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Nutritional support and risk status among cancer patients in palliative home care services
Authors:Y. Orrevall  C. Tishelman  J. Permert  T. Cederholm
Affiliation:(1) Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, 141 86 Stockholm, Sweden;(2) R &; D Unit, Stockholms Sjukhem Foundation, Mariebergsgatan 22, 112 35 Stockholm, Sweden;(3) Department of Medical Epidemiology and Biostatistics and Department of Learning, Informatics, Management and Ethics, Medical Management Center, Karolinska Institutet, 171 77 Stockholm, Sweden;(4) School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK;(5) Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala Science Park, 751 85 Uppsala, Sweden
Abstract:
Goal of work  The aim of this study was to investigate the nutritional risk status and use of nutritional support among cancer patients enrolled in palliative home care services. Differences in the use of nutritional support in relation to nutritional, social and clinical factors, as well as survival were also investigated. Patients and methods  Structured telephone interviews were conducted with cancer patients enrolled in all 21 palliative home care services in the Stockholm region. An interview guide was designed to investigate topics related to the patient’s nutritional situation. Main results  Interviews with 621 patients were analysed. Sixty-eight percent of the patients were scored as at nutritional risk according on a modified version of NRS-2002. Nutritional support was used by 55% of the patients, with oral nutritional supplements most common and 14% using artificial nutrition. Use of nutritional support was related to low BMI and severe weight loss and was more common in patients with shorter survival times. Conclusions  These findings demonstrate that nutritional support is used to treat already malnourished patients with shorter survival time, rather than to prevent malnutrition. A more structured approach to nutritional issues for patients in palliative phases, which considers life expectancy and psycho-social aspects of nutritional issues, could help identify potential candidates for nutritional support.
Keywords:Home care services  Neoplasm  Nutrition assessment  Nutritional support  Palliative care
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