Clinical Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands.
Pediatr Blood Cancer. 2024 Dec;71(12):e31353. doi: 10.1002/pbc.31353. Epub 2024 Oct 3.
Optimal nutrition in pediatric oncology can influence cancer-related outcomes. To establish an understanding of nutrition practice and perceptions of best practice, we queried nutrition providers practicing in pediatric oncology care centers in high-income countries.
An electronic, multidisciplinary, cross-sectional survey of nutrition practices was conducted among pediatric oncology nutrition practitioners. Final analysis included 110 surveys from 71 unique institutions and included practitioners from Europe, the United States, Canada, Australia/New Zealand, South America, and the Middle East/Asia.
The majority of institutions (97%) reported having dietitians; 72% had designated oncology dietitians. Approximately half of the practitioners (47%) reported feeling their institutions were inadequately staffed. The majority (78%) of institutions completed nutrition risk screening, but there was no consensus on specific screening practices. Half (50%) of the institutions that screened for nutrition risk did so in both inpatient and outpatient settings. The majority (80%) of institutions completed a nutrition assessment close to the time of diagnosis. Those that did not cite lack of staff and/or lack of time, lack of standardized approach, and consult only level of nutritional care as primary barriers. The most common topic of nutrition education provided to patients/families was nutrition-related symptom management (68%).
While most institutions reported having pediatric oncology dietitians, we found a lack of standardized practice and perceived inadequate staffing. In addition, what providers perceived to be best practice did not always align with day-to-day clinical practice. Ongoing efforts are needed to develop evidence-based guidelines, including staffing recommendations, to support specialized care in this population.
儿科肿瘤学中的最佳营养可以影响癌症相关结局。为了了解营养实践和最佳实践的认知，我们调查了在高收入国家的儿科肿瘤学护理中心工作的营养提供者。
对儿科肿瘤学营养从业者进行了电子、多学科、横断面的营养实践调查。最终分析包括来自 71 个不同机构的 110 份调查，其中包括来自欧洲、美国、加拿大、澳大利亚/新西兰、南美洲和中东/亚洲的从业者。
大多数机构（97%）报告有营养师；72%有指定的肿瘤营养师。约一半的从业者（47%）报告感觉他们所在的机构人手不足。大多数机构（78%）进行营养风险筛查，但对具体筛查实践没有共识。一半（50%）的筛查营养风险的机构在住院和门诊环境中进行筛查。大多数机构（80%）在接近诊断时进行营养评估。他们认为没有人员和/或缺乏时间、缺乏标准化方法以及仅咨询营养护理水平是主要障碍。向患者/家属提供的营养教育的最常见主题是营养相关症状管理（68%）。
虽然大多数机构报告有儿科肿瘤营养师，但我们发现实践缺乏标准化，并且认为人员配备不足。此外，提供者认为的最佳实践并不总是与日常临床实践一致。需要继续努力制定循证指南，包括人员配备建议，以支持该人群的专业护理。
