دانلود رایگان مقاله انگلیسی دانش و شیوه های انکولوژی های پزشکی در مورد تغذیه درمانی - الزویر 2018

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Background and aims: Despite the identification of malnutrition and administration of nutrition therapy being increasingly recognised as integral to the treatment of cancer patients, this is not always translated into routine clinical practice. The aim of this study was to determine medical oncologists’ awareness of, and ability to assess, nutritional status and when to initiate nutrition therapy, to identify their educational status concerning clinical nutrition and their perceived barriers to the routine use of nutrition therapy in their patients through a survey study. Methods: 155 medical oncologists were invited to complete a digital questionnaire. The questionnaire included information regarding the participants demographic and professional information, clinical nutrition education status, attitudes towards malnutrition and nutrition therapy, and barriers to using nutrition therapy. The questionnaire also included two case scenarios designed to assess ability to diagnose malnutrition/assess nutritional status and identify when nutrition therapy might be indicated. Results: Of 109 medical oncologists who agreed to participate, 43.1% declared that they received clinical nutrition education and 33.9% declared that they followed the oncology sections in the European Society of Clinical Nutrition and Metabolism (ESPEN) Guidelines. The medical oncologists were divided into two groups according to their knowledge score (31 medical oncologists with a knowledge score of <3 and 78 medical oncologists with a knowledge score of
3). The rate of having nutrition education was significantly higher in those with a higher knowledge score (
3) and the rate of medical oncologists having this education during medical and/or oncology education was also significantly higher. The rate of medical oncologists following the oncology sections in the ESPEN guidelines was higher in those with higher knowledge score. Conclusions: Our results emphasize the association between clinical nutrition education and higher knowledge scores in medical oncologists, but reveal a mis-match between knowledge and awareness and what happens in clinical practice. Nutrition therapy might be used more frequently in routine practice when medical oncologists’ lack of knowledge is resolved.

4. Discussion

The present survey study performed on medical oncologists in Turkey investigated the medical oncologists’ clinical nutrition training status, awareness of, and ability to assess, nutritional status and identify malnutrition and barriers to routine use of clinical nutrition in cancer patients.

4.1. Clinical nutrition training status

In the present study less than half of the respondents (43.1%) stated that they had received clinical nutrition education. A previous UK study of the views and practice of oncologists towards nutritional support in patients receiving chemotherapy showed a similar level of nutrition training at either post-graduate or undergraduate level (45%) [11] suggesting the results from our Turkish study are not unusual. Based on our findings strategies to improve access to clinical nutrition education at both undergraduate and postgraduate level should be investigated.