Author Affiliations: Nursing Department, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital (Ms Qin, Drs Tian, and Wu), China; and Nursing College, Shanghai Jiao Tong University School of Medicine (Ms Xu), China.
Cancer Nurs. 2022;45(5):E810-E819. doi: 10.1097/NCC.0000000000001022. Epub 2021 Sep 29.
Oral nutritional supplements (ONS) is a cost-effective nutritional therapy in patients with gastrointestinal cancer. However, information is lacking about adherence to ONS in general clinical settings. Figuring out adherence to ONS and related factors will provide evidence for the improvement of ONS usage practice.
The aim of this study was to survey adherence to ONS in gastrointestinal cancer patients with an ONS prescription and the factors associated with it.
A mixed-method prospective study was conducted. Multivariate analysis and semistructured interviews were performed to identify factors that affected patient adherence to ONS.
Of 111 gastrointestinal cancer patients provided with an ONS prescription, the median of adherence to ONS was 50.00% (interquartile range, 28.57%-91.67%). Multivariate analysis indicated that participants with low weight showed higher adherence to ONS than those with normal weight (β = -2.61, P = .011) or overweight (β = -3.25, P = .002). Semistructured interviews on 14 participants suggested that factors related to adherence to ONS were needs perception and benefits, clarity of the target daily ONS intake, tolerance to ONS, the impact of disease or treatment, personal preference, and professional support.
This study reveals poor adherence to ONS in patients with gastrointestinal cancer and factors related to it in current clinical settings.
Our findings could provide evidence for the development of strategies to improve ONS usage practice. It suggests that the practice in ONS should be improved from aspects of nutritional assessment, education, tolerance, and symptom management, as well as follow-up and monitoring of patients.
口服营养补充剂（ONS）是胃肠道癌症患者一种具有成本效益的营养治疗方法。然而，一般临床环境中关于 ONS 依从性的信息还很缺乏。明确 ONS 的依从性及其相关因素将为改善 ONS 使用实践提供证据。
本研究旨在调查有 ONS 处方的胃肠道癌症患者对 ONS 的依从性及其相关因素。
采用混合方法前瞻性研究。进行多变量分析和半结构式访谈，以确定影响患者 ONS 依从性的因素。
在 111 名接受 ONS 处方的胃肠道癌症患者中，ONS 依从性的中位数为 50.00%（四分位距，28.57%-91.67%）。多变量分析表明，体重低的患者比体重正常（β=-2.61，P=.011）或超重（β=-3.25，P=.002）的患者对 ONS 的依从性更高。对 14 名参与者进行的半结构式访谈表明，与 ONS 依从性相关的因素包括对需求和获益的认知、目标每日 ONS 摄入量的明确性、对 ONS 的耐受性、疾病或治疗的影响、个人偏好和专业支持。
本研究揭示了胃肠道癌症患者目前临床环境中 ONS 依从性差及其相关因素。
我们的研究结果可为改善 ONS 使用实践提供证据。这表明应从营养评估、教育、耐受性和症状管理以及对患者的随访和监测等方面改进 ONS 实践。
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