Health professional attitudes and perceptions of prehabilitation and nutrition before haematopoietic cell transplantation

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS Journal of Human Nutrition and Dietetics Pub Date : 2024-05-02 DOI:10.1111/jhn.13315

Laura J. Miller, Vanessa Halliday, John A. Snowden, Guruprasad P. Aithal, Julia Lee, Diana M. Greenfield

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Abstract

Background

Nutritional prehabilitation may improve haematopoietic cell transplantation (HCT) outcomes, although little evidence exists. The present study aimed to understand healthcare professional (HCP) perceptions of prehabilitation and nutritional care pre-HCT in UK centres.

Methods

An anonymous online survey (developed and refined via content experts and piloting) was administered via email to multidisciplinary HCPs in 39 UK adult centres, between July 2021 and June 2022. Data are presented as proportions of responses. Routine provision denotes that care was provided >70% of time.

Results

Seventy-seven percent (n = 66) of HCPs, representing 61.5% (n = 24) of UK adult HCT centres, responded. All HCPs supported prehabilitation, proposing feasible implementation between induction chemotherapy (60.4%; n = 40) and first HCT clinic (83.3%; n = 55). Only 12.5% (n = 3) of centres had a dedicated prehabilitation service. Nutrition (87.9%; n = 58), emotional wellbeing (92.4%; n = 61) and exercise (81.8%; n = 54) were considered very important constituents. HCPs within half of the HCT centres (n = 12 centres) reported routine use of nutrition screening pre-HCT with a validated tool; 66.7% of HCPs (n = 36) reported using the malnutrition universal screening tool (MUST). Sixty-two percent (n = 41) of HCPs reported those at risk, received nutritional assessments, predominantly by dietitians (91.6%; n = 22) using the dietetic care process (58.3%; n = 14). Body mass index (BMI) was the most frequently reported body composition measure used by HCPs (70.2%, n = 33). Of 59 respondents, non-dietitians most routinely provided dietary advice pre-HCT (82.4%; n = 28 vs. 68%; n = 17, p = 0.2); including high-energy/protein/fat and neutropenic diet advice. Prophylactic enteral feeding pre-HCT was rare, indicated by low BMI and significant unintentional weight loss. Just under half (n = 25 of 59, 42.4%) HCPs reported exercise advice was given routinely pre-HCT.

Conclusions

Nutrition and prehabilitation pre-HCT are considered important and deliverable by HCPs, but current provision in UK centres is limited and inconsistent.

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医疗专业人员对造血细胞移植前康复和营养的态度和看法

背景营养预康复可改善造血细胞移植（HCT）的疗效，但这方面的证据很少。本研究旨在了解英国各中心的医护人员（HCP）对造血干细胞移植前康复和营养护理的看法。方法在 2021 年 7 月至 2022 年 6 月期间，通过电子邮件向英国 39 个成人中心的多学科 HCP 进行匿名在线调查（通过内容专家和试点进行开发和改进）。数据以回复比例表示。结果77%（n = 66）的 HCP 进行了回复，占英国成人 HCT 中心的 61.5%（n = 24）。所有 HCP 都支持预康复，并提出在诱导化疗（60.4%；n = 40）和首次 HCT 诊所（83.3%；n = 55）之间实施预康复是可行的。只有 12.5%（n = 3）的中心有专门的预康复服务。营养（87.9%；n = 58）、情绪健康（92.4%；n = 61）和运动（81.8%；n = 54）被认为是非常重要的组成部分。半数血液透析中心（12 家）的保健医生报告称，他们在血液透析前使用有效工具进行常规营养筛查；66.7% 的保健医生（36 人）报告称使用了营养不良通用筛查工具 (MUST)。62%的高级保健人员（n = 41）报告称，有风险的患者接受了营养评估，主要由营养师（91.6%；n = 22）使用营养护理流程（58.3%；n = 14）进行评估。体重指数（BMI）是保健医生最常使用的身体成分测量方法（70.2%，n = 33）。在 59 名受访者中，非营养师最常提供造血干细胞移植前的饮食建议（82.4%；n = 28 vs. 68%；n = 17，p = 0.2）；包括高能量/蛋白质/脂肪和中性粒细胞饮食建议。HCT前预防性肠内喂养很少见，这表现为低体重指数（BMI）和明显的无意体重减轻。结论HCP认为血液透析前的营养和预康复很重要，也可以提供，但目前英国中心提供的营养和预康复服务有限且不一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

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.