Diplom-Kauffrau, Faculty of Health, School of Nursing Science, PhD Student at the Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany.
Caritas-Hospital Sankt Josef, Landshuter Straße 65, 93053, Regensburg, Germany.
J Cancer Res Clin Oncol. 2021 Jun;147(6):1789-1802. doi: 10.1007/s00432-020-03454-w. Epub 2020 Dec 29.
Due to frequent treatment side effects and weight loss, colorectal cancer patients require oncologic care and nutritional counseling both during and after hospitalization. The current study evaluated differences in discharge and side effects management and nutritional behavior between colorectal cancer patients of a control group without systematic counseling and of an intervention group with access to structured in- and outpatient oncology nurse and nutritional counseling.
The presented explorative, quantitative, single-center, interventional pilot study is a health services research project with a quasi-experimental design. Using a self-designed standardized questionnaire, data were collected from the control group (n = 75) before and from the intervention group (n = 114) after the introduction of in- and outpatient oncology nurse and structured systematic nutritional counseling. The in- and outpatient counseling services were developed and evaluated in the form of a structured nurse-led counseling concept.
Intervention group patients profited significantly from inpatient oncology nurse counseling in seven different areas of discharge management. No differences were observed concerning patient-reported general and gastrointestinal side effects except for xerostomia and dysphagia, but of the patients participating in both in- and outpatient oncology nurse counseling, 90.0% were better able to cope with general side effects of treatment. Patients with in- and outpatient structured systematic nutritional counseling more frequently received nutritional information (p = 0.001), were better at gauging food intolerances (p = 0.023), and followed the dietician's advice in cases of gastrointestinal side effects significantly more often (p = 0.003) than control patients. Counselor-reported outcomes concerning gastrointestinal side effects showed improvement in most of the patients taking part in systematic in- and outpatient nutritional counseling, except for weight loss in 4 patients.
In- and outpatient counseling in discharge and side effects management and nutrition improve the outcomes of colorectal cancer patients. Outpatient counseling should be further developed and evaluated in future studies.
由于频繁的治疗副作用和体重减轻,结直肠癌患者在住院期间和出院后都需要肿瘤学护理和营养咨询。本研究评估了在没有系统咨询的对照组和接受结构化门诊肿瘤护士和营养咨询的干预组中,结直肠癌患者在出院和副作用管理以及营养行为方面的差异。
本研究是一项探索性、定量、单中心、干预性试点研究,采用准实验设计。使用自行设计的标准化问卷,在对照组(n=75)入院前和干预组(n=114)入院后收集数据。入院和门诊肿瘤护士及结构化系统营养咨询服务是在结构化护士主导的咨询概念下开发和评估的。
干预组患者在出院管理的七个不同领域从住院肿瘤护士咨询中获益显著。除口干和吞咽困难外,患者报告的一般和胃肠道副作用方面没有差异,但在接受住院和门诊肿瘤护士咨询的患者中,90.0%的患者能够更好地应对治疗的一般副作用。接受住院和门诊结构化系统营养咨询的患者更频繁地获得营养信息(p=0.001),更能准确评估食物不耐受(p=0.023),并且在出现胃肠道副作用时更经常遵循营养师的建议(p=0.003),明显优于对照组患者。接受系统住院和门诊营养咨询的患者中,除 4 名患者体重减轻外,胃肠道副作用的咨询师报告结果显示大多数患者情况有所改善。
出院和副作用管理以及营养方面的住院和门诊咨询改善了结直肠癌患者的结局。应在未来的研究中进一步开发和评估门诊咨询。