Duerksen Donald R, Keller Heather H, Vesnaver Elisabeth, Allard Johane P, Bernier Paule, Gramlich Leah, Payette Hélène, Laporte Manon, Jeejeebhoy Khursheed
Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
JPEN J Parenter Enteral Nutr. 2015 May;39(4):410-7. doi: 10.1177/0148607114534731. Epub 2014 Jun 2.
Since malnutrition is common in Canadian hospitals, physicians frequently encounter patients with significantly impaired nutrition status. The objective of this study was to determine physician attitudes and perceptions regarding the detection and management of malnutrition in Canadian hospitals.
A survey based on a previously developed questionnaire that focused on guidelines for nutrition support of hospitalized patients was completed by Canadian physicians working on wards in the 18 hospitals participating in the Canadian Malnutrition Task Force study. Data were analyzed descriptively and according to ward (medical vs surgical) and hospital type (academic vs community).
The survey was completed by 428 of the 1220 physicians who were provided with a questionnaire and asked to participate (response rate 35%). While physicians believe that nutrition assessment should be performed at admission (364/419 [87%]), during hospitalization (363/421 [86%]), and at discharge (327/418 [78%]), most felt that this was not being done on a regular basis (admission, 140/423 [33%]; during hospitalization, 175/423 [41%]; at discharge, 121/424 [29%]). Similarly there was a gap between what was perceived to be the ideal management of hospital-related malnutrition and current practices. Physicians felt that the team's nutrition education and use of dietetic resources could be increased, and although their nutrition knowledge was limited, they felt that hospital-associated malnutrition was very relevant to the care they provided.
A multidisciplinary team is needed to address hospital malnutrition, and educational strategies that target physicians are needed to promote better detection and management throughout the hospital stay.
由于营养不良在加拿大医院中很常见，医生经常会遇到营养状况严重受损的患者。本研究的目的是确定加拿大医院医生对营养不良的检测和管理的态度及看法。
参与加拿大营养不良特别工作组研究的18家医院的病房医生完成了一项基于先前制定的问卷的调查，该问卷聚焦于住院患者营养支持指南。数据进行了描述性分析，并根据病房类型（内科与外科）和医院类型（学术型与社区型）进行了分析。
在1220名收到问卷并被邀请参与的医生中，有428名完成了调查（回复率35%）。虽然医生们认为应在入院时（364/419 [87%]）、住院期间（363/421 [86%]）和出院时（327/418 [78%]）进行营养评估，但大多数人认为目前并未定期进行（入院时，140/423 [33%]；住院期间，175/423 [41%]；出院时，121/424 [29%]）。同样，在医院相关营养不良的理想管理与当前实践之间也存在差距。医生们认为可以加强团队的营养教育并增加饮食资源的利用，尽管他们的营养知识有限，但他们认为医院相关营养不良与他们提供的护理密切相关。
需要一个多学科团队来解决医院营养不良问题，并且需要针对医生的教育策略，以促进在整个住院期间更好地进行检测和管理。
