Department of Kinesiology and Physical Education and Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada.
Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
JPEN J Parenter Enteral Nutr. 2021 Jan;45(1):183-192. doi: 10.1002/jpen.1827. Epub 2020 Apr 8.
The nutrition profile of palliative home care clients is unknown. This study describes this group and their nutrition issues and evaluates the performance of the interRAI nutrition Clinical Assessment Protocol (CAP).
This was a cross-sectional secondary analysis using Ontario interRAI Palliative Care (interRAI PC) Assessment data. The sample represents 74,963 unique Ontario home care clients assessed between 2011 and 2018. Frequencies and standardized differences (stdiffs) of nutrition characteristics were presented for cancer (n = 62,394) and noncancer (n = 12,569) diagnostic subgroups. Rates of triggering the nutrition CAP were presented by nutrition issue to evaluate its performance.
Of this sample, 16.7% were ≥85 years of age, 52.6% had a prognosis between 6 weeks and 6 months, and 41.4% required assistance with eating. The prevalence was higher among those with nervous/mental/behavioral disorders (72.6%) compared with those with cancer (37.6%; stdiff = 0.75). However, most nutrition issues experienced were similar (stdiff < 0.20) across diagnostic groups. Of the entire sample, 21% triggered the nutrition CAP, indicating a need for further evaluation or intervention. Yet, 73.4% of those who experienced dry mouth, 71.8% of those who required assistance with eating, and 68.4% of those who received a nutrition consult within the last 3 days did not trigger the nutrition CAP.
Nutrition issues are prevalent in palliative home care clients, regardless of diagnosis; yet the nutrition CAP identified a small fraction of this group. There is a need to focus research and care guidelines toward life-limiting illnesses beyond cancer and address nutrition-related issues in this population.
姑息治疗居家护理客户的营养状况尚不清楚。本研究描述了这一群体及其营养问题，并评估了 interRAI 营养临床评估方案（CAP）的性能。
这是一项使用安大略省 interRAI 姑息治疗（interRAI PC）评估数据的横断面二次分析。该样本代表了 2011 年至 2018 年间评估的 74963 名独特的安大略省居家护理客户。为癌症（n=62394）和非癌症（n=12569）诊断亚组呈现营养特征的频率和标准化差异（stdiff）。通过营养问题呈现触发营养 CAP 的比率，以评估其性能。
在该样本中，16.7%的客户年龄≥85 岁，52.6%的客户预后在 6 周至 6 个月之间，41.4%的客户需要进食帮助。与癌症患者（37.6%；stdiff=0.75）相比，患有神经/精神/行为障碍的患者的患病率更高（72.6%）。然而，在诊断组中，大多数经历的营养问题相似（stdiff<0.20）。在整个样本中，21%的客户触发了营养 CAP，表明需要进一步评估或干预。然而，73.4%经历口干的客户、71.8%需要进食帮助的客户和 68.4%在过去 3 天内接受营养咨询的客户未触发营养 CAP。
无论诊断如何，姑息治疗居家护理客户的营养问题都很普遍；然而，营养 CAP 仅识别了该群体的一小部分。需要将研究和护理指南的重点放在癌症以外的限制生命的疾病上，并解决这一人群中的营养相关问题。
