The Effect of Dietary Modification and Nutritional Education on Nutrition Care Process (NCP) for Increasing Dietary Intake, Body Weight, and Nutritional Status of Cancer Patients at Risk of Malnutrition and Malnourished in the Inpatient of Dharmais Cancer

Fauzatun Hadiyati, Ratna Supriastuti, Arifah Mujiharti

Abstract


Background: Cancer patients that are hospitalized often have problems with their nutrient intake. Low nutrient intake can be affected by malnutrition. In cancer patients, the intake of nutrients needs to be considered specifically in relation to the occurrence of metabolic changes that lead to decreased nutritional status. The objective of this study is to analyze the effect of dietary modification and nutritional education on nutrition care process (NCP) for increasing dietary intake, body weight, and nutritional status of malnourished cancer patients and cancer patients at risk of malnutrition.

Methods: The study was a quasi-experiment with one-group pretest-posttest design. The population consisted of all new adult hospitalized cancer patients. The data were collected from July to September 2019. The statistical analysis used paired sample t-test. Dietary modification and nutritional education were given individually based on each nutrition problem of the patient and their nutritional needs.

Results: There were 83 patients involved for the study. Most of the patients were female (61.4%), aged over 45 years (62.7%), graduated from high school (47%), were housewives (49.4%), and had clinical histories of no comorbidities (90.4%). Most of them had improvement in general condition (74.7%). The study showed significantly increasing dietary intake of energy (889.7 calorie), protein (36.4 gr), fat (49.3 gr), and carbohydrate (131.4 gr) (p = 0.000). The increasing percentage of nutrient intake to nutritional needs before and after intervention of NCP was 39.8 to 88.6% for energy, 44.4 to 104% for protein, 51 to 120% for fat, and 41.5 to 90.1% for carbohydrate. The average increase (but not significant related correlation) in body weight was 0.16 kg (p = 0.141) and body mass index 0.05 kg/m2 (p = 1.94).

Conclusions: Dietary modification and nutritional education on NCP improve dietary intakes (energy, protein, fat, and carbohydrate) of cancer patients at risk of malnutrition and being malnourished.


Keywords


body weight, dietary intake, dietary modification, nutrition care process, nutritional education

References


Ferlay J, Colombet M, Soerjomataram I. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144:1941-53.

Badan Penelitian dan Pengembangan Kesehatan. Hasil Utama RISKESDAS. Kementrian Kesehatan RI. 2018 [cited 29 Agustus 2020]. Available from: https://www.litbang.kemkes.go.id/hasil-utama-riskesdas-2018/

Tappenden KA, Quatrara B, Parkhurst ML, et al. Critical role of nutrition in improving quality of care: an interdisciplinary call to action to address adult hospital malnutrition. J Acad Nutr Diet. 2013;113:1219-37.

Sherry CL, Sauer AC, Thrush KE. Assessment of the nutrition care process in US Hospitals using a web-based tool demonstrates the need for quality improvement in malnurition diagnosis and discharge care. Curr Dev Nutr. 2017;1:e001297.

RCN. Nutrition in children and young people with cancer [Internet]. 2020 [cited 29 April 2020]. Available from: http://www.RCN_Nutrition_2020_Final.pdf

Flood KL, Brown CJ, Carroll MB, Locher JL. Nutritional process of care for older adults admitted to an oncology acute care for elders unit. Critical Reviews in Oncology/ Hematology. 2011;78:73-8.

Kusumayanti IGA, Hadi H, Susetyowati. Faktor-faktor yang mempengaruhi kejadian malnutrisi pasien dewasa di ruang rawat inap rumah sakit. Jurnal Gizi Klinik Indonesia. 2004; 1(1):9-17.

Kementerian Kesehatan Republik Indonesia. Pedoman Proses Asuhan Gizi Terstandar (PAGT). Jakarta: Direktorat Jendral Bina Gizi dan Kesehatan Ibu dan Anak Kementerian Kesehatan RI;2014.49

Wijayanti A. Penatalaksanaan diet kanker. In: Hardinsyah, Supariasa IDN, editors. Ilmu gizi teori dan aplikasi. Jakarta: EGC; 2016.351-58

Kurniasari FN, Harti LB, Ariestiningsih AD, dkk. Buku ajar gizi dan kanker. Jakarta:UB Press;2017.7

Kementerian Kesehatan Republik Indonesia. Pedoman Pelayanan Gizi Rumah Sakit (PGRS). Jakarta: Direktorat Jendral Bina Gizi dan Kesehatan Ibu dan Anak Kementerian Kesehatan RI;2013.16-22

Komisi Akreditasi Rumah Sakit (KARS). Standar nasional akreditasi rumah sakit edisi 1. Jakarta: Komisi Akreditasi Rumah Sakit (KARS) ;2017.158

Handayani D, Astutik P, Nurwati Y, Mahar MA. Efektivitas penatalaksanaan proses asuhan gizi terstandar terhadap perbaikan asupan pasien sindrom metabolik di RSUD Sidoarjo. Journal Gizi Universitas Muhamadiyah Semarang. 2018;7(1):31-9.

