Background:
Malnutrition is a significant supportive care need for people with cancer. The project Investigating practices relating to Malnutrition in Victorian Cancer Services was commenced in 2012 involving 15 Health Services. The project aimed to identify areas for local improvement and reduce the burden of cancer malnutrition .
This project identified 31% of cancer patients are malnourished, with only 56% of these patients receiving dietetic intervention. The largest gaps in services are to patients in tumour streams where malnutrition is poorly recognised.
Aims:
To identify and understand the attitudes, knowledge and practices of oncology clinicians in the management of cancer malnutrition.
Methods:
A 26-question survey was developed. Clinicians working in all Victorian hospital-based oncology services were invited to complete an on-line survey. Established clinician networks were used to contact clinicians by email.
Results:
A total of 124 responses were collected: 47% (n=58) nursing, 30% (n=37) allied health (excluding dietitians) and 23% (n=29) medical clinicians.
Clinicians strongly agreed that malnutrition screening should occur at admission to hospital (96%), at diagnosis (89%), and at regular intervals of the cancer journey (92%). However, only 74% of clinicians reported malnutrition screening was routine in their units.
Clinicians reported low levels of nutrition care embedded into ward practices including the discussion of nutrition on ward rounds (48%), nutrition considered in discharge planning (40%) and only 11% included nutrition in medical discharge summaries.
Respondents sought further education and access to resources including evidence-based clinical guidelines and information on nutrition management strategies.
CONCLUSION
Multidisciplinary clinicians working in cancer services have a good awareness of malnutrition risk and understand that nutrition care is important. However the integration of nutrition management into routine care is limited. Clinicians are seeking further training and education strategies to improve nutrition knowledge and awareness needs to be developed.