A national survey of oncology survivors examining nutrition attitudes, problems and behaviours, and access to dietetic care throughout the cancer journey
A national survey of oncology survivors examining nutrition attitudes, problems and behaviours, and access to dietetic care throughout the cancer journey
复制标题
DOI：
10.1016/j.clnesp.2020.10.023
复制
发表时间：
2021-01-21
影响因子：
3
通讯作者：
Ryan, Aoife M.
中科院分区：
文献类型：
--
作者：
Sullivan, Erin S.;Rice, Niamh;Ryan, Aoife M.
背景：癌症幸存者对营养和营养护理的态度很少被捕获。在回顾他们的经历的基础上更好地了解他们的需求，将使这一患者群体发出声音（很少被捕捉到），并允许更好地规划营养护理。目的：开展一项全国性调查，以确定：(1)癌症幸存者在营养和饮食相关问题方面的经历，(2)营养对癌症幸存者的重要性认知，(3)获得营养支持的经历，(4)幸存者获得营养信息的来源，以及(5)他们对替代饮食策略的使用。方法：过去5年内在爱尔兰被诊断为癌症或接受癌症治疗的幸存者（任何曾经被诊断为癌症的成年人）被要求在爱尔兰20个不同的医院之一完成一项25项的纸质调查。该调查也在主要癌症慈善机构的网站上进行。描述性统计用于检验定量数据。结果：共收到1073份有效回复（63%为女性，平均年龄57岁（18-88岁））。乳腺癌是最常见的（n = 362），其次是结直肠癌（n = 121）。三分之一的受访者患有转移性疾病。45%的人报告了与饮食有关的问题。44%的人体重减轻，其中42%的人表示他们对此感到“不高兴或担心”，而27%的人表示他们对自己的体重减轻感到“高兴/高兴”。52%的人注意到肌肉萎缩，20%的人报告说他们注意到“大量”肌肉萎缩。89%的受访者认为营养对癌症治疗“非常/极其”重要，但58%的受访者表示，他们的医疗团队只“有时”、“很少”或“从未”问及饮食问题。只有39%的人接受过注册营养师（RD）的评估/治疗，74%的人认为他们的建议/护理“非常/非常”有帮助。令人担忧的是，39%的非自愿体重减轻的幸存者和29%的质地改变饮食的幸存者没有得到RD的营养护理。总体而言，57%没有看到RD的人说他们想要更多的饮食支持（获得帮助热线/营养师/额外的可靠信息）。值得关注的是，37%的幸存者正在遵循或尝试过未经证实的替代饮食策略（例如限制性饮食、草药、榨汁或排毒），32%的幸存者报告避免食用特定食物，例如加工肉类或乳制品。大多数人（56%）对媒体和周围人提供的经常相互矛盾的营养信息感到困惑。结论：虽然营养对癌症幸存者来说非常重要，而且有很高比例的人经历了潜在的严重与饮食有关的问题，包括体重和肌肉减少，但只有不到一半的受访者有机会咨询营养师。超过三分之一的人至少使用过一种替代饮食策略，超过一半的人对营养感到困惑。需要在门诊环境中实施全面的营养筛查和肿瘤营养师转诊计划，以确定和促进癌症幸存者营养问题的早期管理。(C) 2020作者。由爱思唯尔有限公司代表欧洲临床营养与代谢学会出版。
Background: Attitudes of cancer survivors to nutrition and nutrition care have rarely been captured. A better understanding of their needs based on a review of their experiences would give voice to this patient group (which has rarely been captured) and allow for better planning of nutritional care. Aims: To conduct a national survey to determine: (1) survivors' experience in relation to nutrition and diet-related problems, (2) perceived importance of the role of nutrition to cancer survivors, (3) the experience of accessing dietetic support, (4) the sources where survivors get nutrition information, and (5) their use of alternative dietary strategies.Methods: Survivors (any adult ever diagnosed with cancer) who had been diagnosed with or treated for cancer in Ireland within the past 5 years, were asked to complete a 25-item paper-based survey at one of 20 different hospital sites in Ireland. The survey was also hosted online on the websites of major cancer charities. Descriptive statistics were used to examine quantitative data.Results: In total, 1073 valid responses were received (63% female, mean age 57 years (range 18-88)). Breast cancer was the most common (n = 362), followed by colorectal (n = 121). One third of respondents had metastatic disease. Diet-related problems were reported by 45%. Weight loss was experienced by 44% and amongst those, 42% reported they were 'unhappy or worried' by this, while 27% reportedbeing 'delighted/happy' with their weight loss. Muscle loss was noted by 52%, with 20% reporting they had noticed 'a lot' of muscle loss. Nutrition was rated as 'very/extremely' important to cancer care by 89% of respondents, yet 58% reported being asked about dietary issues by their medical team only 'sometimes', 'rarely' or 'never'. Only 39% had been assessed/treated by a registered dietitian (RD) and 74% rated their advice/care as 'very/extremely' helpful. Worryingly, 39% of survivors with involuntary weight loss, and 29% of survivors on a texture modified diet had not received nutritional care from an RD. Overall, 57% of those who did not see an RD said they wanted more dietetic support (access to a helpline/dietitian/additional reliable information). Of concern, 37% of survivors were following or had tried alternative, unproven dietary strategies (e.g. restrictive diets, herbal remedies, juicing or detoxes), and 32% reported avoiding specific foods, e.g. processed meat or dairy. A majority (56%) felt confused by the often conflicting nutrition information available in the media and offered by people around them.Conclusions: While nutrition is considered highly important by cancer survivors and a high proportion experience potentially serious diet-related problems including weight and muscle loss, fewer than half surveyed had access to a dietitian. Over a third had used at least one alternative dietary strategy, and over half felt confused about nutrition. Comprehensive nutritional screening and referral programmes to oncology dietitians need to be implemented in the ambulatory setting in order to identify and facilitate early management of the nutritional concerns of cancer survivors. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.