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日本老年人厌食症诊断与管理知识及实践调查。

Survey on the knowledge and practices in anorexia of aging diagnosis and management in Japan.

作者信息

Takagi Sahoko, Satake Shosuke, Sugimoto Ken, Kuzuya Masafumi, Akishita Masahiro, Arai Hidenori, Aprahamian Ivan, Coats Andrew J, Klompenhouwer Tatiana, Anker Stefan D, Wakabayashi Hidetaka

机构信息

Department of Nutrition Management, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.

Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.

出版信息

J Cachexia Sarcopenia Muscle. 2024 Oct;15(5):2164-2174. doi: 10.1002/jcsm.13566. Epub 2024 Aug 21.

Abstract

BACKGROUND

Anorexia of aging (AA) is a condition in older adults that includes loss of appetite and reduced food intake. There is a lack of detailed analysis of the potential influence of educational initiatives in addressing AA. This study aimed to clarify the current state of knowledge and practice regarding AA and its relationship with the availability of continuing education opportunities among Japanese healthcare professionals involved in treating older patients.

METHODS

The Japan Geriatrics Society and the Japanese Association on Sarcopenia and Frailty, in collaboration with the Society on Sarcopenia, Cachexia, and Wasting Disorders, conducted an online questionnaire survey on the knowledge and practices in AA detection and management. Questions were asked in the areas of demographics, screening, definition/diagnosis, treatment, referral, and awareness, with those who 'participate' in continuing education and professional development programmes in nutrition for their patients were classified as the 'education group' and those who 'do not participate' were classified as the 'non-education group'. The results for each question were compared.

RESULTS

The analysis included 870 participants (physicians, 48%; registered dietitians, 16%; rehabilitation therapists, 14%; pharmacists, 12%; nurses, 6%; and other professionals, 5%). The education group (45%) was more likely than the non-education group (55%) to use the Mini-Nutritional Assessment Short Form (MNA-SF) to screen for AA (49% vs. 27%) and less likely not to use a validated tool (33% vs. 47%). More participants used evidence-based tools and materials for AA care (38% vs. 12%), and fewer used their clinical judgement (23% vs. 35%) or were unaware of the tools and materials (9% vs. 23%). The proportion using a team of professionals experienced in AA care were 47% and 24% of the education and non-education groups, respectively. By profession, few physicians used specific validated tools and resources for AA screening and treatment. More than half of the dietitians used the MNA-SF regardless of training opportunity availability. Regarding professional availability and team use, differences in educational opportunities were particularly large among physicians.

CONCLUSIONS

Participation in continuing education programmes on nutrition is associated with responsiveness to AA screening and treatment and the availability of a team of professionals, which may influence the quality of AA treatment. Nutrition education may support the confidence of healthcare professionals working with older adults in AA with complex clinical signs and encourage them to conduct evidence-based practice.

摘要

背景

老年厌食症(AA)是老年人中出现的一种状况,包括食欲不振和食物摄入量减少。目前缺乏对教育举措在应对老年厌食症方面潜在影响的详细分析。本研究旨在阐明日本参与老年患者治疗的医疗保健专业人员对老年厌食症的知识和实践现状,以及其与继续教育机会可得性之间的关系。

方法

日本老年医学会、日本肌少症与衰弱协会与肌少症、恶病质及消瘦症学会合作,就老年厌食症检测与管理方面的知识和实践开展了一项在线问卷调查。问卷涉及人口统计学、筛查、定义/诊断、治疗、转诊和认知等领域,将那些“参与”针对患者的营养继续教育和专业发展项目的人员归为“教育组”,将那些“未参与”的人员归为“非教育组”。对每个问题的结果进行了比较。

结果

分析纳入了870名参与者(医生占48%;注册营养师占16%;康复治疗师占14%;药剂师占12%;护士占6%;其他专业人员占5%)。教育组(45%)比非教育组(55%)更有可能使用微型营养评定简表(MNA-SF)来筛查老年厌食症(49%对27%),且不太可能不使用经过验证的工具(33%对47%)。更多参与者在老年厌食症护理中使用基于证据的工具和材料(38%对12%),而较少使用临床判断(23%对35%)或不了解这些工具和材料(9%对23%)。在教育组和非教育组中,分别有47%和24%的人使用了在老年厌食症护理方面经验丰富的专业团队。按职业划分,很少有医生使用特定的经过验证的工具和资源进行老年厌食症筛查和治疗。无论是否有培训机会,超过一半的营养师都使用MNA-SF。在专业人员可得性和团队使用方面,医生群体中教育机会的差异尤为显著。

结论

参与营养继续教育项目与对老年厌食症筛查和治疗的反应能力以及专业团队的可得性相关,这可能会影响老年厌食症的治疗质量。营养教育可能有助于增强处理有复杂临床症状的老年厌食症患者的医疗保健专业人员的信心,并鼓励他们开展基于证据的实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e8f/11446682/48807691e0bd/JCSM-15-2164-g001.jpg

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