Hematology Unit, Azienda Unità Sanitaria Locale IRCCS, Reggio Emilia, Italy.
EBMT Data Office, Leiden, The Netherlands.
Nutrition. 2020 Nov-Dec;79-80:110998. doi: 10.1016/j.nut.2020.110998. Epub 2020 Aug 28.
Malnutrition in patients undergoing hematopoietic stem cell transplant (HSCT) can develop rapidly without appropriate nutritional support and affect morbidity and mortality. Guidance to monitor and manage nutrition status is described within the literature; however, whether this is applied in clinical practice is unclear.
This paper describes a cross-sectional survey to explore current practice approaches in nutrition support management and adherence to international guidelines.
A total of 108 nurses from 108 centers across 16 countries replied to the questionnaire. A significant variation was observed regarding the availability of documents supporting the monitoring and management of nutrition status, application of recommendations, and nutritional practices.
The findings revealed that country was the most important factor influencing the differences in practice; however, significant differences were also observed based on patient age group (pediatrics vs. adults), department composition (hematology + HSCT unit vs. HSCT unit alone), and availability of nutrition health care professionals. Behavioral differences regarding nutritional practice approaches could be indicative of differences in knowledge or subject awareness, as well as a reflection of diversity across health care system policies.
Guideline dissemination and raising awareness through educational campaigns are suggested approaches to improve health care professionals' knowledge and sensitivity to this important topic.
造血干细胞移植（HSCT）患者如果没有适当的营养支持，可能会迅速出现营养不良，并影响发病率和死亡率。文献中描述了监测和管理营养状况的指南；然而，目前尚不清楚这些指南是否在临床实践中得到应用。
本研究通过横断面调查，探讨了目前营养支持管理中的实践方法和对国际指南的依从性。
来自 16 个国家 108 个中心的 108 名护士回答了问卷。在监测和管理营养状况的文件支持、建议的应用以及营养实践方面，观察到显著的差异。
研究结果表明，国家是影响实践差异的最重要因素；然而，根据患者年龄组（儿科与成人）、科室组成（血液科+HSCT 病房与 HSCT 病房）以及营养保健专业人员的可用性，也观察到了显著的差异。营养实践方法的行为差异可能表明知识或主题意识的差异，以及医疗保健系统政策的多样性的反映。
建议通过教育活动传播指南和提高认识，以提高医疗保健专业人员对这一重要主题的知识和敏感性。
