Clinical dietitians

  • 文章类型: Journal Article
    UNASSIGNED: Clinical dietitians play a crucial role in the nutritional support of patients at risk of malnutrition in primary care settings. The study aimed to evaluate the effect of an individualized nutritional intervention on clinically relevant outcomes for patients with chronic disease at nutritional risk.
    UNASSIGNED: A longitudinal evaluation study was conducted in two Slovenian primary health centres. We used pre-test and post-test design. Patients with chronic disease were screened using the Malnutrition Universal Screening Tool and additional risk factors (≥70 years and BMI <22 kg/m2; lower food intake in the last five days). Patients at nutritional risk were referred to a clinical dietitian for individual nutritional intervention. The effect of the nutritional intervention was assessed six months after the patients\' first visit with a clinical dietitian.
    UNASSIGNED: The sample included 94 patients. Nutritional risk was reduced significantly in high-risk and moderate-risk patients. In a subgroup of patients with a MUST score ≥1 (77 patients), body weight, BMI, Fat-Free Mass Index (FFMI), energy intake, and protein intake increased significantly (p<0.001). At the same time, the phase angle significantly increased (p<0.001), but there were no statistically significant changes in the improvement of grip strength. In a subgroup of patients with MUST score 0 (17 patients), we observed an increase in their median daily energy intake (p<0.001) and median protein intake (p=0.003).
    UNASSIGNED: Nutritional intervention delivered by a clinical dietitian improved patients\' nutritional intake and nutritional and functional status.
    UNASSIGNED: Preveriti učinkovitost individualnih prehranskih ukrepov, ki jih v obravnavi prehransko ogroženih pacientov s kronično boleznijo, načrtuje in izvaja klinični dietetik ter se odražajo v spremembah prehranskega in funkcionalnega stanja pacientov.
    UNASSIGNED: Longitudinalno evalvacijsko raziskavo smo med majem 2020 in novembrom 2022 izvedli v dveh večjih slovenskih zdravstvenih domovih. Prehransko presejanje smo izvedli z uporabo univerzalnega orodja za prehransko presejanje Malnutrition Universal Screening Toll (MUST) in dodatnimi dejavniki tveganja (≥ 70 let in ITM < 22 kg/m2; manjši vnos hrane v zadnjih petih dneh). Prehransko ogrožene paciente smo napotili h kliničnemu dietetiku na individualno prehransko obravnavo. Skupino pacientov smo spremljali v dveh različnih časovnih točkah, uporabili smo dizajn pred postopkom/po postopku. Rezultate smo analizirali po šestih mesecih.
    UNASSIGNED: V vzorec smo vključili 94 bolnikov. Prehranska ogroženost se je pri pacientih z visokim in zmernim tveganjem po šestih mesecih znatno zmanjšala. V podskupini pacientov z oceno MUST ≥ 1 (77 pacientov) so se telesna masa, indeks telesne mase, indeks puste mase, količina zaužite energije in količina zaužitih beljakovin znatno povečali (p < 0,001). Medtem ko se je fazni kot pomembno povečal (p < 0,001), je moč prijema ostala relativno stabilna. V podskupini pacientov z oceno MUST = 0 (17 bolnikov), smo po šestih mesecih opazili porast povprečne količine zaužite energije (p < 0,001) in povprečno količino zaužitih beljakovin (p = 0,003).
    UNASSIGNED: Rezultati raziskave so dokazali, da lahko z individualno naravnavami prehranskimi ukrepi, ki jih izvaja klinični dietetik, pri prehransko ogroženih pacientih s kronično boleznijo pomembno izboljšamo prehransko in funkcionalno stanje ter zmanjšamo njihovo prehransko ogroženost.
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  • 文章类型: Journal Article
    目的:研究门诊患者头颈部癌(HNC)治疗初期哪些营养影响症状(NIS)最为普遍。其次,检查总体生存率降低的风险与NIS或营养风险之间是否存在潜在关系。
    方法:回顾性收集接受放疗和/或全身治疗的HNC门诊患者的数据。临床营养师根据营养风险筛查工具(NRS2002)和东部肿瘤协作组表现状况(ECOG)咨询了所有患者的营养风险筛查,以及通过结构化问卷收集的NIS评估,16种症状的患病率以及它们在营养上的限制程度。计算两个月随访时的体重减轻,并根据BMI调整的体重减轻分级系统(高,得分0-2;低,得分3-4)。
    结果:共纳入110例患者(男性,77%;年龄,66(59-71))。在两个月的随访中,平均体重减轻为4.5kg,BMI越高。86%的患者经历了3个或更多的当前NIS(P-NIS),44%的患者经历了3个或更多的营养限制性NIS(L-NIS)。具有降低总体生存率的高风险的患者占45%,并且包括具有低BMI和高体重减轻百分比的患者。在NIS方面,两组之间没有发现显着差异。
    结论:我们发现NIS在头颈癌患者中非常普遍。女性比男性经历了更多的NIS。一半的患者被归类为总生存率降低的高风险,但这项研究未发现总生存期降低的风险与NIS或营养风险之间存在相关性.
