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从医护人员、患者及家庭照护者综合视角看消化道癌症患者营养管理的现状及影响因素:一项定性研究

Current status and influencing factors of nutrition management in patients with digestive tract cancer from the integrated perspective of medical care staff, patients, and family caregivers: a qualitative study.

作者信息

Zhi Xiaoxu, Chen Jie, Xie Mingzhu, Cao Yuepeng, Sun Tiantian, Zhang Yinan, Zhang Liuliu, Zhao Yun, Jin Yanfei, Xu Qin, Yao Jun

机构信息

The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital &, Jiangsu Institute of Cancer Research, Nanjing, 210009, China.

Department of Nursing, Fudan University Shanghai Cancer Center, No. 270, Dong'an Road, Shanghai, 200032, China.

出版信息

Support Care Cancer. 2024 Dec 21;33(1):46. doi: 10.1007/s00520-024-09109-7.

Abstract

BACKGROUND

The research aimed to collect experience and viewpoints related to the nutrition management of patients with digestive tract cancers from medical care staff, patients, and family caregivers and provide reasonable and effective references for the mode of nutrition management of these patients.

METHODS

Using a phenomenological qualitative research method, six physicians, six nurses, three nutritionists, six patients, and six family caregivers from a tertiary A cancer hospital in Jiangsu Province were chosen by purposive sampling methods from February to June 2023. Data was collected through semi-structured in-depth interviews and analyzed by the content analysis method.

RESULTS

Data analysis revealed two major themes, each with four subcategories: current status of clinical nutrition management tract cancers which consisted of "lack of whole-process nutrition management model," "inadequate role of nutrition management professionals," "lack of a mechanism for continuous improvement of nutrition management quality," and "lack of nutrition science popularization and training system" and influencing factors of clinical nutrition management that contained "patient-related factors," "family-related factors," "medical staff-related factors," and "hospital environment and policy-related factors."

CONCLUSIONS

Nutritional management of digestive cancer patients is currently inadequate and should be viewed through an integrated perspective. Improvements should be made at four angles: patient, family, healthcare provider, and hospital environment by establishing a multidisciplinary nutritional management team.

摘要

背景

本研究旨在收集医护人员、患者及家庭照护者对消化道癌症患者营养管理的经验和观点,为这些患者的营养管理模式提供合理有效的参考。

方法

采用现象学质性研究方法,于2023年2月至6月通过目的抽样法,选取江苏省某三甲肿瘤医院的6名医生、6名护士、3名营养师、6名患者及6名家庭照护者。通过半结构式深入访谈收集数据,并采用内容分析法进行分析。

结果

数据分析揭示了两个主要主题,每个主题包含四个子类别:消化道癌症临床营养管理现状,包括“缺乏全过程营养管理模式”“营养管理专业人员作用不足”“营养管理质量持续改进机制缺失”“营养科普与培训体系缺乏”;以及临床营养管理的影响因素,包括“患者相关因素”“家庭相关因素”“医护人员相关因素”“医院环境与政策相关因素”。

结论

目前消化道癌症患者的营养管理存在不足,应从综合角度看待。应通过建立多学科营养管理团队,从患者、家庭、医护人员和医院环境四个角度进行改进。

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