Onkolojik Tedavi Sürecinde Kanserli Çocuklar ve Ebeveynlerinin Nutrisyon Konusundaki Bilgi, Farkındalık ve Beklentilerinin Değerlendirilmesi

Amaç: Kanserli çocuklarda malnütrisyonun tedavi başarısı dahil birçok parametreyi olumsuz etkilediği saptanmıştır. Bu çalışmada kanser tanısıyla kemoterapi almakta olan çocuklar ve ebeveynlerinin tedavi sürecinde beslenme ve ‘Güvenli Gıda Diyeti’ konusundaki farkındalık, bilgi ve deneyimleri araştırıldı. Yöntem: Kocaeli Üniversitesi Tıp Fakültesi Çocuk Onkoloji Bölümü’nde kanser tanı ve tedavisi alan 8 yaşın üzerindeki hastalar ve ebeveynlerine anket çalışması uygulandı. Ebeveyn anketi 19 soru, çocuk anketi 13 soru içermekteydi. Soruların bir kısmı ‘evet/hayır/fikrim yok’ yanıtlarını, diğerleri ise çoktan seçmeli yanıtlar içeriyordu. Bulgular: Çalışmaya 101 gönüllü (42 hasta çocuk/59 ebeveyn) katıldı. En sık tanılar Hodgkin lenfoma (n=14, %33,3), non-Hodgkin lenfoma (n=8, %19) ve kemik-yumuşak doku sarkomlarıydı (n=8, %19). Hastaların 23’ü (%54,8) kanser tedavisi sürecinde beslenme sorunu yaşadığını düşünüyor ve bu hastaların 4’üne (%17,4) parenteral beslenme (PB) uygulanıyordu. Hastaların 2’si (%4,8) enteral yolla (gastrostomi ve nazogastrik tüp), 4’ü (%9,6) parenteral yolla beslenmişti. Yirmi üç ebeveyn (%43) çocuklarına oral beslenme ürünleri (OBÜ) kullandığını belirtti. Hastalara göre oral beslenme ürünlerinin en beğenilmeyen 2 özelliği tadının kötü olması (n=10, %23,8) ve bulantı etkisiydi (n=5, %11,9). Hastalar ve ebeveynleri ağızdan beslenmenin mümkün olmadığı durumlarda ilk olarak PB’yi seçmişlerdi (n=16, %38,1 ve n=29, %49,2). Sonuç: Kanser tedavisi alan çocuklarda oral beslenme desteklenmelidir. Oral beslenmenin mümkün olmadığı hastalarda diğer enteral beslenme yollarının parenteral yola tercih ve tavsiye edilmesi önerilir.

Anahtar Kelimeler:

çocuk kanseri, beslenme, enteral, parenteral

Evaluation of Knowledge, Awareness and Expectations of Children with Cancer and Their Parents about Nutrition During Oncological Treatment Process

Objective: Malnutrition negatively affects several parameters including treatment success in children with cancer. The awareness, knowledge and experiences of children (receiving chemotherapy with cancer diagnosis) and their parents about nutrition and ‘Safe Food Handling’ during cancer treatment were investigated. Methods: A questionnaire was applied to parents and their children (age 8 years) who were diagnosed and treated for cancer in the Department of Pediatric Oncology, Faculty of Medicine, Kocaeli University. The parent questionnaire included 19 questions and the child questionnaire included 13 questions. Some questions included ‘yes /no / no idea’ and others included multiple-choice answers. Results: A total of 101 volunteers (42 sick children / 59 parents) participated in the study. The most common diseases were Hodgkin's lymphoma (n=14, 33.3%), non-Hodgkin's lymphoma (n=8, 19%) and bone-soft tissue sarcomas (n=8, 19%). Twenty-three (54.8%) patients had nutritional problems during chemotherapy and 4 of them (17.4%) were fed parenterally (PN). Two (4.8%) of the patients were fed enterally (gastrostomy and nasogastric tube), 4 (9.6%) were parenterally. Twenty-three parents (43%) stated that they used oral nutrition supplement (ONS) for their children. According to the patients, the two most undesirable effects of oral nutrition products were poor taste (n=10, 23.8%) and nausea (n=5, 11.9%). Patients and their parents chose primarily PN when oral feeding was not possible (n=16, 38.1% and n=29, 49.2%). Conclusion: Oral feeding should be supported in children receiving cancer treatment. Enteral feeding routes should be preferred and recommended rather than parenteral route in patients in whom oral feeding is not possible.

Keywords:

pediatric cancer, nutrition, enteral, parenteral,

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