Widaman Adrianne M, Day Andrew G, Kuhn Maggie A, Dhaliwal Rupinder, Baracos Vickie, Findlay Merran, Bauer Judith D, de van der Schueren Marian, Laviano Alessandro, Martin Lisa, Gramlich Leah
Department of Nutrition Food Science and Packaging, San Jose State University, San Jose, California, USA.
Department of Otolaryngology, University of California Davis Medical Center, Sacramento, California, USA.
Nutr Clin Pract. 2025 Apr;40(2):405-419. doi: 10.1002/ncp.11211. Epub 2024 Sep 22.
Patient-reported outcome measures have been associated with survival in oncology patients. Altered intake and malnutrition are common symptoms for patients treated for head and neck cancer and esophageal cancer (HNC/EC). The purpose of this study was to examine the relationship between patient-reported satisfaction with medical care and nutrition status.
This prospective cohort study collected data from 11 international cancer care sites.
One hundred and sixtythree adult patients (n = 115 HNC; n = 48 EC) completed a patient satisfaction questionnaire (the Canadian Health Care Evaluation Project Lite) and were included. HNC/EC patient global satisfaction with medical care was 88.3/100 ± 15.3 at baseline and remained high at 86.6/100 ± 16.8 by 6 months (100 max satisfaction score). Poor nutrition status, as defined by the Patient-Generated Subjective Global Assessment Short Form, was associated with lower patient satisfaction with overall medical care, relationship with doctors, illness management, communication, and decision-making 6 months into treatment (P < 0.01). There was no difference in global satisfaction between patients who did and did not report swallowing difficulty (P = 0.99) and patients with and without feeding tube placement (P = 0.36). Patients who were seen by a dietitian for at least one nutrition assessment had global satisfaction with care that was 16.7 percentage points higher than those with no nutrition assessment (89.3 ± 13.8 vs 72.6 ± 23.6; P = 0.005) CONCLUSION: In HNC/EC patient-centered oncology care, decreasing malnutrition risk and providing access to dietitian-led nutrition assessments should be prioritized and supported to improve patient satisfaction and standard of care. Feeding tube placement did not decrease patient satisfaction with medical care.
患者报告的结局指标与肿瘤患者的生存率相关。摄入改变和营养不良是头颈癌和食管癌（HNC/EC）患者的常见症状。本研究的目的是探讨患者报告的医疗护理满意度与营养状况之间的关系。
这项前瞻性队列研究收集了来自11个国际癌症护理机构的数据。
163名成年患者（n = 115例HNC；n = 48例EC）完成了患者满意度问卷（加拿大医疗保健评估项目简版）并被纳入研究。HNC/EC患者对医疗护理的总体满意度在基线时为88.3/100 ± 15.3，到6个月时仍保持较高水平，为86.6/100 ± 16.8（满分100分）。根据患者生成的主观全面评定简表定义的营养状况不佳与治疗6个月时患者对整体医疗护理、与医生的关系、疾病管理、沟通和决策的满意度较低相关（P < 0.01）。报告有吞咽困难和未报告吞咽困难的患者之间的总体满意度无差异（P = 0.99），放置和未放置饲管的患者之间也无差异（P = 0.36）。接受过至少一次营养师营养评估的患者对护理的总体满意度比未接受营养评估的患者高16.7个百分点（89.3 ± 13.8对72.6 ± 23.6；P = 0.005）。结论：在以HNC/EC患者为中心的肿瘤护理中应优先考虑并支持降低营养不良风险和提供营养师主导的营养评估，以提高患者满意度和护理标准。放置饲管并未降低患者对医疗护理的满意度。
