Perception of need for nutritional support in advanced cancer patients with cachexia: a survey in palliative care settings
Perception of need for nutritional support in advanced cancer patients with cachexia: a survey in palliative care settings
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DOI：
10.1007/s00520-018-4104-6
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发表时间：
2018-08-01
影响因子：
3.1
通讯作者：
Tatara, Ryohei
中科院分区：
文献类型：
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作者：
Amano, Koji;Morita, Tatsuya;Tatara, Ryohei
目的很少有研究调查姑息治疗环境中晚期癌症患者对营养支持的需求。因此，我们进行了一项问卷调查，以研究营养支持需求的感知与癌症恶病质之间的关系，以及营养支持的特定需求、感知和信念的流行程度。方法在姑息治疗机构进行问卷调查。患者分为两组：(1)非恶病质/预恶病质和(2)恶病质/难治性恶病质。结果121例患者中117例总有效率为96.7%。两组患者在营养支持需求方面存在显著差异：非恶病质/预恶病质（32.7%）和恶病质/难治性恶病质（53.6%）（p = 0.031）。需要营养支持的患者具体需求为营养咨询（93.8%）、改善食物摄入的想法（87.5%）、口服营养补充剂（83.0%）、肠外营养和水化（77.1%）和管饲（22.9%）。在接受营养支持的最佳时间和医务人员提供营养支持的最佳时间方面，分别是“当厌食症、体重减轻和肌肉无力变得明显时”（48.6%）和“营养支持团队”（67.3%）。对营养治疗的信念排名前3位的分别是“我不希望接受管饲”（78.6%）、“肠外营养和水化是必要的”（60.7%）和“肠外水化是必要的”（59.6%）。结论癌症恶病质患者对营养支持的需求更大。当他们无法口服足够的营养，恶病质的负面影响变得明显时，他们希望得到医务人员的营养支持。大多数患者希望接受肠外营养和水合。
Purpose Few studies have investigated the need for nutritional support in advanced cancer patients in palliative care settings. Therefore, we conducted a questionnaire to examine the relationship between the perception of need for nutritional support and cancer cachexia and the prevalence of specific needs, perceptions, and beliefs in nutritional support.Methods We conducted a questionnaire in palliative care settings. Patients were classified into two groups: (1) non-cachexia/pre-cachexia and (2) cachexia/refractory cachexia.Results A total of 117 out of 121 patients responded (96.7%). A significant difference was observed in the need for nutritional support between the groups: non-cachexia/pre-cachexia (32.7%) and cachexia/refractory cachexia (53.6%) (p = 0.031). The specific needs of patients requiring nutritional support were nutritional counseling (93.8%), ideas to improve food intake (87.5%), oral nutritional supplements (83.0%), parenteral nutrition and hydration (77.1%), and tube feeding (22.9%). The top perceptions regarding the best time to receive nutritional support and the best medical staff to provide nutritional support were "when anorexia, weight loss, and muscle weakness become apparent" (48.6%) and "nutritional support team" (67.3%), respectively. The top three beliefs of nutritional treatments were "I do not wish to receive tube feeding" (78.6%), "parenteral nutrition and hydration are essential" (60.7%), and "parenteral hydration is essential" (59.6%).Conclusions Patients with cancer cachexia expressed a greater need for nutritional support. They wished to receive nutritional support from medical staff when they become unable to take sufficient nourishment orally and the negative impact of cachexia becomes apparent. Most patients wished to receive parenteral nutrition and hydration.