Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
Support Care Cancer. 2020 Nov;28(11):5263-5270. doi: 10.1007/s00520-020-05371-7. Epub 2020 Feb 26.
Cancer-related malnutrition and sarcopenia have severe negative consequences including reduced survival and reduced ability to complete treatment. This study aimed to determine the awareness, perceptions and practices of Australian oncology clinicians regarding malnutrition and sarcopenia in people with cancer.
A national cross-sectional survey of Australian cancer clinicians was undertaken between November 2018 and January 2019. The 30-item online purpose-designed survey was circulated through professional organizations and health services.
The 111 participants represented dietetic (38%), nursing (34%), medical (14%) and other allied health (14%) clinicians. Overall, 86% and 88% clinicians were aware of accepted definitions of malnutrition and sarcopenia, respectively. Perception of responsibility for identification of these conditions varied across participants, although 93% agreed this was a component of their role. However, 21% and 43% of clinicians had limited or no confidence in their ability to identify malnutrition and sarcopenia, respectively. Common barriers to the identification and management of malnutrition were access to the tools or skills required and a lack of services to manage malnourished patients. Common barriers to identification of sarcopenia were lack of confidence and lack of services to manage sarcopenic patients. Enablers for identification and management of malnutrition and sarcopenia were variable; however, training and protocols for management ranked highly.
While awareness of the importance of cancer-related malnutrition and sarcopenia are high, participants identified substantial barriers to delivering optimal nutrition care. Guidance at a national level is recommended to strengthen the approach to management of cancer-related malnutrition and sarcopenia.
癌症相关的营养不良和肌肉减少症会带来严重的负面影响,包括降低生存率和降低完成治疗的能力。本研究旨在确定澳大利亚肿瘤临床医生对癌症患者营养不良和肌肉减少症的认识、看法和实践。
于 2018 年 11 月至 2019 年 1 月对澳大利亚肿瘤临床医生进行了一项全国性的横断面调查。该 30 项在线目的明确设计的调查通过专业组织和卫生服务机构进行了分发。
111 名参与者代表了营养师(38%)、护士(34%)、医生(14%)和其他联合健康专业人员(14%)。总的来说,86%和 88%的临床医生分别了解接受的营养不良和肌肉减少症的定义。虽然 93%的临床医生同意这是他们角色的一部分,但他们对识别这些情况的责任的看法存在差异。然而,21%和 43%的临床医生分别对识别营养不良和肌肉减少症的能力有限或没有信心。识别和管理营养不良的常见障碍是缺乏所需的工具或技能,以及缺乏管理营养不良患者的服务。识别肌肉减少症的常见障碍是缺乏信心和缺乏管理肌肉减少症患者的服务。识别和管理营养不良和肌肉减少症的促成因素各不相同;然而,管理方面的培训和方案的排名很高。
虽然对癌症相关营养不良和肌肉减少症的重要性的认识很高,但参与者确定了提供最佳营养护理的重大障碍。建议在国家层面提供指导,以加强对癌症相关营养不良和肌肉减少症的管理方法。