PES Statements for Cancer - Dietitian Direction

Introduction to PES Statements

PES statements are structured sentences used by dietitians to communicate the nutrition diagnosis of a patient. They are part of the second step of the Nutrition Care Process.

Writing a PES Statement

PES statements are written as follows:

[Problem/nutrition diagnosis] related to [Etiology], as evidenced by [Signs/symptoms].

Potential Nutrition Diagnoses for Cancer

Inadequate energy intake
Inadequate oral intake
Inadequate enteral nutrition infusion
Inadequate protein intake
Swallowing difficulty
Altered GI function
Underweight
Unintended weight loss
Unintended weight gain
Malnutrition (undernutrition)
Limited food acceptance
Limited ability to prepare food for eating

PES Statements for Cancer Examples

Inadequate oral intake related to pain while eating as evidenced by consuming <25% of meals and a 6 lb weight loss over the last 2 weeks.

Inadequate enteral nutrition infusion related to poor tolerance of ordered infusion rate as evidenced by abdominal pain, diarrhea and multiple discontinuations of tube feed.

Inadequate protein intake related to food aversions as evidenced by estimated protein intake of 20 g per day.

Unintended weight loss related to early satiety as evidenced by estimated intake 50% of calculated needs, patient’s clothes from last year are now too big.

Unintended weight gain related to physical inactivity as evidenced by patient no longer going to YMCA, weight gain of 6% in last month.

Malnutrition related to ovarian cancer as evidenced by 8% weight loss in last 4 months, estimated energy intake 50% of calculated needs.

Limited food acceptance related to nausea and food aversions as evidenced by patient frustration, food refusal.

Limited ability to prepare food for eating related to fatigue as evidenced by decreased overall estimated intake, meal skipping.

Quick Tips for Writing the Perfect Cancer PES Statement

Use information gathered in the assessment to determine the nutrition problem
The nutrition diagnosis should ideally be resolved, or at least improved, through a nutrition intervention provided by the dietitian
PES statements should be clear and concise

More Information on PES Statements

Do you need further information about PES statements? Check out these other blog posts:

What is a PES Statement?

Nutrition Diagnosis: Definition & Examples

Nutrition Care Process Steps

Conclusion

Patients with cancer can have a wide variety of nutrition problems and etiologies. There is no “right” or “wrong” PES statement, but make sure yours is specific to the patient using the data you collected in your assessment.