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卵巢癌治疗后的饮食营养师随访。

Dietitian encounters after treatment for ovarian cancer.

机构信息

Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.

Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, QLD, Australia.

出版信息

J Hum Nutr Diet. 2021 Dec;34(6):1053-1063. doi: 10.1111/jhn.12898. Epub 2021 Apr 9.

Abstract

BACKGROUND

After ovarian cancer treatment, women report health issues that may be amenable to change with dietary support. The present study investigated how many women encounter a dietitian post-treatment and the factors associated with dietitian service use.

METHODS

We used data from a cohort of women with invasive epithelial ovarian cancer to identify socio-economic, clinical and personal factors associated with dietitian encounter after treatment completion. Data were collected at regular intervals using validated questionnaires up to 4 years post-treatment completion. Logistic regression (LR) and generalised linear mixed models (GLMM) were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) to assess factors associated with dietitian encounter at any time-point post-treatment (LR), as well as in the 3 months prior to a follow-up questionnaire (GLMM) to assess time-varying factors.

RESULTS

Of 819 women, 97 (12%) reported seeing a dietitian post-treatment. Factors associated with dietitian encounter were being overweight (OR  = 1.7, CI = 1.1-2.8), having poorer self-rated health (OR  = 2.5, CI = 1.2-5.2; OR  = 2.3, CI = 1.2-4.4) or poorer diet quality (OR  = 0.5, CI = 0.2-1.0) pre-diagnosis, treatment within the public health system (OR  = 1.8, CI = 1.2-2.7), previous support from dietetic (OR  = 3.1, CI = 1.8-5.4; OR  = 2.8, CI = 1.8-4.2) or other allied health services (OR  = 2.0, CI = 1.2-3.2; OR  = 3.7, CI = 2.4-5.5), and having progressive disease at follow-up (OR  = 2.2, CI = 1.4-3.3). Most women (86%) with ≥ 3 moderate-to-severe nutrition impact symptoms did not report a dietitian encounter post-treatment.

CONCLUSIONS

Few women encounter a dietitian post-treatment for ovarian cancer, including those with multiple nutrition impact symptoms. Further work is needed to engage those likely to benefit from dietitian support but less likely to seek or receive it.

摘要

背景

卵巢癌治疗后,女性会报告一些可能通过饮食支持来改善的健康问题。本研究调查了治疗后有多少女性会咨询营养师,以及哪些因素与营养师服务的使用有关。

方法

我们使用了一组侵袭性上皮性卵巢癌女性的数据,以确定与治疗完成后与营养师接触相关的社会经济、临床和个人因素。使用经过验证的问卷在治疗完成后长达 4 年的时间内定期收集数据。使用逻辑回归(LR)和广义线性混合模型(GLMM)计算调整后的比值比(OR)和 95%置信区间(CI),以评估治疗后任何时间点(LR)以及在随访问卷前 3 个月(GLMM)与营养师接触相关的因素,以评估时间变化的因素。

结果

在 819 名女性中,有 97 名(12%)报告在治疗后咨询过营养师。与与营养师接触相关的因素包括超重(OR=1.7,CI=1.1-2.8)、自我报告健康状况较差(OR=2.5,CI=1.2-5.2;OR=2.3,CI=1.2-4.4)或治疗前饮食质量较差(OR=0.5,CI=0.2-1.0)、在公共卫生系统内接受治疗(OR=1.8,CI=1.2-2.7)、之前接受过饮食治疗(OR=3.1,CI=1.8-5.4;OR=2.8,CI=1.8-4.2)或其他联合健康服务(OR=2.0,CI=1.2-3.2;OR=3.7,CI=2.4-5.5)、随访时疾病进展(OR=2.2,CI=1.4-3.3)。大多数(86%)有≥3 个中度至重度营养影响症状的女性在治疗后没有报告与营养师接触。

结论

很少有女性在卵巢癌治疗后会咨询营养师,包括那些有多个营养影响症状的女性。需要进一步努力让那些可能受益于营养师支持但不太可能寻求或接受支持的人参与进来。

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