Kirbiyik Feza, Ozkan Emre
Nutricia Advanced Medical Nutrition, Department of Medical Affairs, Istanbul, Turkey.
Nutricia Advanced Medical Nutrition, Department of Medical Affairs, Istanbul, Turkey.
Clin Nutr ESPEN. 2018 Oct;27:32-37. doi: 10.1016/j.clnesp.2018.07.004. Epub 2018 Aug 9.
Despite the identification of malnutrition and administration of nutrition therapy being increasingly recognised as integral to the treatment of cancer patients, this is not always translated into routine clinical practice. The aim of this study was to determine medical oncologists' awareness of, and ability to assess, nutritional status and when to initiate nutrition therapy, to identify their educational status concerning clinical nutrition and their perceived barriers to the routine use of nutrition therapy in their patients through a survey study.
155 medical oncologists were invited to complete a digital questionnaire. The questionnaire included information regarding the participants demographic and professional information, clinical nutrition education status, attitudes towards malnutrition and nutrition therapy, and barriers to using nutrition therapy. The questionnaire also included two case scenarios designed to assess ability to diagnose malnutrition/assess nutritional status and identify when nutrition therapy might be indicated.
Of 109 medical oncologists who agreed to participate, 43.1% declared that they received clinical nutrition education and 33.9% declared that they followed the oncology sections in the European Society of Clinical Nutrition and Metabolism (ESPEN) Guidelines. The medical oncologists were divided into two groups according to their knowledge score (31 medical oncologists with a knowledge score of <3 and 78 medical oncologists with a knowledge score of ≥3). The rate of having nutrition education was significantly higher in those with a higher knowledge score (≥3) and the rate of medical oncologists having this education during medical and/or oncology education was also significantly higher. The rate of medical oncologists following the oncology sections in the ESPEN guidelines was higher in those with higher knowledge score.
Our results emphasize the association between clinical nutrition education and higher knowledge scores in medical oncologists, but reveal a mis-match between knowledge and awareness and what happens in clinical practice. Nutrition therapy might be used more frequently in routine practice when medical oncologists' lack of knowledge is resolved.
尽管营养不良的识别以及营养治疗的实施越来越被视为癌症患者治疗不可或缺的一部分，但这并非总能转化为常规临床实践。本研究的目的是通过一项调查研究，确定医学肿瘤学家对营养状况的认识、评估能力以及开始营养治疗的时机，识别他们在临床营养方面的教育状况以及他们认为在患者中常规使用营养治疗的障碍。
邀请155名医学肿瘤学家完成一份数字问卷。问卷包括有关参与者的人口统计学和专业信息、临床营养教育状况、对营养不良和营养治疗的态度以及使用营养治疗的障碍等信息。问卷还包括两个病例场景，旨在评估诊断营养不良/评估营养状况的能力以及确定何时可能需要营养治疗。
在同意参与的109名医学肿瘤学家中，43.1%宣称他们接受过临床营养教育，33.9%宣称他们遵循欧洲临床营养与代谢学会（ESPEN）指南中的肿瘤学部分。根据知识得分，医学肿瘤学家被分为两组（31名知识得分<3分的医学肿瘤学家和78名知识得分≥3分的医学肿瘤学家）。知识得分较高（≥3分）的人员接受营养教育的比例显著更高，并且在医学和/或肿瘤学教育期间接受过这种教育的医学肿瘤学家比例也显著更高。遵循ESPEN指南中肿瘤学部分的医学肿瘤学家比例在知识得分较高的人员中更高。
我们的结果强调临床营养教育与医学肿瘤学家较高知识得分之间的关联，但揭示了知识与意识以及临床实践中实际情况之间的不匹配。当医学肿瘤学家知识欠缺的问题得到解决时，营养治疗在常规实践中可能会更频繁地使用。
