐增加了能量摄入。两组的蛋白质摄入量没有差异。研究表明,两组中超过三分之二的患者因疲劳、食欲不振、呕吐、口干或味觉障碍等副作用,导致营养摄入受到影响。当调整副作用因素后,在后组中,患者的能量摄入量增加了 22%(95%CI6.1-38.0)(p=0.007)。实施饮食护理者后,在后组中,有 41%的患者表示他们了解自己的营养需求,而在前组中这一比例为 67%(p=0.001)。

结论

在病房工作的受过教育和培训的饮食护理者可以增加血液系统癌症患者的营养摄入和知识,并且在多学科营养管理中发挥重要作用。

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