Brown J K, Radke K J
School of Nursing, State University of New York, Buffalo, USA.
Oncol Nurs Forum. 1998 Apr;25(3):547-53.
PURPOSE/OBJECTIVES: To describe weight change in patients from the time of cancer diagnosis to the last healthcare encounter before death, to describe reported nutritional assessment, intervention, and evaluation; and to determine the relationship of weight change and cancer-related symptoms to nutritional assessment, intervention, and evaluation.
Descriptive, correlational.
A National Cancer Institute-designated cancer center and its associated university medical center in the northeastern United States.
Medical records of 93 individuals with non-small cell lung cancer.
Retrospective chart review.
Weight change; nutritional assessment, intervention, and evaluation; and cancer-related symptoms.
Mean weight change from cancer diagnosis to last healthcare encounter was -4.75 kg (SD = 6.05 kg). The mean regression slope of weight change was -3.69 kg/healthcare encounter (SD = 6.49 kg). The results of content analysis indicated that 90 subjects had nutritional assessments, 54 subjects had interventions, and 24 subjects had evaluations of intervention effectiveness. No association existed between weight change or cancer-related symptoms and nutritional assessment. Nutritional intervention was positively associated with dysphagia and depression, and evaluation of intervention effectiveness was positively associated with weight loss and dysphagia.
Assessments of weight change and appetite usually were reported and appeared to be a routine part of patient care. However, assessments of weight loss and anorexia led to interventions only 60% of the time. When interventions were recommended, only 44% were evaluated for effectiveness.
Assessment of nutritional status needs to be broadened, interventions need to be initiated more often, and creative solutions to nutritional problems need to be sought. Regular evaluation of interventions is essential.
目的/目标：描述患者从癌症诊断到死亡前最后一次医疗接触期间的体重变化，描述所报告的营养评估、干预措施及评估情况；并确定体重变化及癌症相关症状与营养评估、干预措施及评估之间的关系。
描述性、相关性研究。
美国东北部一家由国立癌症研究所指定的癌症中心及其附属大学医学中心。
93例非小细胞肺癌患者的病历。
回顾性病历审查。
体重变化；营养评估、干预措施及评估；癌症相关症状。
从癌症诊断到最后一次医疗接触期间，患者体重平均变化为-4.75千克（标准差=6.05千克）。体重变化的平均回归斜率为-3.69千克/次医疗接触（标准差=6.49千克）。内容分析结果表明，90名受试者接受了营养评估，54名受试者接受了干预措施，24名受试者接受了干预效果评估。体重变化或癌症相关症状与营养评估之间不存在关联。营养干预与吞咽困难和抑郁呈正相关，干预效果评估与体重减轻和吞咽困难呈正相关。
体重变化和食欲评估通常会被报告，似乎是患者护理的常规部分。然而，体重减轻和厌食评估仅在60%的情况下会导致采取干预措施。当建议采取干预措施时，只有44%会评估其效果。
需要拓宽营养状况评估范围，更频繁地启动干预措施，并寻求解决营养问题的创造性方法。定期评估干预措施至关重要。
