与家庭合作促进癌症护理中的营养：PIcNIC 干预的可行性和可接受性。
Partnering with families to promote nutrition in cancer care: feasibility and acceptability of the PIcNIC intervention.
机构信息
School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
National Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Cost, Australia.
出版信息
BMC Palliat Care. 2018 Mar 20;17(1):50. doi: 10.1186/s12904-018-0306-4.
BACKGROUND
Malnutrition is frequent in patients with cancer, particularly those in advanced stages of the disease. The aim of the present study was to test the feasibility of a family-centred nutritional intervention, based on the Family Systems theory and past research.
METHODS
This was a single-arm trial assessing feasibility (eligibility, recruitment and retention rates); acceptability by patients, family caregivers and health professionals; intervention fidelity, and energy/protein intake (in one site only). Two sites were involved; one each in Australia (AUS) and Hong Kong (HK), with one site delivering the intervention to oncology patients receiving curative treatments in the hospital, and the other to advanced cancer patients in the home.
RESULTS
The sample included 53 patients (23 from AUS and 30 from HK), 22 caregivers (3 from AUS and 19 from HK) and 30 health professionals (20 from AUS and 10 from HK). Recruitment was difficult in the acute inpatient oncology care setting (AUS) and feasibility criteria were not met. Sufficient recruitment took place in the home care setting with advanced cancer patients in HK. Patients, family members and health professionals found the intervention helpful and acceptable, and patients and families indicated they would take part in the future in a similar study. Energy and protein intake improved from baseline to end of intervention (mean 22 kcal/kg/day to 26 and 0.9 g/kg/day to 1.0 respectively).
CONCLUSION
The new intervention is feasible in a home setting when delivered to patients with advanced cancer, acceptable to patients and families, and has the potential to improve nutritional status in patients. A large randomised trial is warranted in the future.
背景
癌症患者经常出现营养不良，尤其是疾病晚期的患者。本研究旨在测试一种以家庭为中心的营养干预措施的可行性，该措施基于家庭系统理论和以往的研究。
方法
这是一项单臂试验，评估了可行性（合格性、招募率和保留率）；患者、家庭照顾者和卫生专业人员的可接受性；干预的忠实度，以及能量/蛋白质摄入量（仅在一个地点进行）。两个地点参与其中；一个在澳大利亚（AUS），另一个在香港（HK），一个地点在医院为接受根治性治疗的肿瘤患者提供干预，另一个地点在家庭为晚期癌症患者提供干预。
结果
样本包括 53 名患者（23 名来自 AUS，30 名来自 HK）、22 名照顾者（3 名来自 AUS，19 名来自 HK）和 30 名卫生专业人员（20 名来自 AUS，10 名来自 HK）。在急性住院肿瘤护理环境（AUS）中招募困难，且未达到可行性标准。在香港的家庭护理环境中，对晚期癌症患者进行了充分的招募。患者、家庭成员和卫生专业人员认为该干预措施是有帮助和可接受的，患者和家属表示他们将来会在类似的研究中参与。能量和蛋白质摄入量从基线到干预结束时有所改善（平均 22 kcal/kg/天增加到 26 和 0.9 g/kg/天增加到 1.0）。
结论
当为晚期癌症患者提供家庭环境中的新干预措施时，该干预措施是可行的，可被患者和家庭接受，并有潜力改善患者的营养状况。未来需要进行大规模的随机试验。
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