Kamkhoad Donruedee, Santacroce Sheila Judge, Patoomwan Autchareeya
Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
School of Nursing, The University of North Carolina at Chapel Hill, North Carolina, USA.
Asia Pac J Oncol Nurs. 2023 Nov 21;11(1):100348. doi: 10.1016/j.apjon.2023.100348. eCollection 2024 Jan.
This study aimed to explore the perspectives of pediatric oncology clinicians in Thailand on children's gastrointestinal symptoms, eating habits, and nutrition during cancer chemotherapy. Additionally, it sought to identify factors influencing children's nutritional status, including the characteristics of the children, clinician-related factors, and hospital-level factors.
The study involved pediatric oncology clinicians working at a tertiary hospital in Bangkok. Data were collected through interviews, focusing on three key areas: (1) children's gastrointestinal symptoms, eating behaviors, and nutrition, (2) clinicians' cognitions and behaviors that impact children's nutrition, and (3) environmental factors. Each participating clinician also identified a colleague who could offer additional perspectives. Interviews were conducted in the Thai language and analyzed using directed content analysis.
A total of 22 participants were enrolled in the study, comprising sixteen nurses, four physicians, one child life specialist, and one Hospital Nutrition Service staff member. The majority of participants were female (95.4%), with an average age of 37.77 years and an average of 15.55 years of experience in caring for children with cancer. Factors influencing children's nutritional status included the children's cancer diagnosis, treatment exposures, and symptoms. Clinicians attributed changes in children's weight and eating patterns to these symptoms. Influential clinician-related factors included current practices that impacted children's symptoms and food intake. Hospital-level factors included both direct influences on children and those arising from clinical practices.
To optimize the nutritional status of Thai children undergoing chemotherapy, multi-level interventions are needed. These interventions should target children's symptoms, clinician knowledge, role norms, and address issues related to the hospital environment, specifically those elements that contribute to unpleasant experiences.
本研究旨在探讨泰国儿科肿瘤临床医生对癌症化疗期间儿童胃肠道症状、饮食习惯和营养状况的看法。此外，研究还试图确定影响儿童营养状况的因素，包括儿童特征、临床医生相关因素和医院层面因素。
该研究纳入了在曼谷一家三级医院工作的儿科肿瘤临床医生。通过访谈收集数据，重点关注三个关键领域：（1）儿童胃肠道症状、饮食行为和营养状况；（2）影响儿童营养的临床医生认知和行为；（3）环境因素。每位参与的临床医生还指定了一位能提供额外观点的同事。访谈以泰语进行，并采用定向内容分析法进行分析。
共有22名参与者纳入研究，包括16名护士、4名医生、1名儿童生活专家和1名医院营养服务工作人员。大多数参与者为女性（95.4%），平均年龄37.77岁，平均有15.55年照顾癌症患儿的经验。影响儿童营养状况的因素包括儿童的癌症诊断、治疗暴露情况和症状。临床医生将儿童体重和饮食模式的变化归因于这些症状。有影响的临床医生相关因素包括影响儿童症状和食物摄入的现行做法。医院层面因素包括对儿童的直接影响以及临床实践产生的影响。
为优化接受化疗的泰国儿童的营养状况，需要采取多层次干预措施。这些干预措施应针对儿童症状、临床医生知识、角色规范，并解决与医院环境相关的问题，特别是那些导致不愉快经历的因素。
