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营养相关症状与晚期癌症患者饮食摄入和与饮食相关的困扰的关联。

Associations of nutrition impact symptoms with dietary intake and eating-related distress in patients with advanced cancer.

机构信息

Palliative and Supportive Care Center, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan; Department of Psycho-Oncology and Palliative Medicine, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan.

Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G1Z2, Canada.

出版信息

Clin Nutr ESPEN. 2024 Apr;60:313-319. doi: 10.1016/j.clnesp.2024.02.027. Epub 2024 Feb 26.

Abstract

BACKGROUND & AIMS: There is no definition of nutrition impact symptoms (NISs) in cancer care. Moreover, there is a lack of evidence on the associations of NISs with dietary intake and eating-related distress (ERD) in advanced cancer. Therefore, this study aimed to determine the associations of NISs with dietary intake and ERD in patients with advanced cancer.

METHODS

This study entailed a secondary analysis of a multicenter self-reported questionnaire designed to develop measurements that assess ERD experienced by patients. Participants evaluated their dietary intake and 19 symptoms regarded as NISs using a 10-point scale. To determine the association between dietary intake and the number of NISs with a score ≥4, estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the logistic regression model were calculated. Furthermore, to assess the association between ERD and the number of NISs with a score ≥4, multiple regression analysis was performed.

RESULTS

A total of 302 patients were included in the analysis. The higher the number of NISs with a score ≥4, the lower the dietary intake tended to be. In the logistic regression model, significantly higher adjusted ORs than in the no NISs with a score ≥4 group were observed in the 4-6 NISs group, 7-9 NISs group, and 10 or more group (0.19 [95% CI, 0.07-0.52], p = 0.001; 0.11 [95% CI, 0.03-0.42], p = 0.001; 0.07 [95% CI, 0.01-0.36], p = 0.002, respectively). In the multiple regression analysis, the number of NISs with a score ≥4 was identified as one of the factors significantly associated with ERD.

CONCLUSIONS

Having 4 or more NISs with a score ≥4 was shown to be predictive of the likelihood of reduced dietary intake. Furthermore, the higher the number of NISs with a score ≥4, the more likely the eating-related quality of life was impaired in advanced cancer.

摘要

背景与目的

癌症治疗中尚无营养影响症状(NIS)的定义。此外,在晚期癌症中,NIS 与饮食摄入和与进食相关的苦恼(ERD)之间的关联也缺乏证据。因此,本研究旨在确定 NIS 与晚期癌症患者饮食摄入和 ERD 的关联。

方法

本研究对一项多中心自我报告问卷的二次分析进行了研究,该问卷旨在开发评估患者 ERD 体验的测量方法。参与者使用 10 分制评估他们的饮食摄入和 19 种被认为是 NIS 的症状。为了确定饮食摄入与评分≥4 的 NIS 数量之间的关联,使用逻辑回归模型计算了估计的调整后比值比(OR)和 95%置信区间(CI)。此外,为了评估 ERD 与评分≥4 的 NIS 数量之间的关联,进行了多元回归分析。

结果

共纳入 302 名患者进行分析。评分≥4 的 NIS 数量越多,饮食摄入往往越低。在逻辑回归模型中,与评分≥4 的无 NIS 组相比,评分 4-6、7-9 和 10 个或更多 NIS 组的调整后 OR 显著更高(0.19[95%CI,0.07-0.52],p=0.001;0.11[95%CI,0.03-0.42],p=0.001;0.07[95%CI,0.01-0.36],p=0.002)。在多元回归分析中,评分≥4 的 NIS 数量被确定为与 ERD 显著相关的因素之一。

结论

评分≥4 的 NIS 数量达到 4 个或更多与饮食摄入减少的可能性相关。此外,评分≥4 的 NIS 数量越多,晚期癌症患者的与进食相关的生活质量受损的可能性越大。

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