{"id":8705,"date":"2024-08-27T20:47:38","date_gmt":"2024-08-27T18:47:38","guid":{"rendered":"https:\/\/sygeplejevidenskab.dk\/?p=8705"},"modified":"2025-07-14T20:37:32","modified_gmt":"2025-07-14T18:37:32","slug":"forebyggelse-af-vaegttab-hos-patienter-med-hoved-halskraeft-i-straale-eller-kemostraalebehandling-et-systematisk-review-og-meta-analyse","status":"publish","type":"post","link":"https:\/\/sygeplejevidenskab.dk\/index.php\/2024\/08\/27\/forebyggelse-af-vaegttab-hos-patienter-med-hoved-halskraeft-i-straale-eller-kemostraalebehandling-et-systematisk-review-og-meta-analyse\/","title":{"rendered":"Forebyggelse af v\u00e6gttab hos patienter med hoved-halskr\u00e6ft i str\u00e5le-eller kemostr\u00e5lebehandling \u2013 Et systematisk review og meta-analyse"},"content":{"rendered":"

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B\u00f8jesen M, Juhl CB, N\u00f8rgaard B. Prevention of weight loss in patients with head and neck cancer in ongoing radiation or chemoradiation therapy-A systematic review and meta-analysis. Eur J Oncol Nurs. 2024 Jul 14;72:102668.<\/span> DOI: 10.1016\/j.ejon.2024.102668.<\/a><\/p>\n

Introduktion
\n<\/span><\/strong>Ved et kurativt behandlingsforl\u00f8b for hoved-halskr\u00e6ft (HH) med str\u00e5leterapi\/kemostr\u00e5leterapi, f\u00f8lger ofte en bred vifte af bivirkninger der \u00f8ger risikoen for fejlern\u00e6ring og v\u00e6gttab hos patienten. Dette er associeret med en \u00f8get risiko for nedsat behandlingstolerance, indl\u00e6ggelser, samt ikke-planlagte behandlingspauser, og derved risiko for reduceret tumorkontrol. Derfor er en underst\u00f8ttende ern\u00e6ringsindsats n\u00f8dvendig, og anbefalet som en del af behandlingsforl\u00f8bet jf. internationale retningslinjer som ESPEN-guidelines. Denne indsats varierer dog i form og frekvens ude i praksis, b\u00e5de nationalt og internationalt.<\/span><\/p>\n

Form\u00e5l
\n<\/span><\/strong>Dette systematiske review identificerer og syntetiserer eksisterende evidens for ern\u00e6ringsinterventioner til HH-patienter i str\u00e5leterapi\/kemostr\u00e5leterapi, og identificerer n\u00f8gleelementer til forebyggelse af v\u00e6gttab.<\/span><\/p>\n

Metode
\n<\/span><\/strong>Der blev s\u00f8gt i databaserne PubMed, CINAHL, Cochrane Library og Scopus efter relevante studier.
\n<\/span>En narrativ syntese blev udf\u00f8rt for at uddybe fundene, suppleret af en meta-analyse.<\/span><\/p>\n

Resultater
\n<\/span><\/strong>I alt blev 27 studier identificeret. De fleste studier fokuserede p\u00e5 effekten af orale ern\u00e6ringstilskud (ONS) og individuel ern\u00e6ringsr\u00e5dgivning (INC). En positiv effekt af ONS kombineret med ugentlig INC blev p\u00e5vist, hvor compliance, h\u00e5ndtering af bivirkninger, involvering af familien samt sundhedspersonalets viden og tilgang blev identificeret som n\u00f8gleelementer i st\u00f8tte til ern\u00e6ringsindtag hos HH-patienter under str\u00e5leterapi\/kemostr\u00e5leterapi.<\/span><\/p>\n

Metaanalysen viste en ikke-signifikant effekt af ONS alene, men en signifikant effekt, n\u00e5r det blev kombineret med INC. Der blev ikke fundet en samlet effekt af INC alene, men en signifikant effekt blev observeret i RCT-studierne.<\/span><\/p>\n

Konklusion og implikationer for praksis
\n<\/span><\/strong>Resultaterne tyder p\u00e5 at den optimale effekt opn\u00e5s ved ONS kombineret med ugentlig INC, og kr\u00e6ver samtidig st\u00f8tte fra et tv\u00e6rfagligt team til at h\u00e5ndtere bivirkninger samt fokus p\u00e5 at \u00f8ge compliance bl.a. ved involvering af patientens netv\u00e6rk og ressourcer, samt styrkelse af sundhedspersonalets viden.<\/span><\/p>\n

Resultaterne kan benyttes vejledende til organisering og planl\u00e6gning af interventionen i praksis, men yderligere forskning er n\u00f8dvendig for at udvikle og implementere strategier, der kan forbedre patienternes compliance og involvering.<\/span><\/p>\n

Malene Overvad B\u00f8jesen, Klinisk Sygeplejespecialist, Cand Scient San. Email: moh@regionsjaelland.dk<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Download som PDF B\u00f8jesen M, Juhl CB, N\u00f8rgaard B. Prevention of weight loss in patients with head and neck cancer 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