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英国一项针对 COVID-19 患者在住院前后营养护理途径的调查。

A UK survey of nutritional care pathways for patients with COVID-19 prior to and post-hospital stay.

机构信息

Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK.

Plymouth Institute of Health Research, University of Plymouth, Plymouth, UK.

出版信息

J Hum Nutr Diet. 2021 Aug;34(4):660-669. doi: 10.1111/jhn.12896. Epub 2021 May 12.

Abstract

BACKGROUND

During the global COVID-19 pandemic, UK dietitians have delivered the best care to help patients recover from the infection. The present study examined the development and evaluation of care pathways to manage nutritional care of patients following COVID-19 infection prior to and after discharge.

METHODS

Registered UK dietitians completed an online questionnaire comprising 26 questions about the development of a pathway, its use, evaluation and training needs.

RESULTS

Of 57 responses from organisations, 37 (65%) were involved in the planning/management of nutritional care. Only 19 responses had a new or adapted COVID-19 pathway. Of these, 74% reported involvement of dietetic services, 47% reported > 1 eligibility criteria for pathway inclusion and 53% accepted all positive or suspected cases. All respondents used nutritional screening, first-line dietary advice (food first) and referral for further advice and monitoring. Weight and food intake were the most used outcome measure. All pathways addressed symptoms related to nutrition, with the most common being weight loss with poor appetite, not being hungry and skipping meals in 84% of pathways. Over half of respondents (54%) planned to evaluate their pathway and 83% reported that they were 'very or reasonably confident' in their team's nutritional management of COVID-19. Less than half (42%) reported on training needs.

CONCLUSIONS

Despite challenges encountered, pathways were developed and implemented. Dietitians had adapted to new ways of working to manage nutritional care in patients prior to and after discharge from hospital following COVID-19 infection. Further work is needed to develop strategies for evaluation of their impact.

摘要

背景

在全球 COVID-19 大流行期间,英国营养师为帮助患者从感染中康复提供了最佳护理。本研究探讨了在 COVID-19 感染前后出院的患者的营养护理管理路径的制定和评估。

方法

注册英国营养师完成了一份包含 26 个问题的在线问卷,内容涉及路径的制定、使用、评估和培训需求。

结果

在来自组织的 57 份回复中,有 37 份(65%)参与了营养护理的规划/管理。只有 19 份回复制定了新的或改编的 COVID-19 路径。其中,74%的人报告了营养服务的参与,47%的人报告了>1 个纳入路径的标准,53%的人接受了所有阳性或疑似病例。所有回复者都使用了营养筛查、一线饮食建议(先吃食物)和转介以获取进一步的建议和监测。体重和食物摄入量是最常用的结果衡量指标。所有路径都解决了与营养相关的症状,最常见的症状是 84%的路径中出现的体重减轻、食欲不振、不感到饥饿和不吃正餐。超过一半的回复者(54%)计划评估他们的路径,83%的人表示他们对团队 COVID-19 的营养管理“非常有信心或有一定信心”。不到一半(42%)的人报告了培训需求。

结论

尽管面临挑战,但路径已经制定并实施。营养师已经适应了新的工作方式,以在 COVID-19 感染后患者在医院前和出院后管理营养护理。需要进一步开展工作以制定评估其影响的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5394/8250968/eceb595426df/JHN-34-660-g006.jpg

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