Department of Surgery, Western Precinct, Melbourne Medical School, The University of Melbourne, St Albans, VIC 3021, Australia; Department of Nutrition and Dietetics, Western Health, Footscray, VIC 3011, Australia.
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3220, Australia; Allied Health Research, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.
Clin Nutr ESPEN. 2021 Dec;46:343-349. doi: 10.1016/j.clnesp.2021.09.734. Epub 2021 Sep 28.
Patients undergoing surgery for upper gastrointestinal (UGI) cancer are at high risk of malnutrition, and a multidisciplinary approach to management is recommended. This study aimed to determine practices, awareness and perceptions of multi-disciplinary clinicians with regards to malnutrition screening and provision of nutrition support.
A national survey of dietitians, surgeons, oncologists and nurses was conducted using a 30-item online REDCap survey, including questions regarding self-reported malnutrition screening/nutrition support practices, awareness and perceptions, and barriers and enablers. The survey was distributed via professional organisations/networks between 1st September and 30th November 2020. Results are presented as counts and percentages.
There were 130 participants (56% dietitians, 25% surgeons, 11% nurses, 8% oncologists). The majority reported that dietitians and nurses performed malnutrition screening, and dietitians and surgeons prescribed nutrition support. Most participants reported that their health service had dietetics support available overall (98%), however only 41% reported having an outpatient service. Participants (>90%) demonstrated very high awareness of the significance of malnutrition and the importance of early nutrition support. Participants mostly perceived dietitians, nurses and surgeons to be responsible for malnutrition screening, whilst responsibility of prescription of nutrition support was mostly dietitians and surgeons. There were a higher number of barriers for the outpatient setting (48%) than the inpatient setting (38%).
Participants identified a high awareness of the importance of identification and treatment of malnutrition in UGI cancer surgery. However reported practices varied and appear to be lacking in the outpatient setting, with significant barriers identified to providing optimal nutrition care.
接受上消化道（UGI）癌症手术的患者存在营养不良的高风险，建议采用多学科方法进行管理。本研究旨在确定多学科临床医生在营养不良筛查和提供营养支持方面的实践、意识和看法。
使用包含 30 个项目的在线 REDCap 调查对营养师、外科医生、肿瘤学家和护士进行了全国性调查，包括有关自我报告的营养不良筛查/营养支持实践、意识和看法以及障碍和促进因素的问题。该调查于 2020 年 9 月 1 日至 11 月 30 日通过专业组织/网络分发。结果以计数和百分比表示。
共有 130 名参与者（56%为营养师，25%为外科医生，11%为护士，8%为肿瘤学家）。大多数人报告说营养师和护士进行了营养不良筛查，营养师和外科医生开具了营养支持处方。大多数参与者报告说，他们的医疗服务总体上都有营养师的支持（98%），但只有 41%的人报告有门诊服务。参与者（>90%）对营养不良的重要性和早期营养支持的重要性表现出高度认识。参与者大多认为营养师、护士和外科医生负责营养不良筛查，而营养支持的处方责任主要由营养师和外科医生承担。门诊环境的障碍（48%）比住院环境（38%）更多。
参与者认为在 UGI 癌症手术中识别和治疗营养不良非常重要。然而，报告的实践情况各不相同，并且在门诊环境中似乎缺乏，并且发现了提供最佳营养护理的重大障碍。
