The effect of nutrition counseling on nutritional status for breast cancer patients in dr. Sardjito Hospital, Indonesia

S. Susetyowati, S. R. Dwidanarti, R. Pangastuti, H. Wulandari, Farah Faza, Nadira D'mas Getare Sanubari
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Abstract

Background: Nutrition counseling in breast cancer (BC) patients show long-term adherence to a dietary pattern and effects on nutritional status and quality of life (QOL).Objective : We evaluated the effects of nutrition counseling for nutrients intake dan nutritional status improvement among breast cancer patients.Material and Methods: This research was conducted in a Pre-experimental design; one group pretest-postest design was conducted on 45 BC patients who underwent radiotherapy for five weeks in the Radiotherapy Unit, dr. Sardjito Hospital, Indonesia. Nutrition counseling was demonstrated by trained fieldworkers to 45 participants using a nutrition booklet for BC patients and a food model as an intervention technique. Continuous nutrition counseling was given three times: weeks 1, 3, and 5 of radiotherapy. We examined anthropometry, biochemical, physical, dietary, and Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire to obtain nutritional status.Results: Most of the participants had a body mass index (BMI) ≥25 kg/m2 (62.2%). After the participants were receiving nutrition counseling, there were increases in intake of energy, protein, carbohydrate, vitamin A, vitamin C, and vitamin E amounted 124.54 kcal, 8.12 g (p=0.01), 5.84 g, 234.43 mg, 0.042 mg, and 0.44 mg, respectively. Intake of fruits and vegetables improved on the first, third, and fifth week (1.44, 2.36, and 4.03 portion/day, respectively) (p=0.001). Handgrip strength (HGS) showed slight improvement (p=0.081). However, HGS ameliorated from 15.85 kgs in the early to 16.97 kgs in the end stage of therapy. Bodyweight decreased 0.28 kg; however, there are no changes in PG-SGA score, hemoglobin (Hb), and albumin levels.Conclusion: Nutrition counseling improves patients’ nutrition intake despite there is no significant alteration in nutritional status. In addition, nutrition counseling for breast cancer patients during radiotherapy is essential to maintain and improve nutrient intake and nutritional status. In the long-term period, it might be affected to improve quality of life. 
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营养咨询对印度尼西亚Sardjito医生医院乳腺癌患者营养状况的影响
背景:乳腺癌(BC)患者的营养咨询显示长期坚持饮食模式并对营养状况和生活质量(QOL)产生影响。目的:评价营养咨询对乳腺癌患者营养摄入和营养状况改善的影响。材料与方法:本研究采用预实验设计;对印度尼西亚dr. Sardjito医院放射治疗科接受放射治疗5周的45名BC患者进行了一组前测后测设计。营养咨询由训练有素的现场工作人员向45名参与者演示,使用BC患者营养小册子和食物模型作为干预技术。放疗第1周、第3周、第5周连续3次给予营养咨询。我们检查了人体测量、生化、物理、饮食和患者主观整体评估(PG-SGA)问卷来获得营养状况。结果:大多数参与者体重指数(BMI)≥25 kg/m2(62.2%)。在接受营养咨询后,参与者的能量、蛋白质、碳水化合物、维生素A、维生素C和维生素E的摄入量分别增加了124.54千卡、8.12克(p=0.01)、5.84克、234.43毫克、0.042毫克和0.44毫克。水果和蔬菜的摄入量在第一、第三和第五周有所改善(分别为1.44、2.36和4.03份/天)(p=0.001)。握力(HGS)略有改善(p=0.081)。然而,HGS从早期的15.85公斤改善到治疗末期的16.97公斤。体重下降0.28 kg;然而,PG-SGA评分、血红蛋白(Hb)和白蛋白水平没有变化。结论:营养咨询可改善患者的营养摄入,但患者的营养状况并无明显改变。此外,在放疗期间对乳腺癌患者进行营养咨询对于维持和改善营养摄入和营养状况至关重要。从长期来看,它可能会影响到生活质量的提高。
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