Nutritional assessment, intervention, and evaluation of weight loss in patients with non-small cell lung cancer.
OBJECTIVE
To describe weight change in patients from the time of cancer diagnosis to the last healthcare encounter before death, to describe reported nutritional assessment, intervention, and evaluation; and to determine the relationship of weight change and cancer-related symptoms to nutritional assessment, intervention, and evaluation.


METHODS
Descriptive, correlational.


METHODS
A National Cancer Institute-designated cancer center and its associated university medical center in the northeastern United States.


METHODS
Medical records of 93 individuals with non-small cell lung cancer.


METHODS
Retrospective chart review.


METHODS
Weight change; nutritional assessment, intervention, and evaluation; and cancer-related symptoms.


RESULTS
Mean weight change from cancer diagnosis to last healthcare encounter was -4.75 kg (SD = 6.05 kg). The mean regression slope of weight change was -3.69 kg/healthcare encounter (SD = 6.49 kg). The results of content analysis indicated that 90 subjects had nutritional assessments, 54 subjects had interventions, and 24 subjects had evaluations of intervention effectiveness. No association existed between weight change or cancer-related symptoms and nutritional assessment. Nutritional intervention was positively associated with dysphagia and depression, and evaluation of intervention effectiveness was positively associated with weight loss and dysphagia.


CONCLUSIONS
Assessments of weight change and appetite usually were reported and appeared to be a routine part of patient care. However, assessments of weight loss and anorexia led to interventions only 60% of the time. When interventions were recommended, only 44% were evaluated for effectiveness.


CONCLUSIONS
Assessment of nutritional status needs to be broadened, interventions need to be initiated more often, and creative solutions to nutritional problems need to be sought. Regular evaluation of interventions is essential.
Brown
J K
JK
School of Nursing, State University of New York, Buffalo, USA.
Radke
K J
KJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000451:nursing*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D009511:New England / Q000453:epidemiology; D009731:Nursing Audit; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000175:diagnosis / Q000209:etiology / Q000451:nursing*; D012044:Regression Analysis; D012189:Retrospective Studies; D015431:Weight Loss