肿瘤内科住院患者膳食认知行为横断面多中心研究  

A multi-center survey on dietary knowledge and behavior among Chinese inpatients in oncology department

作　　者：丛明华[1] 王杰军[2] 方玉[3] 刘英华[4] 孙明晓 吴穷[6] 王湛 黄岩[7] 凌轶群[8] 刘勇[9] 李全福 刘义冰[11] 朱江[12] 朱陵君[13] 郑振东[14] 李玲 刘东颖[16] 刘自民[17] 石汉平[18] 袁芃[19] CONG Ming-hua;WANG Jie-jun;FANG Yu;LIU Ying-hua;SUN Ming-xiao;WU Qiong;WANG Kan;HUANG Yan;LING Yiqun;LIU Yong;LI Quan-fu;LIU Yi-bing;ZHU Jiang;ZHU Ling-jun;ZHENG Zhen-dong;LI Ling;LIU Dong-ying;LIU Zi-min;SHI Han-ping;YUAN Peng(National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China;Oncology Department, Shanghai Changzheng Hospital, Shanghai 200003, China;Clinical Nutrition Department Beijing University Cancer Hospital, Beijing 100142, China;Nutrition Department, Chinese PLA General Hospital, Beijing 100853,China;Beijing EDEN Hospital, Beijing 100000, China;Oncology Department, Affiliated Hospital of Bengbu Medical College,Bengbu 233004, Anhui, China;Oncology Department, Sun Yan-sen University Cancer Hospital, Guangzhou 510060, China;Clinical Nutrition Department, Fudan University Cancer Hospital, Shanghai 200032, China;Oncology Department, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu, China;Oncology Department, Ordos Central Hospital, Eerduosi 017000, Inner Mongolia Autonomous Region, China;Oncology Department, Hebei Medical University Cancer Hospital, Shijiazhuang 050011 China;Oncology Department, West China Hospital, Sichuan University, Chengdu 610041, China;Oncology Department, Jiangsu Province Hospital, Nanjing 210029, China;Oncology department, General Hospital of Shenyang Military, Shenyang 110016,China;Palliative Care Center, Zhengzhou Ninth People’s Hospital, Zhengzhou 450053, China;Oncology Department, Tianjin Medical University Cancer Hospital, Tianjing 300070, China;Oncology Department, Affiliated Hospital of Qingdao University Qingdao 266071, Shandong, China;Department of General Surgery/Medical Oncology Center, Aviation General Hospital/Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China;Oncology Department, Chinese Academy of Medical Sciences Cancer Hospital, Beijing 100021, China)

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院,北京100021 [2]第二军医大学长征医院肿瘤内科,上海200003 [3]北京大学肿瘤医院临床营养科,北京100142 [4]中国人民解放军总医院营养科,北京100853 [5]北京怡德医院,北京100000 [6]蚌埠医学院附属第一医院肿瘤内科 [7]中山大学肿瘤医院肿瘤内科,广州510060 [8]复旦大学肿瘤医院临床营养科,上海200032 [9]徐州市中心医院肿瘤内科 [10]内蒙古鄂尔多斯中心医院肿瘤科 [11]河北医科大学第四医院肿瘤内科,石家庄050011 [12]四川大学华西医院肿瘤内科,成都610041 [13]江苏省人民医院肿瘤内科,南京210029 [14]沈阳军区总医院肿瘤内科,沈阳110016 [15]郑州市第九人民医院缓和医学科,郑州450053 [16]天津医科大学肿瘤医院肿瘤内科,天津300070 [17]青岛大学附属医院肿瘤内科 [18]中国科学院北京转化医学研究院/航空总医院肿瘤医学中心/普外科,北京100012 [19]中国医学科学院肿瘤医院肿瘤内科,北京100021

出　　处：《肿瘤代谢与营养电子杂志》2017年第1期39-44,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：国家高技术研究发展计划(863计划)(2014AA022206)

