Department of Palliative Medicine, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka City, Osaka, 534-0021, Japan.
Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Kita-ku, Hamamatsu City, Shizuoka, 433-8558, Japan.
Support Care Cancer. 2019 Aug;27(8):2869-2876. doi: 10.1007/s00520-018-4590-6. Epub 2018 Dec 15.
Few studies have investigated nutrition impact symptoms and eating-related distress among advanced cancer patients and their families. This is a questionnaire survey to examine the severity of nutrition impact symptoms and the prevalence of eating-related distress among them in palliative and supportive care settings.
Questionnaires for patients and their families were preliminarily developed. We selected 16 common symptoms of advanced cancer, i.e., 9 symptoms of the ESAS-r and 7 of the PG-SGA. Each questionnaire concerning eating-related distress consisted of 12 items.
A total of 140 out of 147 patients responded (95.2%). They were classified into two groups: (1) non-cachexia/pre-cachexia (n = 57) and (2) cachexia/refractory cachexia (n = 83). The top 3 out of 16 symptoms in all patients were feeling of well-being, lack of appetite, and tiredness. Significant differences were observed in 8 symptoms between the two groups: tiredness (p = 0.007), drowsiness (p = 0.007), lack of appetite (p < 0.001), early satiety (p = 0.001), diarrhea (p = 0.025), abnormal taste (p = 0.02), difficulty swallowing (p = 0.002), and feeling of well-being (p = 0.003). Regarding eating-related distress in patients, significant differences were observed in all items, except for 2, between the two groups. Concerning eating-related distress in families, significant differences were observed in all items between the two groups.
Advanced cancer patients with cachexia have more severe nutrition impact symptoms than those without cachexia, and patients with cachexia and their families have greater eating-related distress than those without cachexia.
鲜有研究调查晚期癌症患者及其家属的营养影响症状和与饮食相关的困扰。本研究采用问卷形式，旨在调查姑息治疗和支持治疗环境中晚期癌症患者营养影响症状的严重程度和与饮食相关的困扰的发生率。
初步制定了患者及其家属的问卷。我们选择了 16 种常见的晚期癌症症状，即 ESAS-r 中的 9 种症状和 PG-SGA 中的 7 种症状。每个与饮食相关的困扰问卷包含 12 个项目。
共有 147 名患者中的 140 名（95.2%）做出回应。他们被分为两组：（1）非恶液质/恶液质前期（n=57）和（2）恶液质/难治性恶液质（n=83）。所有患者中排名前 3 的症状是幸福感、缺乏食欲和疲倦。两组患者之间有 8 种症状存在显著差异：疲倦（p=0.007）、嗜睡（p=0.007）、缺乏食欲（p<0.001）、早饱（p=0.001）、腹泻（p=0.025）、味觉异常（p=0.02）、吞咽困难（p=0.002）和幸福感（p=0.003）。关于患者的与饮食相关的困扰，两组之间除了 2 项之外，所有项目均存在显著差异。关于家庭的与饮食相关的困扰，两组之间所有项目均存在显著差异。
患有恶液质的晚期癌症患者比不患有恶液质的患者有更严重的营养影响症状，患有恶液质的患者及其家庭比不患有恶液质的患者及其家庭有更大的与饮食相关的困扰。
