营养状况对肺癌患者心理功能和应对方式的影响。

Effect of nutritional status on psychological functioning and coping in patients with lung cancer.

机构信息

Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland.

Department of Logistic and Transport Systems, Faculty of Mechanical Engineering, Wroclaw University of Technology, Wroclaw, Poland.

出版信息

Nutrition. 2023 May;109:111970. doi: 10.1016/j.nut.2022.111970. Epub 2023 Jan 7.

DOI:10.1016/j.nut.2022.111970

PMID:36905837

Abstract

OBJECTIVES

Lung cancer is the most common cancer. In patients with lung cancer, malnutrition may result in shorter overall survival, poorer treatment response, increased risk for complications and impaired physical and mental function. The aim of this study was to assess the effects of nutritional status on the psychological functioning and coping in patients with lung cancer.

METHODS

The present study included 310 patients treated for lung cancer at the Lung Center between 2019 and 2020. The standardized instruments were used: Mini Nutritional Assessment (MNA) and Mental Adjustment to Cancer (MAC). Of the 310 patients, 113 (59%) were at risk for malnutrition and 58 (30%) had malnutrition.

RESULTS

Patients with a satisfactory nutritional status and those at risk for malnutrition reported statistically significantly higher levels of constructive coping compared with patients with malnutrition (P = 0.040). Patients with malnutrition were more likely to have more advanced cancer: T4 tumor (60.3 versus 38.5; P = 0.007), distant metastases: M1 or M2 (43.9 versus 28.1; P = 0.043), tumor metastases (60.3 versus 39.3; P = 0.008) and brain metastases (19 versus 5.2: P = 0.005). Patients with malnutrition were more likely to have higher levels of dyspnea (75.9 versus 57.8; P = 0.022) and a performance status of ≥2 (69 versus 44.4; P = 0.003).

CONCLUSIONS

Malnutrition is significantly more common in patients using negative strategies for coping with cancer. Lack of constructive coping is a statistically significant predictor of increased risk for malnutrition. Advanced cancer stage is a statistically significant independent predictor of malnutrition, increasing the risk of malnutrition by more than twofold.

摘要

目的

肺癌是最常见的癌症。在肺癌患者中，营养不良可能导致总生存期缩短、治疗反应较差、并发症风险增加以及身体和精神功能受损。本研究旨在评估营养状况对肺癌患者心理功能和应对方式的影响。

方法

本研究纳入了 2019 年至 2020 年在肺科中心接受肺癌治疗的 310 名患者。使用了标准化的工具：微型营养评估（MNA）和癌症心理调整（MAC）。在 310 名患者中，有 113 名（59%）有营养不良风险，58 名（30%）有营养不良。

结果

营养状况良好和有营养不良风险的患者与营养不良的患者相比，采用建设性应对方式的比例显著更高（P=0.040）。营养不良的患者更有可能患有更晚期的癌症：T4 肿瘤（60.3%比 38.5%；P=0.007）、远处转移：M1 或 M2（43.9%比 28.1%；P=0.043）、肿瘤转移（60.3%比 39.3%；P=0.008）和脑转移（19%比 5.2%；P=0.005）。营养不良的患者呼吸困难程度更高（75.9%比 57.8%；P=0.022）和体能状态≥2（69%比 44.4%；P=0.003）的可能性更大。