Effect of a multidisciplinary nutrition care model integrating health education and individualized nutritional support on physical function and nutritional outcomes in patients with advanced malignant tumors: a randomized controlled trial.

BACKGROUND

Malnutrition is highly prevalent among patients with advanced malignant tumors and is associated with impaired physical function, reduced treatment tolerance, and poor prognosis. Structured, individualized nutritional strategies may improve clinical outcomes.

OBJECTIVE

To evaluate the effects of a nurse-led, multidisciplinary nutritional intervention model on nutritional status, immune function, quality of life, and patient satisfaction in individuals with advanced malignancies.

METHODS

In this single-center randomized controlled trial, 96 patients with stage III-IV malignant tumors were randomly assigned (1:1) to a control group (routine hospital nutritional care) or an intervention group receiving the nurse-led, multidisciplinary nutritional intervention model. The intervention incorporated systematic nutritional risk screening (PG-SGA), individualized caloric calculation using the Harris-Benedict equation, protocol-driven enteral/parenteral nutrition strategies, standardized immunonutrition when indicated, structured patient education, and dynamic multidisciplinary monitoring. The primary outcome was total clinical response rate at 1 month. Secondary outcomes included nutritional indices (PNI, NRI, NAI), biochemical markers (Hb, ALB, PALB, TFN), immune markers (IgA, IgG, IgM), SF-36 quality-of-life scores, and patient satisfaction.

RESULTS

After one month, the group receiving the nurse-led, multidisciplinary nutritional intervention model demonstrated a significantly higher total clinical response rate compared with routine care [95.83% vs. 79.17%, risk ratio 1.21 (95% CI 1.04-1.41), P < 0.05]. Nutritional indices and biochemical markers improved significantly in the intervention group (all P < 0.05). Declines in immunoglobulin levels were less pronounced compared with controls. All SF-36 domains improved significantly, and patient satisfaction was higher [97.92% vs. 79.17%, risk ratio 1.24 (95% CI 1.06-1.44), P < 0.05].

CONCLUSION

The nurse-led, multidisciplinary nutritional intervention model significantly improves short-term nutritional status, immune preservation, quality of life, and patient satisfaction in patients with advanced malignant tumors. Larger multicenter trials with long-term follow-up are warranted.