某教學醫院門診癌症病人接受營養照護介入之成效

本研究目的為探討營養照護介入對於門診癌症病人的攝食狀況之影響。透過病歷回溯方式收集民國104年10月至民國107年12月期間透過醫師或護理師轉介，接受兩次營養諮詢且體位及飲食資料齊全之門診癌症病人，共106人（男性64名、女性42名）。結果顯示，本研究招收之癌症病人（n=106），以乳癌居首（19.8%）、其次依序為肺癌（16.0%）、大腸癌（10.4%）、攝護腺癌（10.4%）與食道癌（9.4%）。營養諮詢後的體重（62.5±12.4 kg）稍微高於諮詢前的體重（62.2±12.6 kg），顯示營養介入後病人體重可以穩定維持，但體重增加幅度在統計上未達顯著差異（p=0.069）；在身體質量指數（body mass index, BMI）上也發現同樣的趨勢，介入後BMI（24.2±4.3 kg/m^2）微幅高於介入前BMI（24.1±4.5 kg/m^2），但同樣的未達顯著差異（p=0.128）。介入前後在飲食資料的各項指標上皆有明顯提升，每日熱量攝取（介入前：1516.5±562.5、介入後：1761.1±496.6kcal/day，p＜0.001）、每日蛋白質攝取（介入前：60.7±24.6、介入後：70.2±22.4g/day，p＜0.001）、熱量攝取達需求之百分比（介入前：79.3±25.8、介入後：91.1±20.8%，p＜0.001）以及蛋白質攝取達需求之百分比（介入前：81.1±31.6、介入後：92.2±26.3%，p＜0.001），四項指標皆有顯著差異。經進一步分析，發現頭頸癌、食道癌與非頭頸癌患者，介入後每日熱量攝取（p＜0.001）、每日蛋白質攝取（p=0.032）、熱量攝取達需求之百分比（p＜0.001）以及蛋白質攝取達需求之百分比（p=0.007）四項指標的介入前後改變量皆有顯著差異，且頭頸癌、食道癌患者介入之成效優於非頭頸癌。綜合結果顯示，營養照護介入對於癌症病人有正面的成效，特別在頭頸癌、食道癌患者介入效果更加顯著。

關鍵字

營養照護；癌症；成效評估

並列摘要

The purpose of this study was to investigate the effect of nutritional care intervention on the eating status of outpatients with cancer. A total of 106 outpatients (64 males and 42 females) who had received 2 nutritional counseling sessions through physician or nurse practitioner referrals with complete weight and dietary data between October 2015 and December 2018 were recruited. The results had showed that breast cancer (19.8%), followed by lung cancer (16.0%), colorectal cancer (10.4%), prostate cancer (10.4%), and esophageal cancer (9.4%) were the most common cancers enrolled in this study (n = 106). Body weight after nutritional counseling (62.5 ± 12.4 kg) was slightly higher than the weight before counseling (62.2 ± 12.6 kg), indicating that the weight of patients could be maintained steadily after nutritional intervention, but the increase in weight did not reach a statistically significant difference (p = 0.069). The same trend was found for body mass index (BMI), with a slightly higher post-intervention BMI (24.2 ± 4.3 kg/m^2) than the BMI prior to intervention (24.1 ± 4.5 kg/m^2), but again, no significant difference was reached (p = 0.128). The daily caloric intake (1516.5 ± 562.5, 1761.1 ± 496.6 kcal/day, p ＜ 0.001), daily protein intake (60.7 ± 24.6, 70.2 ± 22.4 g/day, p ＜ 0.001), percentage of caloric intake meeting the requirement (79.3 ± 25.8, 91.1 ± 20.8%, p ＜ 0.001), and percentage of protein intake meeting the requirement (81.1 ± 31.6, 92.2 ± 26.3 %, p ＜ 0.001) were significantly improved after the intervention. Further analysis had revealed that there were significant differences in daily caloric intake (p ＜ 0.001), daily protein intake (p = 0.032), percentage of caloric intake meeting the requirement (p ＜ 0.001) and percentage of protein intake meeting the requirement (p = 0.007) among patients with head-and-neck cancer, esophageal cancer and those without head-and-neck cancer after the intervention. In addition, the intervention had yielded a greater efficacy among the patients with head-and-neck cancer. In conclusion, our results had demonstrated that nutritional care interventions had positive effects on cancer patients, especially in head-and-neck cancer and esophageal cancer patients.

並列關鍵字

nutritional care ； cancer ； effectiveness evaluation

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