Malnutrition and chemotherapy-induced nausea and vomiting: Implications for practice
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Purpose/Objectives: To determine the prevalence of malnutrition and chemotherapy-induced nausea and vomiting (CINV) limiting patients' dietary intake in a chemotherapy unit. Design: Cross-sectional descriptive audit. Setting: Chemotherapy ambulatory care unit in a teaching hospital in Australia. Sample: 121 patients receiving chemotherapy for malignancies, aged 18 years and older, and able to provide verbal consent. Methods: An accredited practicing dietitian collected all data. Chi-square tests were used to determine the relationship of malnutrition with variables and demographic data. Main Research Variables: Nutritional status, weight change, body mass index, prior dietetic input, CINV, and CINV that limited dietary intake. Findings: Thirty-one participants (26%) were malnourished, 12 (10%) had intake-limiting CINV, 22 (20%) reported significant weight loss, and 20 (18%) required improved nutrition symptom management. High nutrition risk diagnoses, CINV, body mass index, and weight loss were significantly associated with malnutrition. Thirteen participants (35%) with malnutrition, significant weight loss, intake-limiting CINV, and/or who critically required improved symptom management reported no prior dietetic contact; the majority of those participants were overweight or obese. Conclusions: Of patients receiving chemotherapy in this ambulatory setting, 26% were malnourished, as were the majority of patients reporting intake-limiting CINV. Implications for Nursing: Patients with malnutrition and/or intake-limiting CINV and in need of improved nutrition symptom management may be overlooked, particularly patients who are overweight or obese - an increasing proportion of the Australian population. Evidence-based practice guidelines recommend implementing validated nutrition screening tools, such as the Malnutrition Screening Tool, in patients undergoing chemotherapy to identify those at risk of malnutrition who require dietitian referral.
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