    To examine which nutritional impact symptoms (NIS) were most prevalent at the initial state of treatment in outpatients with head and neck cancer (HNC). Secondly, to examine whether there is a potential relation between risk of reduced overall survival to NIS or nutritional risk.
    Retrospective data collection from outpatients with HNC undergoing radiotherapy and/or systemic therapy. A clinical dietitian consulted all patients with the inclusion of a nutritional risk screening according to the Nutritional Risk Screening tool (NRS 2002) and Eastern Cooperative Oncology Group performance status (ECOG), and an assessment of NIS collected with a structured questionnaire, with the prevalence of 16 symptoms and to what degree they were nutritionally limiting. Weight loss at two months follow-up was calculated and patients were categorized as either at low or high risk of reduced overall survival in accordance with a BMI-adjusted weight loss grading system (high, score 0-2; low, score 3-4).
    A total of 110 patients were included (male, 77%; age, 66 (59-71)). The mean weight loss was 4.5 kg at two months follow-up, increasing with higher BMI. Eighty-six percentage of the patients experienced 3 or more of the present NIS (P-NIS), and 44% of the patients experienced 3 or more of the nutritionally limiting NIS (L-NIS). Patients who have a high risk of reduced overall survival accounted for 45% and consisted of patients with low BMI and high percentual weight loss. No significant difference was found between the two groups in terms of NIS.
    We found NIS to be highly prevalent among patients with head and neck cancer. Women experienced more NIS than men. Half of the patients were categorized as being at high risk of reduced overall survival, but no relation between the risk of reduced overall survival to NIS or nutritional risk was found in this study.
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  • 文章类型: Journal Article
    目的:确定沙特阿拉伯临床医生评估儿科患者的生长图和实践类型;评估临床医生对生长图的解释和理解。
    方法:这是一项横断面研究,包括居住在沙特阿拉伯的105名儿科医生和营养师。参与者完成了一份在线问卷,该问卷评估:居住地区,工作设施,儿科患者评估的典型做法,以及正确解释和理解增长图数据的能力。使用描述性和卡方统计学对数据进行分析。
    结果:大多数受访者(70.5%)报告通常使用CDC或WHO的增长图表。只有52.4%的人报告在年度/定期访视期间总是使用生长图和讨论儿科患者的体重状况。54.3%的人报告在所有情况下都与他/她的护理人员讨论患者的体重状况。只有23.8%的人正确回答了口译问题,50.5%正确回答了理解问题。居住在南方的临床医生比例更高,中央,和西部地区报告说,他们总是或经常与他/她的照顾者(100%,89.2%和81.4%,分别)(P值=0.004)。只在私立医院工作的临床医生,通常使用沙特生长图的人最不可能报告他们总是或经常与他/她的护理人员讨论患者的体重状况(50%和61.5%,分别)(所有Ps<0.05)。
    结论:沙特阿拉伯临床医生对生长图的利用需要进一步评估。居住在北部和东部地区的临床医生,只在私立医院工作的人,通常使用沙特增长图的人在增长图利用方面表现出较差的做法。
    OBJECTIVE: To identify types of growth charts and practices employed by clinicians to assess pediatric patients in Saudi Arabia; To assess clinicians\' interpretation and comprehension of growth charts.
    METHODS: This is a Cross-sectional study including 105 pediatricians and dietitians residing in Saudi Arabia. Participants completed an online questionnaire which assessed: region of residence, work facility, typical practices in pediatric patient assessment, and ability to correctly interpret and comprehend growth chart data. Data were analyzed using descriptive and chi-square statistics.
    RESULTS: Majority of respondents (70.5%) reported typically using either the CDC or WHO growth charts. Only 52.4% reported always using growth charts and discussing weight status of pediatric patients during annual/regular visits, and 54.3% reported discussing the patient\'s weight status with his/her caregiver(s) under all circumstances. Only 23.8% correctly answered the interpretation question, while 50.5% correctly answered the comprehension question. A higher percentage of clinicians residing in the Southern, Central, and Western regions reported that they always or often discuss the patient\'s weight status with his/her caregiver(s) (100%, 89.2% and 81.4%, respectively) (P value = 0.004). Clinicians who worked in private hospitals only, and who typically used the Saudi growth charts were least likely to report that they always or often discuss the patient\'s weight status with his/her caregiver(s) (50% and 61.5%, respectively) (All Ps < .05).
    CONCLUSIONS: Growth chart utilization among clinicians in Saudi Arabia needs further evaluation. Clinicians residing in the Northern and Eastern regions, who worked in private hospitals only, and who typically used the Saudi growth charts showed poorer practices with regards to growth chart utilization.
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