營養諮詢對消化道癌症營養狀況之成效評估

THE EFFECTIVENESS OF NUTRITION COUNSELING FOR IMPROVING THE NUTRITIONAL STATUS OF PATIENTS WITH DIGESTIVE TRACT CANCER

張麗娟(Li-Chuan Chang) ； 林逸文(Yie-Wen Lin)

《秀傳醫學雜誌》 19卷1期 (2020/06) Pp. 53-64

https://doi.org/10.3966/156104972020061901005

摘要

本研究目的為探討營養諮詢介入對於消化道癌症病人的營養狀況、癌症營養知識及生活品質之影響，並調查癌症病人對營養諮詢服務的滿意度。由營養師招收首次住院的消化道癌症病人，並於營養諮詢介入前及營養諮詢介入後填寫問卷，了解其飲食攝取量、營養補充品使用狀況、癌症營養知識的改變及對於營養諮詢的滿意度等。結果顯示，本研究招收之癌症病人（n=44），以結腸直腸癌最多（72.7%），胃癌次之（25.0%），癌症期別以第二期居多（36.4%），第一期次之（25.0%）。治療方式以手術合併化學治療（43.2%）為主。在營養諮詢前之體重已顯著低於平常體重（p＜0.0001）。營養諮詢後的體重（52.5±13.4kg）仍低於營養諮詢前（52.9±14.0kg）（p=0.5649）；血紅素、血球比容和白血球在營養諮詢前後均無顯著差異；營養諮詢可以顯著提升癌症病人豆魚蛋肉類食物之攝取份數（p＜0.0001）和營養補充品的攝取（p＜0.0001）及矯正癌症病人的飲食迷思（p＜0.0001）。在滿意度結果顯示，多數癌症病人（95.5%）可聽得懂營養師的衛教，約有（90.9%）病人可遵照營養諮詢內容執行，且認為營養諮詢是有幫助（81.8%）或非常有幫助（11.4%）。綜合結果顯示，營養諮詢介入對於癌症病人有正面的成效。

關鍵字

營養諮詢 ； 消化道癌症 ； 成效評估

並列摘要

This study highlights the effectiveness of nutrition counseling for improving the nutritional status, knowledge, and quality of life of patients with digestive tract cancer. We investigated the opinions of cancer patients regarding nutrition counseling services. Patients newly hospitalized for gastrointestinal cancer were given surveys before and after undergoing a dietitian-led intervention to evaluate their dietary intake, consumption of nutritional supplements, perception of cancer-related nutrition knowledge, and opinions regarding nutrition counseling. A total of 44 patients were included in this study. Patients with colorectal cancer comprised the highest percentage of study participants (72.7%), followed by patients with gastric cancer (25.0%). Moreover, 36.4% of patients had Stage II cancer and 25.0% had Stage I cancer. Both these groups had undergone chemotherapy and surgery. The results indicated that patients had significant body weight reduction compared with their initial average weight (p ＜0.0001) before the dietetic consultation was conducted. Furthermore, the body weight of patients (52.5 ± 13.4 kg) remained below the initial weight after the consultation was conducted (52.9 ± 14.0 kg; p = 0.5649). The hemoglobin, hematocrit, and leukocyte levels exhibited no significant differences before and after the intervention. Nevertheless, the dietary counseling resulted in the improvement of the dietary intake (p ＜ 0.0001) of beans, fish, eggs, and meat (p ＜ 0.0001) and nutritional supplements (p ＜ 0.0001). Furthermore, dietary counseling decreased misunderstandings regarding diet (p ＜ 0.0001). Consequently, 95.5% of the participants stated that the dietetic consultations were satisfactory and conferred a high degree of understanding regarding nutrition. Approximately 90.9% of the participants were capable of adhering to the recommended dietetic suggestions because the suggestions were helpful (81.8%) or very helpful (11.4%). In conclusion, the dietetic intervention had positive effects on the cancer patients.

並列關鍵字

Dietetic consultations ； Gastrointestinal cancer ； Effectiveness of nutrition counseling