Need for nutritional support, eating-related distress and experience of terminally ill patients with cancer: a survey in an inpatient hospice
Need for nutritional support, eating-related distress and experience of terminally ill patients with cancer: a survey in an inpatient hospice
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DOI：
10.1136/bmjspcare-2014-000783
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发表时间：
2016-09-01
影响因子：
2.7
通讯作者：
Takagi, Ibuki
中科院分区：
文献类型：
--
作者：
Amano, Koji;Maeda, Isseki;Takagi, Ibuki
目的癌症恶病质给晚期癌症患者带来了巨大的负担。主要原因是缺乏对癌症恶病质的了解，以及增加体重的尝试失败。营养支持的作用尚未明确，对患者饮食相关的困扰也知之甚少。目前还没有研究调查住院病人对营养支持的需求。本研究的主要目的是探讨营养支持的需求，饮食相关的痛苦和患者的经历。方法对60例晚期癌症住院病人进行问卷调查。我们首先询问住院病人对营养治疗的需求。然后，我们询问患者是否有四项未满足的需求。最后一个问题由19个项目组成，涉及患者与饮食有关的痛苦经历。结果37例患者总有效率为62%。37名患者中有28名（76%）对癌症恶病质的营养治疗有一般未满足的需求，超过一半的患者需要特殊的支持，如“关注”和“解释”。19项中排名前5的主要是日常饮食、营养和减肥。其中，前四名属于应对策略组，第五名属于源自患者自身的机制组。结论：住院安宁疗护的癌症末期病人中，有相当一部分需要营养支援，且有较高的进食相关痛苦。
Objectives Cancer cachexia creates a large burden for terminally ill patients with cancer. The main causes are a lack of knowledge of cancer cachexia and unsuccessful attempts to increase body weight. The role of nutritional support has not been clarified, and patients' eating-related distress is poorly understood. There has been no study investigating into needs for nutritional support in an inpatient hospice. The primary aim of this study was to explore needs for nutritional support, eating-related distress and patients' experiences.Methods A survey was conducted involving 60 patients with advanced cancer in an inpatient hospice. We first asked about need for nutrition therapy in the inpatient hospice. We then asked whether patients had unmet needs for four items. The last question was composed of 19 items concerning patients' experience of eating-related distress.Results Thirty-seven patients responded (62%). Most of the patients, 28 of 37 (76%), had general unmet needs for nutrition therapy for cancer cachexia, and more than half needed specific support, such as 'attention' and 'explanation'. The top 5 of the 19 items were mainly about daily diet, nutrition and losing weight. Of these, the top four belonged to the group of coping strategies and the fifth to the group of mechanisms originating from patients themselves.Conclusions A number of terminally ill patients with cancer admitted to an inpatient hospice had need for nutritional support and experienced high levels of eating-related distress.