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终端用户对一项以患者及家庭为中心的干预措施改善肿瘤患者营养摄入情况的看法:一项描述性定性分析

End-user perceptions of a patient- and family-centred intervention to improve nutrition intake among oncology patients: a descriptive qualitative analysis.

作者信息

Marshall Andrea P, Tobiano Georgia, Roberts Shelley, Isenring Elisabeth, Sanmugarajah Jasotha, Kiefer Deborah, Fulton Rachael, Cheng Hui Lin, To Ki Fung, Ko Po Shan, Lam Yuk Fong, Lam Wang, Molassiotis Alex

机构信息

Nursing and Midwifery Education and Research Unit, Gold Coast Health, 1 Hospital Blvd, Southport, QLD 4215 Australia.

Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, QLD 4215 Australia.

出版信息

BMC Nutr. 2020 Jul 21;6:29. doi: 10.1186/s40795-020-00353-8. eCollection 2020.

Abstract

BACKGROUND

People with cancer are at high risk of malnutrition. Nutrition education is an effective strategy to improve patient outcomes, however, little is known regarding the impact of family and/or carer involvement in nutrition education and requires investigation. The purpose of the study was to evaluate PIcNIC (artnering with famlies to promote utrition n ancer care) intervention acceptability from the perspective of patients, families and health care providers.

METHODS

A descriptive qualitative study was undertaken at an inpatient and an outpatient hospital setting in Australia and an outpatient/home setting in Hong Kong. A patient-and-family centred intervention including nutrition education, goals setting/nutrition plans, and food diaries, was delivered to patients and/or families in the inpatient, outpatient or home setting. Semi-structured interviews were used to explore perceptions of the intervention. 64 participants were interviewed; 20 patients, 15 family members, and 29 health care professionals. Data were analysed using deductive and inductive content analysis.

RESULTS

Two categories were identified; 1) 'context and intervention acceptability'; and 2) 'benefits of patient- and family-centred nutrition care'. Within each category redundant concepts were identified. For category 1 the redundant concepts were: the intervention works in outpatient settings, the food diary is easy but needs to be tailored, the information booklet is a good resource, and the intervention should be delivered by a dietitian, but could be delivered by a nurse. The redundant concepts for category 2 were: a personalised nutrition plan is required, patient and family involvement in the intervention is valued and the intervention has benefits for patients and families. Converging and diverging perceptions across participant groups and settings were identified.

CONCLUSIONS

In this paper we have described an acceptable patient- and family-centred nutrition intervention, which may be effective in increasing patient and family engagement in nutrition care and may result in improved nutrition intakes. Our study highlights important contextual considerations for nutrition education; the outpatient and home setting are optimal for engaging patients and families in learning opportunities.

摘要

背景

癌症患者存在营养不良的高风险。营养教育是改善患者预后的有效策略,然而,关于家庭和/或照顾者参与营养教育的影响知之甚少,需要进行调查。本研究的目的是从患者、家庭和医疗服务提供者的角度评估PIcNIC(与家庭合作促进癌症护理中的营养)干预的可接受性。

方法

在澳大利亚的一家住院和门诊医院以及香港的一个门诊/家庭环境中进行了一项描述性定性研究。一项以患者和家庭为中心的干预措施,包括营养教育、目标设定/营养计划和食物日记,被提供给住院、门诊或家庭环境中的患者和/或家庭。采用半结构化访谈来探讨对该干预措施的看法。共访谈了64名参与者;20名患者、15名家庭成员和29名医疗专业人员。使用演绎和归纳内容分析法对数据进行分析。

结果

确定了两类;1)“背景和干预可接受性”;2)“以患者和家庭为中心的营养护理的益处”。在每一类中都确定了冗余概念。对于第1类,冗余概念是:该干预措施在门诊环境中有效,食物日记简单但需要量身定制,信息手册是一个很好的资源,该干预应由营养师提供,但也可由护士提供。第2类的冗余概念是:需要个性化的营养计划,重视患者和家庭参与干预,且该干预对患者和家庭有益。确定了不同参与者群体和环境之间的趋同和分歧看法。

结论

在本文中,我们描述了一种可接受的以患者和家庭为中心的营养干预措施,这可能有效地提高患者和家庭参与营养护理的程度,并可能导致营养摄入量的改善。我们的研究强调了营养教育中重要的背景因素;门诊和家庭环境最适合让患者和家庭参与学习机会。

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