Chou Yun-Jen, Liou Yan-Ting, Lai Sheng-Ru, Tien Yu-Wen, Kuo Hsuan-Ju, Yang Hui-Ying, Shun Shiow-Ching
School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
National Taiwan University Cancer Center, Taipei, Taiwan.
Eur J Oncol Nurs. 2023 Oct;66:102352. doi: 10.1016/j.ejon.2023.102352. Epub 2023 Jun 10.
This study assessed the changes in malnutrition status, symptom severity, and anorexia-cachexia-related quality of life (QoL) before and after pancreatic surgery and identified significant factors associated with changes in anorexia-cachexia-related QoL in patients with operable pancreatic cancer.
In total, 76 patients with pancreatic cancer who were scheduled to undergo surgery were recruited from a medical center in northern Taiwan. The Mini Nutritional Assessment, Symptom Severity Scale, and Functional Assessment of Anorexia-Cachexia Therapy scale were used to assess the patients' nutritional status, symptom severity, and anorexia-cachexia-related QoL, respectively. Bioelectrical impedance analysis was performed using X-Scan Plus II to assess body composition. A generalized estimating equation approach was used to identify significant factors associated with anorexia-cachexia-related QoL.
In total, 42.1% of the patients had malnutrition or were at risk of malnutrition before surgery. Preoperative malnutrition (β = -3.857, p = .001) and higher early satiety (β = -0.629, p = .005), insomnia (β = -0.452, p = .025), and pain (β = -0.779, p < .001) were associated with lower anorexia-cachexia-related QoL.
Clinicians should actively assess the nutritional status of patients with pancreatic cancer before surgery and provide symptom cluster management interventions to improve nutrition, insomnia, and pain, which is crucial for enhancing patients' anorexia-cachexia-related QoL.
本研究评估了胰腺癌患者胰腺手术前后营养不良状况、症状严重程度以及厌食 - 恶病质相关生活质量(QoL)的变化,并确定了可手术胰腺癌患者厌食 - 恶病质相关生活质量变化的相关显著因素。
总共从台湾北部一家医疗中心招募了76例计划接受手术的胰腺癌患者。分别使用微型营养评定法、症状严重程度量表和厌食 - 恶病质治疗功能评定量表来评估患者的营养状况、症状严重程度以及厌食 - 恶病质相关生活质量。使用X - Scan Plus II进行生物电阻抗分析以评估身体成分。采用广义估计方程法来确定与厌食 - 恶病质相关生活质量相关的显著因素。
总共42.1%的患者在手术前存在营养不良或有营养不良风险。术前营养不良(β = -3.857,p = .001)以及较高的早饱感(β = -0.629,p = .005)、失眠(β = -0.452,p = .025)和疼痛(β = -0.779,p < .001)与较低的厌食 - 恶病质相关生活质量相关。
临床医生应在手术前积极评估胰腺癌患者的营养状况,并提供症状群管理干预措施以改善营养、失眠和疼痛,这对于提高患者厌食 - 恶病质相关生活质量至关重要。