ABSTRACT
Introduction: This study investigated the applicability of the Subjective Global Nutritional Assessment (SGNA) tool to evaluate the nutritional status of pediatric cancer patients. Methods: This was a multicenter, observational cohort study of infants, children, and adolescents diagnosed with malignant tumors. Participants were evaluated at the moment they were diagnosed with a malignant tumor (EV1) and at the third month of treatment (EV2). Objective data were collected and the SGNA questionnaire was applied. Correlation between the methods was performed using the Kendall test. Results: We evaluated 216 patients at EV1 and 172 patients at EV2. During EV1, 7% of patients presented with some degree of malnutrition, according to objective measures, and 35.7% according to the SGNA. During EV2, they presented 6.4% and 26.8%, respectively. The SGNA showed ability to diagnose more malnutrition than objective indicators and the agreement found between both methods was moderate and weak. We observed a significant correlation between the SGNA and the nutritional indicators (p = <0.002), thus proving its efficacy in assessing nutritional status. Conclusion: The SGNA was applicable for evaluating the nutritional status of children and adolescents diagnosed with malignant tumors, and effective in tracking malnutrition prevalence when compared to objective nutritional assessment methods. (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Nutrition Assessment , NeoplasmsABSTRACT
Introdução: Crianças e adolescentes com câncer apresentam alterações provenientes tanto da patologia quanto do tratamento que podem refletir no estado nutricional (EN) ao diagnóstico e ao longo do tratamento. O objetivo primário do estudo foi avaliar a aplicabilidade do instrumento Avaliação Nutricional Subjetiva Global (ANSG) na avaliação do Estado Nutricional (EN) de pacientes oncológicos pediátricos. Métodos: Estudo de coorte observacional e descritivo com lactentes, crianças e adolescentes diagnosticados com neoplasia maligna. Os participantes do estudo foram avaliados ao diagnóstico (AV1) e ao terceiro mês de tratamento (AV2). Dados objetivos foram aferidos e o instrumento ANSG foi aplicado. O teste de Kendall foi utilizado para analisar a correlação entre os métodos. Resultados: Realizadas 42 avaliações ao diagnóstico e 26 ao terceiro mês de tratamento. Observou-se predominância de pacientes bem nutridos nos dois momentos da avaliação. Na AV1, 7,2% dos pacientes foram identificados com algum grau de desnutrição conforme indicadores objetivos e 38,1% de acordo com o ANSG. Na AV2, houve redução na prevalência de pacientes desnutridos. O método ANSG mostrou correlação significativa com os indicadores nutricionais peso-para-idade e estaturapara- idade e foi eficaz no rastreamento de desnutrição. Conclusão: A ANSG é um instrumento útil na identificação de risco nutricional e pode ser utilizado na prática clínica assistencial, em conjunto com outros métodos de avaliação nutricional. O monitoramento do EN da população oncológica pediátrica é fundamental, a fim de intervir de maneira adequada. (AU)
from both the pathology itself and the treatment, which can reflect on their nutritional status (NS) at diagnosis and throughout the treatment. The primary objective of the study was to assess the applicability of the Subjective Global Nutritional Assessment (SGNA) tool to assess the NS of pediatric oncology patients. Methods: This was a descriptive, observational cohort study including infants, children and adolescents diagnosed with malignant neoplasia. Participants were assessed at diagnosis (NA1) and in the third month of treatment (NA2). Objective data were measured and the SGNA tool was applied. The Kendall test was used in order to analyze the correlation between the methods. Results: A total of 42 assessments were performed at diagnosis and 26 in the third month of treatment. A prevalence of well-nourished patients was observed in the two assessment moments. During NA1, 7.2% of the patients presented some degree of malnutrition according to objective indicators and 38.1%, according to SGNA. During NA2, there was a reduction in the prevalence of malnourished patients. The SGNA method showed a significant correlation with weightfor- age and height-for-age nutritional indicators and was efficient to trace malnutrition. Conclusion: The SGNA is a useful tool for the identification of nutritional risk and may be used in the clinical practice in combination with other nutritional assessment methods. The monitoring of the NS of pediatric patients who have cancer is vital in order to ensure adequate intervention. (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Nutrition Assessment , Nutritional Status , Neoplasms/complications , Neoplasms/epidemiology , Child , Adolescent , InfantABSTRACT
The occurrence of diarrhea in critically ill patients is frequent, regardless of the cause of initial admission to the IntensiveCare Unit (ICU). Nosocomial diarrhea may have important clinical and economic implications. It's proper handlingdepends on correct diagnosis and recording. The aim of the present study was to verify the knowledge concerningthe concept of diarrhea of health professionals working in the ICUs of a Trauma Center. This is a cross-sectional studyconducted in July 2016 with 89 professionals, those being 18 nurses, 41 nurse technicians and 30 nursing assistantsworking in ICUs. Workers on leave or vacation were excluded. Participants answered a self-administered questionnairecontaining 12 objective questions. Descriptive statistical analyses of absolute and relative frequencies were performedusing SPSS 21.0 software. Most of the employees were between 51 and 60 years old and worked mostly at night.Only 60% of health professionals correctly identified diarrhea and 31% of professionals do not consider the numberof evacuations to classify diarrhea. A third reported completing the full medical record of bowel movements in thechart set in the patients' bed and (3%) received training on the subject within the institution. It was observed thatthe knowledge of these professionals was similar to those of the other studies, but still not satisfactory. The situationrepresents an important factor for the super- or under-diagnosis of this disease and consequent complications, arguingfor the potential that continuing education has to contribute for clinical practice qualification
A ocorrência de diarreia em pacientes criticamente enfermos é frequente, independente da causa de admissão inicial à Unidade de Tratamento Intensivo (UTI) e pode ter importantes implicações clínicas e econômicas. O seu manejo adequado depende de correto diagnóstico e registro. O objetivo do presente estudo foi verificar o conhecimento sobre o conceito de diarreia dos profissionais de enfermagem que trabalham em UTIs de um Hospital de Pronto Socorro. Trata-se de um estudo transversal realizado em julho de 2016 com 89 profissionais, sendo 18 enfermeiros, 41técnicos e 30 auxiliares de enfermagem que trabalham UTIs. Foram excluídos trabalhadores em licença ou férias. Os participantes responderam um questionário auto-aplicável contendo 12 questões objetivas. Foram realizadas análises estatísticas descritivas de frequências absolutas e relativas, utilizando o software SPSS 21.0. A maioria dos funcionários tinha idade entre 51 e 60 anos e trabalhava à noite. Apenas 60% dos profissionais de saúde identificaram corretamente diarreia e 31% dos profissionais não consideram o número de evacuações para a sua classificação. Um terço referiu preencher de forma completa o registro das evacuações no prontuário fixado no leito dos pacientes, e a minoria (3%)recebeu treinamento sobre o tema no âmbito da instituição. Observou-se que o conhecimento destes profissionais foi semelhante aos dos outros estudos, porém ainda pouco satisfatório. A situação representa um fator importante para o super, ou sub diagnóstico deste agravo e consequentes complicações, demonstrando o potencial que a educação permanente tem para contribuir na qualificação da pratica clínica