Holdoway Anne
Consultant Dietitian, The Bath Clinic, Bath; Chair, Managing Adult Malnutrition in the Community Panel; Education Officer, British Association for Parenteral and Enteral Nutrition.
Br J Nurs. 2022 Nov 24;31(21):S20-S27. doi: 10.12968/bjon.2022.31.21.S20.
Dietary advice, the provision of timely nutritional support and the alleviation of diet-related issues, should be an essential component of a holistic approach to palliative and end-of-life care, adjusted to account for the stage in the patient's journey, including prognosis. With an ageing population and increasing numbers of people living with not just one life-limiting disease but several, the dietary management of these patients is becoming more complex. This article considers the issues patients and families experience, how nurses can play a key role in identifying and alleviating nutrition- and diet-related issues in palliative care, including the use of tools to screen, assess and guide nutrition conversations and interventions. The content of the article is mostly drawn from the literature relating to palliative cancer care, knowledge derived from stakeholder engagement, clinical observations in a dietetic role in a hospice setting and qualitative research on the role of diet in palliative care as perceived by patients, carers, and health professionals.
饮食建议、及时提供营养支持以及缓解与饮食相关的问题，应成为姑息治疗和临终关怀整体方法的重要组成部分，并根据患者病程阶段（包括预后）进行调整。随着人口老龄化以及患有不止一种限制生命疾病而是多种此类疾病的人数不断增加，对这些患者的饮食管理正变得愈发复杂。本文探讨了患者及其家属所面临的问题，以及护士如何在识别和缓解姑息治疗中与营养和饮食相关的问题方面发挥关键作用，包括使用工具进行筛查、评估以及指导营养方面的交流和干预。本文内容大多取材于与姑息性癌症护理相关的文献、从利益相关者参与中获得的知识、在临终关怀机构担任饮食相关角色时的临床观察，以及患者、护理人员和健康专业人员对饮食在姑息治疗中作用的定性研究。
