Malnutrition and chemotherapy-induced nausea and vomiting: Implications for practice

PURPOSE/OBJECTIVES: To determine the prevalence of malnutrition and chemotherapy-induced nausea and vomiting (CINV) limiting patients' dietary intake in a chemotherapy unit.

DESIGN: Cross-sectional descriptive audit.

SETTING: Chemotherapy ambulatory care unit in a teaching hospital in Australia.

SAMPLE: 121 patients receiving chemotherapy for malignancies, aged 18 years and older, and able to provide verbal consent.

METHODS: An accredited practicing dietitian collected all data. Chi-square tests were used to determine the relationship of malnutrition with variables and demographic data.

MAIN RESEARCH VARIABLES: Nutritional status, weight change, body mass index, prior dietetic input, CINV, and CINV that limited dietary intake.

FINDINGS: Thirty-one participants (26%) were malnourished, 12 (10%) had intake-limiting CINV, 22 (20%) reported significant weight loss, and 20 (18%) required improved nutrition symptom management. High nutrition risk diagnoses, CINV, body mass index, and weight loss were significantly associated with malnutrition. Thirteen participants (35%) with malnutrition, significant weight loss, intake-limiting CINV, and/or who critically required improved symptom management reported no prior dietetic contact; the majority of those participants were overweight or obese.

CONCLUSIONS: Of patients receiving chemotherapy in this ambulatory setting, 26% were malnourished, as were the majority of patients reporting intake-limiting CINV.

IMPLICATIONS FOR NURSING: Patients with malnutrition and/or intake-limiting CINV and in need of improved nutrition symptom management may be overlooked, particularly patients who are overweight or obese-an increasing proportion of the Australian population. Evidence-based practice guidelines recommend implementing validated nutrition screening tools, such as the Malnutrition Screening Tool, in patients undergoing chemotherapy to identify those at risk of malnutrition who require dietitian referral.