{"title":"影响晚期癌症患者肠外营养决策的因素：一项系统综述","authors":"Jennifer McCracken, Sabrina Bajwah, Clare Shaw","doi":"10.1111/jhn.70009","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Many factors beyond clinical guidelines may influence healthcare professionals' (HCPs) decision-making. This systematic review aims to identify the factors that affect HCPs decision-making around parenteral nutrition (PN) in advanced cancer.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A literature search was conducted by May 2023 via MEDLINE, Embase, PsycINFO, The Cochrane Library, CINAHL, PubMed, Web of Knowledge and PROSPERO. Fourteen additional papers were identified. Two reviewers independently screened all papers with consensus reached on inclusion. Three reviewers conducted quality appraisal independently. Reference checking and citation tracking were completed for all included papers.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 458 papers identified, 5 papers met the eligibility criteria (3 online surveys, 2 qualitative studies). All papers were European. Papers were published between 2020 and 2023. Six themes were identified as affecting decision-making: clinical indications, quality of life, hope, the multidisciplinary team, barriers to facilitating home PN and the influence of relatives. Performance status was a commonly considered indicator of suitability for home PN. PN is more common for people with advanced cancer and intestinal failure (IF) in the UK. Barriers to providing PN included unclear clinical indication, colleague objections, lack of local expertise and poor communication between HCPs.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Collaborative working and effective communication are essential between acute services, IF centres and community services to facilitate decision-making around PN in advanced cancer. It is important for HCPs to set realistic expectations. Communication must be sensitive to the patient's values and culture.</p>\n </section>\n </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Affecting Healthcare Professionals' Decision-Making Around Parenteral Nutrition in Advanced Cancer: A Systematic Review\",\"authors\":\"Jennifer McCracken, Sabrina Bajwah, Clare Shaw\",\"doi\":\"10.1111/jhn.70009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Many factors beyond clinical guidelines may influence healthcare professionals' (HCPs) decision-making. 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引用次数: 0
摘要
背景：临床指南之外的许多因素可能影响医疗保健专业人员（HCPs）的决策。本系统综述旨在确定影响晚期癌症患者肠外营养（PN）决策的因素。方法于2023年5月通过MEDLINE、Embase、PsycINFO、Cochrane Library、CINAHL、PubMed、Web of Knowledge和PROSPERO进行文献检索。另外确定了14份文件。两名审稿人独立筛选所有达成共识的论文。三名评审人员独立进行质量评估。所有纳入的论文均完成了文献检查和引文跟踪。结果458篇论文中，5篇符合入选标准（3篇在线调查，2篇定性研究）。所有的报纸都是欧洲的。论文发表于2020年至2023年之间。确定了影响决策的六个主题：临床指征、生活质量、希望、多学科团队、促进家庭PN的障碍和亲属的影响。性能状态通常被认为是适合家庭PN的指标。在英国，PN在晚期癌症和肠衰竭（IF）患者中更为常见。提供PN的障碍包括临床指征不明确、同事反对、缺乏当地专业知识以及医护人员之间沟通不畅。结论急诊服务、IF中心和社区服务之间的协作和有效沟通是促进晚期癌症PN决策的必要条件。对医务人员来说，设定现实的期望是很重要的。沟通必须对病人的价值观和文化敏感。
Factors Affecting Healthcare Professionals' Decision-Making Around Parenteral Nutrition in Advanced Cancer: A Systematic Review
Background
Many factors beyond clinical guidelines may influence healthcare professionals' (HCPs) decision-making. This systematic review aims to identify the factors that affect HCPs decision-making around parenteral nutrition (PN) in advanced cancer.
Methods
A literature search was conducted by May 2023 via MEDLINE, Embase, PsycINFO, The Cochrane Library, CINAHL, PubMed, Web of Knowledge and PROSPERO. Fourteen additional papers were identified. Two reviewers independently screened all papers with consensus reached on inclusion. Three reviewers conducted quality appraisal independently. Reference checking and citation tracking were completed for all included papers.
Results
Of 458 papers identified, 5 papers met the eligibility criteria (3 online surveys, 2 qualitative studies). All papers were European. Papers were published between 2020 and 2023. Six themes were identified as affecting decision-making: clinical indications, quality of life, hope, the multidisciplinary team, barriers to facilitating home PN and the influence of relatives. Performance status was a commonly considered indicator of suitability for home PN. PN is more common for people with advanced cancer and intestinal failure (IF) in the UK. Barriers to providing PN included unclear clinical indication, colleague objections, lack of local expertise and poor communication between HCPs.
Conclusion
Collaborative working and effective communication are essential between acute services, IF centres and community services to facilitate decision-making around PN in advanced cancer. It is important for HCPs to set realistic expectations. Communication must be sensitive to the patient's values and culture.
期刊介绍：
Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on:
- Clinical nutrition and the practice of therapeutic dietetics
- Clinical and professional guidelines
- Public health nutrition and nutritional epidemiology
- Dietary surveys and dietary assessment methodology
- Health promotion and intervention studies and their effectiveness
- Obesity, weight control and body composition
- Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments.
- Appetite, Food intake and nutritional status
- Nutrigenomics and molecular nutrition
- The journal does not publish animal research
The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.
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