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A survey of preoperative surgical nutrition practices, opinions, and barriers across Canada
McGill University - MacDonald Campus, 151165, School of Dietetics and Human Nutrition, Sainte-Anne-de-Bellevue, Quebec, Canada.
Saskatchewan Health Authority, 7234, Clinical Nutrition Services, Regina, Saskatchewan, Canada.
University of Alberta Faculty of Medicine & Dentistry, 12357, Gastroenterology, Edmonton, Alberta, Canada.
McGill University, 5620, Department of Anesthesia, Montreal, Quebec, Canada.
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2024 (English)In: Applied Physiology, Nutrition and Metabolism, ISSN 1715-5312, E-ISSN 1715-5320, Vol. 49, no 5, p. 687-699Article in journal (Refereed) Published
Abstract [en]

Malnutrition is prevalent among surgical candidates and associated with adverse outcomes. Despite being potentially modifiable, malnutrition risk screening is not a standard preoperative practice. We conducted a cross-sectional survey to understand healthcare professionals' (HCP) opinions and barriers regarding screening and treatment of malnutrition. HCPs working with adult surgical patients in Canada were invited to complete an online survey. Barriers to preoperative malnutrition screening were assessed using the Capability Opportunity Motivation-Behaviour model. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using summative content analysis. Of the 225 HCPs surveyed (n=111 dietitians, n=72 physicians, n=42 allied healthcare professionals), 96%-100% agreed that preoperative malnutrition is a modifiable risk factor associated with worse surgical outcomes and is a treatment priority. Yet, 65% (n=142/220; dietitians: 88% vs. physicians: 40%) reported screening for malnutrition, mostly in the postoperative period (n=117) by dietitians (n=94), and just 42% (48/113) of non-dietitian respondents referred positively screened patients to a dietitian for further assessment and treatment. The most prevalent barriers for malnutrition screening were related to opportunity, including availability of resources (57%, n=121/212), time (40%, n=84/212) and support from others (38%, n=80/212). In conclusion, there is a gap between opinion and practice among surgical HCPs pertaining to malnutrition. Although HCPs agreed malnutrition is a surgical priority, the opportunity to screen for nutrition risk was a great barrier.

Place, publisher, year, edition, pages
National Research Council Canada , 2024. Vol. 49, no 5, p. 687-699
Keywords [en]
enhanced recovery after surgery, prehabilitation, preoperative, surgical nutrition, nutritional status, nutrition, screening
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:oru:diva-111029DOI: 10.1139/apnm-2023-0195ISI: 001205661500001PubMedID: 38241662Scopus ID: 2-s2.0-85192027280OAI: oai:DiVA.org:oru-111029DiVA, id: diva2:1832750
Available from: 2024-01-30 Created: 2024-01-30 Last updated: 2025-01-20Bibliographically approved

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Ljungqvist, Olle

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