Department of Surgery, Stanford University School of Medicine, Stanford, California; Stanford Prevention Research Center, Stanford, California.
Department of Surgery, Stanford University School of Medicine, Stanford, California.
J Surg Res. 2024 Oct;302:80-91. doi: 10.1016/j.jss.2024.07.030. Epub 2024 Aug 1.
Nutrition is critical to gastrointestinal (GI) disease prevention and treatment, including operations, yet perioperative nutrition practices vary widely. We aimed to understand GI surgical patient and health care provider's perioperative nutrition beliefs and practices.
We used a mixed-methods approach, including a patient survey (n = 19), provider survey (n = 26), and semistructured interviews with a subset of providers (n = 15). Providers included surgeons, gastroenterologists, medical oncologists, advanced practice providers, and dietitians. Provider interviews were transcribed, iteratively coded, and thematically analyzed. Quantitative and qualitative data were integrated.
94.7% of patients and 100% of providers surveyed believe that nutrition affects outcomes. Patients seek nutrition information from diverse resources (73.7% from websites or blogs, 42.1% from documentaries, and 36.8% from books or /magazines) and people (52.6% from family members, 42.1% from a significant other, partner, or spouse, and 36.8% from a dietitian or nutritionist). Providers cited a lack of quality information, misinformation, and inconsistency among health care providers as barriers to high-quality nutrition care. Both patients and providers noted that nutritional supplements have drawbacks, with 100% of patients and 96.2% of providers expressing interest in house- made plant-based protein smoothie or soup alternatives.
This study led to the development of a multidisciplinary task force, which has collaborated on multiple interventions to improve inpatient perioperative surgical nutrition (e.g., smoothie pilot and postoperative menu revisions).
营养对于胃肠道（GI）疾病的预防和治疗至关重要，包括手术，但围手术期的营养实践差异很大。我们旨在了解 GI 外科患者和医疗保健提供者的围手术期营养信念和实践。
我们使用了混合方法，包括患者调查（n=19）、提供者调查（n=26），以及对一部分提供者（n=15）的半结构式访谈。提供者包括外科医生、胃肠病学家、肿瘤内科医生、高级实践提供者和营养师。对提供者的访谈进行了转录、迭代编码和主题分析。整合了定量和定性数据。
94.7%的患者和 100%的调查提供者认为营养会影响结果。患者从各种资源（73.7%来自网站或博客，42.1%来自纪录片，36.8%来自书籍或杂志）和人（52.6%来自家人，42.1%来自重要他人、伴侣或配偶，36.8%来自营养师或营养学家）中寻求营养信息。提供者提到缺乏高质量的信息、错误信息和医疗保健提供者之间的不一致是高质量营养护理的障碍。患者和提供者都注意到营养补充剂有缺点，100%的患者和 96.2%的提供者对自制植物性蛋白质冰沙或汤替代品表示感兴趣。
这项研究促成了一个多学科工作组的成立，该工作组合作开展了多项干预措施，以改善住院围手术期外科营养（例如，冰沙试点和术后菜单修订）。
