目的 探索肿瘤晚期患者营养状况恶化潜在剖面类别,分析不同类别的影响因素,并探讨其与未满足需求的相关关系,为后期改善患者未满足需求水平提供新的思路。方法 选取2024年1—12月南通市肿瘤医院肿瘤内科收治的肿瘤晚期患者为研究对象,采用患者主观整体评估量表、未满足需求简明量表对入组的调研对象的营养状况和未满足需求进行问卷调查。结果 有效问卷178份(92.71%)。肿瘤晚期患者营养状况恶化得分(8.45±1.61)分,未满足需求得分为(65.60±8.24)分。将肿瘤晚期患者营养状况恶化分为3个潜在剖面类别:高、中、低营养状况恶化组。三个类别组在年龄(χ2=15.639,P=0.004)、共病数量(χ2=6.980,P=0.031)、体质指数(χ2=12.179,P=0.016)及社会支持(χ2=10.367,P=0.035)方面差异有统计学意义。多因素Logistic回归分析显示:年龄、共病数量、体质指数及社会支持成为营养状况恶化的影响因素(P＜0.05)。差异性分析结果显示:不同潜在剖面类别肿瘤晚期患者未满足需求组间差异显著(F=22.149,P＜0.01),高营养状况恶化组患者的未满足需求水平显著高于中营养状况恶化组(P＜0.01)及低营养状况恶化组(P＜0.01),中营养状况恶化组患者的未满足需求水平显著高于低营养状况恶化组(P＜0.01)。结论 不同潜在剖面类别的营养状况恶化与患者的未满足需求水平密切相关。临床工作人员应及时识别患者的营养恶化风险剖面并早期实施个体化营养支持与心理社会干预,是改善晚期肿瘤患者需求和生存质量的关键。
Abstract
Objective To explore the latent profile categories of nutritional status deterioration in patients with advanced tumors, analyze the influencing factors of different categories, and investigate their correlation with unmet needs, providing new ideas for improving the level of unmet needs in patients in the later stage. Method Patients with advanced tumors admitted to the Department of Oncology of Nantong Cancer Hospital from January to December 2024 were selected as the research objects. The enrolled research objects were investigated with the malignant assessment of nutritional status scale and the brief unmet needs questionnaire. Result 178 valid questionnaires were collected (92.71%). The score of deterioration of nutritional status in patients with advanced tumors was (8.45±1.61) points, and the score of unmet needs was (65.60±8.24) points. The deterioration of nutritional status in patients with advanced tumors was classified into three latent profile categories: high, medium and low deterioration of nutritional status groups. There were significant differences among the three category groups in terms of age (χ2=15.639, P=0.004), number of comorbidities (χ2=6.980, P=0.031), BMI (χ2=12.179, P=0.016), and social support (χ2=10.367, P=0.035). Logistic regression analysis showed that age, the number of comorbidities, BMI and social support were the influencing factors of deteriorating nutritional status (P < 0.05). The results of the difference analysis show that: There were significant differences in unmet needs among the groups of patients with advanced tumors in different profiles (F=22.149, P < 0.01). The level of unmet needs of patients in the high nutritional status deterioration group was significantly higher than that in the medium nutritional status deterioration group (P < 0.01) and the low nutritional status deterioration group (P < 0.01). The level of unmet needs in the middle nutrition deterioration group was significantly higher than that in the low nutrition deterioration group (P < 0.01). Conclusion The deterioration of nutritional status in different profiles is closely related to the level of unmet needs of patients. Clinical staff should promptly identify the risk profile of nutritional deterioration in patients and implement individualized nutritional support and psychosocial intervention at an early stage, which is the key to improving the needs and quality of life of patients with advanced tumors.
关键词
肿瘤晚期 /
营养状况恶化 /
营养治疗 /
未满足需求 /
安宁疗护 /
剖面 /
影响因素 /
相关性
Key words
Advanced tumor /
Deterioration of nutritional status /
Nutritional therapy /
Unmet requirements /
Hospice care /
Profile /
Influencing factors /
Relevance
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参考文献
[1] VILCHEZ-MARQUEZ F, NARVAEZ-SIMON M, DIAZ-CALVILLO P, et al. Plaque-like myofibroblastic tumor: first report of a locally advanced tumor[J]. Am J Dermatopathol, 2025,47(4):283-286.
[2] REILLY J, FARIDMOAYER E, LAPKUS M, et al. Vascular invasion predicts advanced tumor characteristics in papillary thyroid carcinoma[J]. Am J Surg, 2022,223(3):487-491.
[3] SAMBATARO D, POLITI M R, MESSINA A, et al. Relationship of inflammatory parameters and nutritional status in cancer patients[J]. Anticancer Res, 2023,43(6):2821-2829.
[4] WU X, WANG W, ZHANG D, et al. Nutritional status, lifestyle habits and cancer mortality: a population-based prospective cohort study[J]. Eur J Nutr, 2022,61(3):1343-1352.
[5] WANG H M, WANG T J, HUANG C S, et al. Nutritional status and related factors in patients with gastric cancer after gastrectomy: a cross-sectional study[J]. Nutrients, 2022,14(13).
[6] HAMAKER M E, OOSTERLAAN F, VAN HUIS L H, et al. Nutritional status and interventions for patients with cancer-a systematic review[J]. J Geriatr Oncol, 2021,12(1):6-21.
[7] HSU M L, BOULANGER M C, OLSON S, et al. Unmet needs, quality of life, and financial toxicity among survivors of lung cancer[J]. JAMA Netw Open, 2024,7(4):e246872.
[8] STOUT N L, BOATMAN D, RICE M, et al. Unmet needs and care delivery gaps among rural cancer survivors[J]. J Patient Exp, 2024,11:682749241.
