Nutritional assessment, intervention, and evaluation of weight loss in patients with non-small cell lung cancer.

PURPOSE/OBJECTIVES: 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. DESIGN: Descriptive, correlational. SETTING: A National Cancer Institute-designated cancer center and its associated university medical center in the northeastern United States. SAMPLE: Medical records of 93 individuals with non-small cell lung cancer. METHODS: Retrospective chart review. MAIN RESEARCH VARIABLES: Weight change; nutritional assessment, intervention, and evaluation; and cancer-related symptoms. FINDINGS: 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. IMPLICATIONS FOR NURSING PRACTICE: 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.