探索诊断癌症患者营养不良的障碍：关于肿瘤学家观点的研究

Q3 Nursing

Clinical Nutrition Open Science Pub Date : 2024-10-05 DOI:10.1016/j.nutos.2024.10.001

Lisa Heide Koteng , Kari Sand , Ingvild Paur , Asta Bye , Bente Ervik , Tora S. Solheim , Inger Ottestad , Trude R. Balstad

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引用次数: 0

摘要

背景和目的癌症患者营养不良的风险很高，但在癌症诊所中，相关的 ICD-10 营养不良代码却未得到充分利用。了解肿瘤学家的观点对于优化营养不良诊断代码和加强营养实践以改善患者护理至关重要。本研究旨在探讨肿瘤学家对营养不良ICD-10编码的使用和可行性的看法。研究方法：本研究采用定性研究方法，对来自挪威三家医院的肿瘤学家（人数=14）进行了四次焦点小组访谈。结果几乎没有肿瘤学家熟悉营养不良诊断代码。他们认为这些代码在临床实践中并不适用，部分原因是诊断标准复杂。没有人系统地使用这些代码，而是依靠询问患者的体重、体重减轻情况、食物摄入量和食欲。肿瘤专家优先识别需要营养治疗的患者，认为诊断代码对于提供高质量的治疗没有必要。提高代码使用率的建议包括经济激励措施、加强与临床营养师的合作以及自动编码的数字系统。他们没有使用 ICD-10 营养不良编码，认为复杂的诊断标准和编码与营养治疗缺乏相关性是限制因素。

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Exploring the barriers to diagnosing malnutrition in patients with cancer: A study on oncologists' perspectives

Background and aim

Patients with cancer are at high risk of malnutrition, yet relevant ICD-10 codes for malnutrition are underutilized in cancer clinics. Understanding oncologists' perspectives is crucial for optimizing malnutrition diagnosis codes and enhancing nutritional practices to improve patient care. This study aims to explore oncologists' perspectives on the use and feasibility of the ICD-10 codes for malnutrition.

Methods

A qualitative study was conducted, consisting of four focus group interviews with oncologists (n=14) from three Norwegian hospitals. A semi-structured interview guide, covering five main topics, guided the discussions.

Results

Few oncologists were familiar with the malnutrition diagnosis codes. The codes were considered inapplicable in clinical practice, partly due to complex diagnostic criteria. None used the codes systematically, instead relying on inquiries about patients' weight, weight loss, food intake, and appetite. Oncologists prioritized identifying patients in need of nutritional treatment, considering diagnosis codes unnecessary for providing quality care. Proposals for increased code utilization included economic incentives, enhanced collaboration with clinical dietitians, and digital systems for automated coding.

Conclusion

The oncologists expressed that they prevent and treat malnutrition in patients with cancer, but not systematically. They do not utilize ICD-10 codes for malnutrition, citing both complex diagnostic criteria and the codes’ lack of relevance to nutritional treatment as limiting factors.

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来源期刊

Clinical Nutrition Open Science Nursing-Nutrition and Dietetics

CiteScore

2.20

自引率

0.00%

发文量

审稿时长

18 weeks