恶性肿瘤患者膳食指导标准的应用现状、影响因素及优化
路径:一项全国性调查研究

肿瘤代谢与营养电子杂志 ›› 2025, Vol. 12 ›› Issue (5) : 631-642.

论著

恶性肿瘤患者膳食指导标准的应用现状、影响因素及优化路径:一项全国性调查研究

1张西,1 戴香婷,1 黄嘉欣,2 袁芃,1 李宁,3 于康,4 凌轶群,5 叶文锋,6 王昆,7 方玉,8 姚庆华,9 余慧青,10 高淑清,11 李菊芳,12 孔永霞,13 郭增清,14 周岚,15 李淑娈,16 白静慧,17 马麟,1 丛明华?

作者信息 +

Awareness and usage of a dietary guide by cancer patients and clinicians a national survey study

1Zhang Xi,1Dai Xiangting,1Huang Jiaxin,2Yuan Peng,1Li Ning,3Yu Kang,4Ling Yiqun,5Ye Wenfeng,6 Wang Kun,7 Fang Yu,8Yao Qinghua,9Yu Huiqing,10 Gao Shuqing,11Li Jufang,12 Kong Yongxia,13 Guo Zengqing,14Zhou Lan,15Li Shuluan,16 BaiJinghui,17 Ma Lin,1? Cong Minghua

Author information +

1 Department of Comprehensive Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021 China 2Department of VIP Medical Services National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021 China 3 Department of Clinical Nutrition & Health Medicine Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China 4 Department of Nutrition Fudan University Shanghai Cancer Center Shanghai 200032 China 5 Department of Clinical Nutrition Sun Yat-sen University Cancer Center Guangzhou 510060 Guangdong China 6 Department of Pain Relief Tianjin Medical University Cancer Institute and Hospital Tianjin 300060 China 7 Department of Nutrition Key Laboratory of Carcinogenesis and Translational Research Ministry of Education / Beijing Peking University Cancer Hospital Beijing 100142 China 8 Department of Integrated Chinese and Western Medicine Institute of Basic Medicine and Cancer IBMC The Cancer Hospital of the University of Chinese Academy of Sciences Zhejiang Cancer Hospital Chinese Academy of Sciences Hangzhou 310022 Zhejiang China 9 Department of Clinical Nutrition Chongqing University Cancer Hospital School of Medicine Chongqing University Chongqing 400030 China 10 Department of Clinical Nutrition The Fourth Hospital of Hebei Medical University Shijiazhuang 050011 Hebei China 11 Department of Clinical Nutrition Shanxi Provincial Cancer Hospital / Shanxi Hospital of the Cancer Hospital Chinese Academy of Medical Sciences / Affiliated Cancer Hospital of Shanxi Medical University Taiyuan 030013 Shanxi China 12 Department of Clinical Nutrition Henan Cancer Hospital Zhengzhou 450000 Henan China 13 Department of Clinical Nutrition Fujian Medical University Cancer Hospital Fujian Cancer Hospital Fuzhou 350014 Fujian China 14 Department of Clinical Nutrition Yunnan Provincial Tumor Hospital The Third Affiliated Hospital of Kunming Medical University Kunming 650118 Yunnan China 15 Department of Clinical Nutrition National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital and Shenzhen Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Shenzhen 518116 China 16 Department of General Internal Medicine Cancer Hospital of China Medical University / Liaoning Cancer Hospital Shenyang 110042 Liaoning China 17 Department of Chronic Non-communicable Disease Control Shanxi Provincial Center for Disease Control and Prevention Taiyuan 030012 Shanxi China

