Nutrition screening, assessment and intervention practices for children
with cancer in Aotearoa, New Zealand
Abstract
Objective: The purpose of this study was to investigate
dietetic resource and current nutrition screening, assessment and
intervention practices in paediatric oncology centres in Aotearoa, New
Zealand. Methods: A national survey of the two specialist
treatment centres and 14 Shared Care Centres (SCC’s) that provide care
to childhood cancer patients in Aotearoa, New Zealand (NZ) was
conducted. Results: The two specialist treatment centres in
Aotearoa, NZ were the only centres with dedicated dietetic oncology FTE;
this FTE was devoted to inpatient care. Only 5 SCC’s (44%) had access
to general paediatric dietetic support. Dietetic cover for
outpatients/day-stay, and use of standardised nutrition screening and
assessment tools was limited. Weight and height were commonly measured
but there was inconsistency in the frequency and recording of
measurements. Nutrition interventions including nutrition education,
oral nutrition support (ONS), enteral nutrition (EN) and intravenous
nutrition (IVN) were available within all centres but criteria for
initiating support varied. Common barriers to providing nutrition
interventions included staff resourcing and ad-hoc referral pathways.
Awareness of the relevance and clinical benefit of nutrition in
paediatric oncology was low; suggestions to improve nutrition screening,
assessment and intervention within Aotearoa, New Zealand included the
creation of standardised screening and referral criteria.
Conclusion: Resource limitations and lack of nutritional
screening and assessment prevent adequate nutritional intervention for
children with cancer in Aotearoa, NZ. Akin to other high-income
countries there is a need to harmonise the management of nutritional
challenges among children with cancer. This study provides a first step
in establishing an evidence base to help support efforts to address this
need in Aotearoa, NZ.