摘　　要：目的调查肿瘤内科住院患者膳食认知现状、膳食摄入量、营养状况,分析肿瘤患者膳食营养知识水平、行为习惯及营养不良可能的发生原因,为医护人员对患者进行营养宣教及营养治疗提供依据。方法以全国分布的18家医院,选择肿瘤内科住院患者进行横断面调查研究。患者以面对面调查形式自行填写膳食知识及行为问卷调查,主诊医生查房询问患者膳食摄入情况及进行食欲评分;营养师进行营养风险筛查、膳食史回顾调查,按ESPEN及中国肿瘤营养指南推荐的拇指法则计算患者的能量及蛋白质每日目标需要量。比较患者实际营养摄入量与目标摄入量是否有差别。结果共完成535例有效问卷调查:95.2%的患者认为科学的膳食非常重要,70%的患者对如何科学的膳食存在疑问,82.0%的患者会遇到膳食知识矛盾的困惑,当获取的膳食信息有矛盾时,64.2%的患者会听取主诊医师的意见;主诊医师、网络、电视是患者了解如何科学膳食的最主要的3条途径,分别占所有途径的26.0%、18.5%以及16.1%;99.6%的患者存在膳食知识误区,认为患病后不可食用某类或全部富含蛋白质的食物;90.0%以上的患者服用灵芝孢子粉、海参、人参、冬虫夏草以及其他类保健食品;93.0%的患者未接受过规范的营养教育。通过营养风险筛查、膳食调查及评价发现:15.6%的患者存在营养风险(NRS 2002≥3分),实际每日摄入能量为1169.20±465.97kcal,显著性低于目标需求量1797.95±375.27kcal(P<0.01),仅达目标需要量的65.3%;实际每日蛋白质摄入量为46.55±21.40g,显著性低于目标需求量(P<0.01),仅达目标需要量的74.4%。主诊医师查房询问患者膳食情况表明:69.0%的患者认为饮食还行、挺好的、很好或者非常好。通过膳食回顾调查发现,其中有34.0%的患者能量摄入不足目标量60.0%。可见如果仅通过查房医生简单的询问,不足以正确的反应患者Objective To investigate the current associated factors of dietary knowledge,intake and nutritional status in malignancy inpatients,and the malnutrition causes involved in dietary nutrition knowledge level,behavior,providing recommendations to patients for nutrition education and intervention.Methods535participants,from18hospitals were investigated by a self-made questionnaire composed of dietary knowledge and behavior.Physicians asked and recorded the level of dietary intake and appetite scoring of the participants.Nutritional risk screened with NRS2002and dietary survey by24h dietary recalls were completed by adietitian.Besides,the target energy intake and the target protein intake was calculated by“rule of thumb”recommended by ESPENguideline,comparing the difference between the actual intake and target intake.Results According to the questionnaire,95.2%ofparticipants thought it was important to have a good dietetic habit,and nearly half of them searched for guides on how to diet;70%of the patients had no clear idea of what was a scientific dietary;82%of patients had contradictary dietary knowledge contradiction;64.2%of patients would listen to the opinion of the attending physician when contradiction happened.The three main ways tolearn about diet are attending physician,network,and TV,respectively26.0%,18.5%and16.1%.Importantly,99.6%of the patientmistakes on dietary knowledge,for example,crab,chicken,lamb,fish and prawns should not be eaten by cancer patients.In addition,more than90%of participants taking ganoderma lucidum spore powder,sea cucumber,ginseng,cordyceps sinensis and so on.93%of the patients never received a qualified nutrition education.Besides,15.6%of the participants had nutritional risk(NRS2002≥3scores).The actual daily energy intake was1169.20±465.97kcal,which was significantly less than target energy intake(P<0.01),amounting to65.3%of the target requirements.Actual daily protein intake was46.55±21.40g,which was significantly less than targetenergy intake(P<0.01),amounting to74.4%of t

关 键 词：肿瘤患者 膳食知识 行为 多中心调查 

分 类 号：R473.73[医药卫生—护理学]