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文章历史 +

摘要

目的评估《恶性肿瘤患者膳食指导》标准在肿瘤患者和临床医师中的应用现状、影响因素及优化路径。方法本研究由中国医学科学院肿瘤医院联合全国 14 家医学中心共同开展,采用德尔菲法分别设计针对患者与临床医师的《恶性肿瘤患者膳食指导》标准相关的问卷进行调查,并收集数据。结果 2023 年 4 月至 2024 年 5 月,共纳入了 504 例恶性肿瘤患者与 238 名临床医师。问卷调查结果显示,35. 12%的恶性肿瘤患者和 78. 15%的临床医师知晓该膳食指导标准。其中肿瘤病史超过 3 年的患者(41. 05%)以及日常关注肿瘤患者健康科普的患者(49. 40%),对膳食指导标准的知晓率相对较高。同样,具备高级职称(90. 48%)以及从事肿瘤患者膳食指导工作超过 10 年(90. 63%)的临床医师,对标准的知晓率更高。恶性肿瘤患者主要通过网络、电视及广播(49. 15%)等渠道了解膳食指导标准,而临床医师则主要通过单位培训了解该标准(66. 67%)。在膳食指导原则方面,患者最为关注的是“合理膳食,适当运动” (82. 54%),其次是“多摄入富含蛋白质的食物” (71. 03%)及 “多吃蔬菜、水果和其他植物性食物”(70. 04%)。在膳食推荐摄入量方面,患者主要关注蛋白质的推荐摄入量(85. 32%),其次是能量的推荐摄入量(60. 32%)。另外,约有 65. 87%的患者被开具过膳食处方,且 82. 23%的患者认为处方有效。 97. 41% 的临床医师认为应定期举办或开展相关培训,且更倾向于线上培训班的形式 71. 82%)。临床医师主要在科普宣传 (79. 57%)、工作指导(64. 52%)及科研教学(26. 34%)中应用膳食指导标准。结论《恶性肿瘤患者膳食指导》标准在临床医师中接受度较高,但对患者的普及不足,需通过差异化推广策略提升标准知晓率。另外,应细化患者重点关注的指导原则条目,加大较少受关注条目的宣传力度,提升膳食处方开具率和应用率。

Abstract

Objective This study aims to evaluate the current implementation status influencing factors and optimization pathways of the 􀆵Dietary Guide for Cancer Patients guidelines among cancer patients and clinicians. Method This survey was organized by the Cancer Hospital of the Chinese Academy of Medical Sciences and 14 other medical centers across the country and included 504 patients with cancer and 238 clinicians. Based on the Delphi method the survey was conducted using separate questionnaires related to the 􀆵Dietary Guide for Cancer Patients comprising patient- and clinician-specific questionnaires. Result A total of 504 patients with malignant tumors and 238 clinical physicians were included. Approximately 35. 12% of patients with cancer and 78. 15% of clinicians were aware of the dietary guide. Cancer patients with time of tumor onset ≥3 years 41. 05% and those engaged in education of healthy diet 49. 40% demonstrated higher awareness of the dietary guide. Similarly clinicians with senior professional titles 90. 48% and ≥10 years experience 90. 63% in oncology nutrition showed greater knowledge of the guide. The primary pathway to understand the guide were the internet TV and radio 49. 15% for patients with cancer and institution-sponsored training 66. 67% among clinicians. The primary dietary guide item of concern for cancer patients was balanced diet and moderate exercise 82. 54% followed by increased intake of protein -rich foods 71. 03% and vegetables fruits and plant -origin foods 70. 04% . In terms of recommended intakes of nutrients protein 85. 32% was the main concern for patients followed by energy requirements 60. 32% . Approximately 65. 87% of the patients received dietary prescriptions from their providers and 82. 23% of these patients deemed the prescriptions effective. The survey revealed that 97. 41% of the clinicians believed that dietary guide training should be conducted regularly with a preference for online training courses. Clinicians primarily applied the dietary guide in public science communication 79. 57% followed by professional training 64. 52% and education and scientific research 26. 34% . Conclusion The "Dietary Guide for Cancer Patients" standard is highly accepted among clinicians but remains insufficiently popularized among patients necessitating the adoption of differentiated promotion strategies to enhance awareness of the standard. Furthermore it is imperative to elaborate on the guideline entries that patients prioritize while intensifying the promotion of less attention-grabbing entries in order to elevate the prescription rate and utilization of dietary prescriptions.

导出引用

1张西,1 戴香婷,1 黄嘉欣,2 袁芃,1 李宁,3 于康,4 凌轶群,5 叶文锋,6 王昆,7 方玉,8 姚庆华,9 余慧青,10 高淑清,11. 恶性肿瘤患者膳食指导标准的应用现状、影响因素及优化路径:一项全国性调查研究[J]. 肿瘤代谢与营养电子杂志. 2025, 12(5): 631-642

1Zhang Xi,1Dai Xiangting,1Huang Jiaxin,2Yuan Peng,1Li Ning,3Yu Kang,4Ling Yiqun,5Ye Wenfeng,6 Wang Kun,7 Fang Yu,8Yao Qinghua,9Yu Huiqing,10 Gao Shuqing,11Li Jufang,12 Kong Yongxia,13 Guo Zengqing,14Z. Awareness and usage of a dietary guide by cancer patients and clinicians a national survey study[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2025, 12(5): 631-642