[9] BARREA L, GALLO M, RUGGERI R M, et al. Nutritional status and follicular-derived thyroid cancer: an update[J]. Crit Rev Food Sci Nutr, 2021,61(1):25-59.
[10] BAIL J, MENESES K, DEMARK-WAHNEFRIED W. Nutritional status and diet in cancer prevention[J]. Semin Oncol Nurs, 2016,32(3):206-214.
[11] CHONG E, CROWE L, MENTOR K, et al. Systematic review of caregiver burden, unmet needs and quality-of-life among informal caregivers of patients with pancreatic cancer[J]. Support Care Cancer, 2022,31(1):74.
[12] 倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010,45(4):378-380.
[13] 张帆, 朱树贞, 邓平基. 领悟社会支持量表在国内住院病人社会支持研究中的应用评价[J]. 护理研究, 2018,32(13):2048-2052.
[14] BAUER J, CAPRA S, FERGUSON M. Use of the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer[J]. Eur J Clin Nutr, 2002,56(8):779-785.
[15] 闫婷婷. 癌症患者未满足需求简明量表的汉化及应用研究[Z]. 郑州:郑州大学, 2018.
[16] KARIN M, BOGUT A, HOJSAK I, et al. Nutritional status and its effect on complications in patients with colorectal cancer[J]. Wien Klin Wochenschr, 2020,132(15-16):431-437.
[17] CUI X, JIAO J, YANG L, et al. Advanced tumor organoid bioprinting strategy for oncology research[J]. Mater Today Bio, 2024,28:101198.
[18] MEKAL D, SOBOCKI J, BADOWSKA-KOZAKIEWICZ A, et al. Evaluation of Nutritional Status and the Impact of Nutritional Treatment in Patients with Pancreatic Cancer[J]. Cancers (Basel), 2023,15(15).
[19] TOSTES N F, DA C A S D, MARTUCCI R B. Association between nutritional status and muscle strength in pediatric cancer patients[J]. Clin Nutr ESPEN, 2021,43:436-441.
[20] BROWN T, EDWARDS A, PASHLEY A, et al. Nutritional status and post-operative complications in patients undergoing surgery for advanced pharyngeal or laryngeal cancer[J]. Eur Arch Otorhinolaryngol, 2023,280(12):5531-5538.
[21] 郭蕾. 早期肠内营养与肠外营养护理结合心理干预在食管癌、贲门癌术后的效果分析[J]. 现代诊断与治疗, 2021,32(16):2677-2679.
[22] YAO J, WU P, LI Z, et al. Nutritional status and systemic inflammation in COPD: prognostic value of the advanced lung cancer inflammation index[J]. Front Nutr, 2025,12:1550490.
[23] WIJMA A G, HOGENBIRK R, DRIESSENS H, et al. Nutritional support in pancreatic cancer patients and its effect on nutritional status: an observational regional HPB network study investigating current practice[J]. Support Care Cancer, 2024,32(7):487.
[24] PHAM V B, NGUYEN T T H, LE THI H, et al. Nutritional status and feeding regimen of patients with esophagus cancer-a study from vietnam[J]. Healthcare (Basel), 2021,9(3):289.
[25] KARALEXI M A, MARKOZANNES G, TAGKAS C F, et al. Nutritional status at diagnosis as predictor of survival from childhood cancer: a review of the literature[J]. Diagnostics (Basel), 2022,12(10).
[26] 胡雪晴, 赵赟博, 聂鑫, 等. 肌少症与老年局部进展期结直肠癌患者长期预后的相关性分析[J]. 中华老年医学杂志, 2024,43(7):851-856.
[27] 彭玺霖, 柳丛祺, 周瑞豪, 等. 肌少症与老年食管癌患者术后不良结局的研究进展[J]. 国际麻醉学与复苏杂志, 2023,44(11):1193-1198.
[28] MINHAJAT R, HARJIANTI T, RASYID H, et al. Colorectal cancer patients' outcome in correlation with dietary and nutritional status: a systematic review[J]. Ann Med, 2023,55(2):2281662.
[29] MUSZYNSKI T, JEDRYCHOWSKI T, WITALEWSKA A, et al. Nutritional status and related factors in gastric cancer patients after gastrectomy: a cross-sectional study[J]. Pol Przegl Chir, 2024,97(2):1-10.
[30] AZZINI E, FURINI T, POLITO A, et al. Vitamin nutritional status in patients with pancreatic cancer: a narrative review[J]. Int J Mol Sci, 2024,25(9).
[31] KRIETEMEYER M, KEMPER C, CLUTTER J, et al. The association of social support and income on the nutritional status and physical activity of older female cancer survivors[J]. J Geriatr Oncol, 2022,13(3):334-336.
[32] 邵晴. 鼻咽癌放化疗患者营养补充认知度的影响因素及其重要性矩阵分析[J]. 实用临床医药杂志, 2024,28(13):7-12.
[33] 齐淑静,付改霞,齐瑞霞.中医食疗联合营养治疗改善恶性肿瘤患者厌食症状[J].中华灾害救援医学,2024,11(1):1-6.
[34] GRABE-HEYNE K, HENNE C, MARIAPPAN P, et al. Intermediate and high-risk non-muscle-invasive bladder cancer: an overview of epidemiology, burden, and unmet needs[J]. Front Oncol, 2023,13:1170124.
[35] DE NUNZIO C, GIANNATEMPO P, PASSALACQUA R, et al. Epidemiology and unmet needs of bladder cancer in Italy: a critical review[J]. Minerva Urol Nefrol, 2020,72(1):1-12.
[36] ZENG C, QIU G, XIE X, et al. Combined small cell lung cancer: current progress and unmet needs[J]. Am J Cancer Res, 2023,13(9):3864-3874.
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