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个体化营养护理治疗疾病相关营养不良:关注患者的实际需求,改善临床结局。

Individualised Nutritional Care for Disease-Related Malnutrition: Improving Outcomes by Focusing on What Matters to Patients.

机构信息

Bath Clinic, Circle Health Group, Bath BA2 7BR, UK.

First Page Nutrition Ltd., Chippenham SN15 5HS, UK.

出版信息

Nutrients. 2022 Aug 27;14(17):3534. doi: 10.3390/nu14173534.

Abstract

Delivering care that meets patients' preferences, needs and values, and that is safe and effective is key to good-quality healthcare. Disease-related malnutrition (DRM) has profound effects on patients and families, but often what matters to patients is not captured in the research, where the focus is often on measuring the adverse clinical and economic consequences of DRM. Differences in the terminology used to describe care that meets patients' preferences, needs and values confounds the problem. Individualised nutritional care (INC) is nutritional care that is tailored to a patient's specific needs, preferences, values and goals. Four key pillars underpin INC: what matters to patients, shared decision making, evidence informed multi-modal nutritional care and effective monitoring of outcomes. Although INC is incorporated in nutrition guidelines and studies of oral nutritional intervention for DRM in adults, the descriptions and the degree to which it is included varies. Studies in specific patient groups show that INC improves health outcomes. The nutrition care process (NCP) offers a practical model to help healthcare professionals individualise nutritional care. The model can be used by all healthcare disciplines across all healthcare settings. Interdisciplinary team approaches provide nutritional care that delivers on what matters to patients, without increased resources and can be adapted to include INC. This review is of relevance to all involved in the design, delivery and evaluation of nutritional care for all patients, regardless of whether they need first-line nutritional care or complex, highly specialised nutritional care.

摘要

提供符合患者偏好、需求和价值观的、安全有效的护理是高质量医疗保健的关键。与疾病相关的营养不良(DRM)对患者及其家庭有深远的影响,但患者关心的往往不是研究中所关注的,因为研究的重点通常是衡量 DRM 的不良临床和经济后果。用于描述符合患者偏好、需求和价值观的护理的术语差异混淆了问题。个体化营养护理(INC)是根据患者的特定需求、偏好、价值观和目标量身定制的营养护理。INC 有四个关键支柱:患者关心的问题、共同决策、循证多模式营养护理以及对结果的有效监测。尽管 INC 已纳入营养指南和成人 DRM 口服营养干预研究中,但描述和包含程度各不相同。特定患者群体的研究表明,INC 可改善健康结果。营养护理过程(NCP)提供了一个实用的模型,帮助医疗保健专业人员实现个体化营养护理。该模型可用于所有医疗保健环境中的所有医疗保健学科。跨学科团队方法提供了符合患者需求的营养护理,无需增加资源,并且可以进行调整以纳入 INC。本综述与所有参与设计、提供和评估所有患者营养护理的人员相关,无论他们是否需要一线营养护理还是复杂、高度专业化的营养护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a9d/9460401/7c212a3168da/nutrients-14-03534-g001.jpg

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