Susetyowati, Hamam H, Asdie AH, Hakimi M. Penerapan algoritma asuhan gizi terstandar berbasis skrining gizi. Jurnal Gizi Klinik Indonesia. 2014;11(1):20-30.

Yunita Y, Asdie AH, Susetyowati. Pelaksanaan proses asuhan gizi terstandar (PAGT) terhadap asupan gizi dan kadar glukosa darah pasien diabetes melitus tipe 2. Jurnal Gizi Klinik Indonesia. 2013;10(2):82-91.

Suhaema, Iswidhani, Sulasty SU. Penerapan nutrition care process (NCP) pada pasien diabetes melitus tipe 2 di rumah sakit umum Provinsi NTB berpengaruh pada perbaikan asupan zat gizi dan kadar glukosa darah. Jurnal Kesehatan Prima. 2013;7 (1):1087-99.

Fayakun YL and Susetyowati. Peranan proses asuhan gizi terstandar terhadap asupan gizi, status gizi dan lama rawat pada pasien rawat inap di RSUP Dr Hasan Sadikin Bandung Tahun 2010 [Tesis] [internet]. Yogyakarta: Universitas Gadjah Mada;2011 [cited 29 July 2019]. Available from : http://lib.ugm.ac.id/ind/?page_id=248

Purwaningsih S, Darmono SS, Judiono. Pengaruh pemberian diet modifikasi terhadap status gizi pasien kanker dengan kemoradiasi. Medica Hospitalia. 2014;2(3):205-11.

Balgis P, Probosuseno, Astuti H. Pemberian diet modifikasi komersil dan pengaruhnya terhadap asupan makanan dan status gizi pasien penyakit ginjal kronik pre hemodialisis di RSUP DR. M. Djamil Padang. Jurnal Gizi Klinik Indonesia. 2008;5(2): 71-7.

Raymond JL, Morrow K. Krause and Mahan’s Food & The Nutrition Care Process 15th edition. Canada:2021;231.

Susetyowati, Pangastuti R, Dwidanarti SR, Wulandari H. Asupan makan, status gizi dan kualitas hidup pasien kanker payudara di RSUP Dr Sardjito Yogyakarta. Jurnal Gizi Klinik Indonesia. 2018;14(4):146-53.

Baldwin C, Kimber KL, Gibbs M, Weekes CE. Supportive interventions for enhancing dietary intake in malnourished or nutritionally at risk adults (review). Cochrane Database Syst Rev. 2016;12(12):CD009840.

Lassen KO, Kruse F, Bjerrum M, et al. Nutritional care of Danish Medical Inpatients: effect on dietary intake and the occupational groups perspectives on intervention. Nutr J. 2004;3:1-3.

Miller PE, Miller N, Faith J, Lewis AE. Implementation and evaluation of outcomes related to the nutrition care process through the use of electronic health records. Journal of The American Dietetic Association. 2010;110(9):A-86 Suppl 2-Abstracts.

Murphy, Howarter. Patient Outcome from Nutrition Education and councelling Reports (Nutrition Care Process Terminology via ANDHI). Journal of The American Dietetic Association. 2017;117(9).Supl.

Simanjuntak RR, Martha IK, Ali R. Pengaruh pesan gizi singkat dan pendidikan gizi terhadap praktik makan pasien rawat inap di rumah sakit umum daerah Salatiga. Jurnal Gizi Indonesia. 2016; 4(2):120-24.

Herawati MR, Dyah NS, Cahyo H. Pengaruh edukasi gizi terhadap sisa makan pasien dengan diet makanan biasa. Jurnal Riset Gizi 2014;2(1):66-71.

Weta IW, Wirasamadi NLP. Kecukupan zat gizi dan perubahan status gizi pasien selama dirawat di rumah sakit umum pusat Sanglah Denpasar. Gizi Indon. 2009;32(2):139-49.

Ernawati K, Nazza RR, Ayu LAP, et al. Perbedaan status gizi penderita tuberkulosis paru antara sebelum pengobatan dan saat pengobatan fase lanjutan di Johar Baru, Jakarta Pusat. Majalah Kedokteran Bandung. 2018;50(2):74-8.

Par’i HM. Penilaian status gizi dilengkapi Proses Asuhan Gizi Terstandar. Jakarta: EGC;2016.201


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DOI: 10.33371/ijoc.v15i2.768

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