| Schirmer, Ferrari & Trindade88 Schirmer EM, Ferrari A, Trindade LC. Evolução da mucosite oral após intervenção nutricional em pacientes oncológicos no serviço de cuidados paliativos. Rev Dor. 2012;13(2):141-6
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Evaluate the evolution of oral mucositis in cancer patients assisted by the PC service, after medical and nutritional intervention and guidance, in addition to evaluating how mucositis severity interferes with patients’ food ingestion. |
Qualitative prospective study using interviews and previously structured questionnaire. |
Before intervention, mucositis grade I was present in more than half the patients and almost half of them ingested solid food. Few individuals had mucositis grade IV where all ingested liquid food. After intervention, more than half the patients had no mucositis and no restrictions to diet consistency. Oral complaints, such as xerostomia dysgeusia, appetite loss, anorexia and candidiasis were decreased. |
Nutritional guidance, such as mouth washing with chamomile tea, avoiding very acid, dry, hard or spicy food, restrict salt, avoid very hot food or preparations may help improving mucositis, thus assuring better QL. |
| Loyolla, Pessini, Bottoni, et al.99 Loyolla VC, Pessini L, Bottoni A, Serrano, SC, Teodoro AL, Bottoni A. Terapia nutricional enteral em pacientes oncológicos sob cuidados paliativos: uma análise da bioética. Saúde, Ética & Justiça. 2011;16(1):47-59.
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Analyze, from bioethics point of view, the use of nutritional therapy for cancer patients under PC, observing vision and participation of patients and their families in the decision to use such therapy |
Qualitative study with semistructured questionnaire. |
Most patients and caregivers were informed about indicated ENT by the nutritionist. When asked about what is and what is the purpose of TNE, most have answered that it served to fortify and feed patients. With regard to the choice by patients or caregivers to start or not TNE, answer was yes for many, but some were in doubt and thought that this should be a physician’s decision. As to ENT being a basic care that should always be provided, answers have varied from replacement by other if not bringing benefits or cannot be withdrawn because it is patient’s right. |
ENT is considered a basic care by patients and/or caregivers and is patient’s right, which shall be replaced but never withdrawn if not bringing benefit to patients. Although nutritionist was the professional more explaining about ENT, patients and caregivers feel they are unable to decide about using ENT. |
| Silva, Lopes, Trindade, et al.1010 Silva PB, Lopes M, Trindade LC, Yamanouchi CN. Controle dos sintomas e intervenção nutricional. Fatores que interferem na qualidade de vida de pacientes oncológicos em cuidados paliativos. Rev Dor. 2010;11(4):282-8.
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Analyze, by means of previously validated questionnaire, how nutritional intervention and symptoms control have interfered with QL of cancer patients. |
Quantitative prospective study. Tools: three previously structured questionnaires on QL, socioeconomic aspects and food questionnaire1111 Orrevall Y, Tishelman C, Permert J, Cederholm T. Nutritional support and risk status among cancer patients in palliative home care services. Support Care Cancer. 2009;17(2):153-61.. |
Most patients were under oral diet and were classified as lacking more intensive care. After medical and nutritional interventions and discussion of cases, the use of food supplements and gastrointestinal symptoms have decreased and appetite was improved, in addition to better QL of patients. |
Giving diet and therapy guidance contemplating dietary indication, diet consistency, possible associated comorbidities, respecting food and cultural preferences, minimizing food-related discomfort, thus assuring better QL. |
| Orrevall, Tishelman, Permert, et al.11 |
Investigate the nutritional risk status and the use of nutritional therapy among cancer patients enrolled in home PC services. |
Quantitative study using phone interview and a questionnaire |
Most studied patients were diagnosed as at nutritional risk. As to nutritional therapy, most used common oral nutritional supplements, while the minority used artificial nutrition, especially PNT. Common oral supplements were related to low BMI and severe weight loss. |
Evaluate the nutritional risk of PC patients helps improving nutritional approach, however the use of nutritional therapy should consider life expectancy and patients’ psychosocial aspects. |
| Muir & Linklater1212 Muir CI, Linklater GT. A qualitative analysis of the nutritional requirements of palliative care patients. J Hum Nutr Diet. 2011;24(5):470-8.
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Explore the meaning of food, food ingestion and body weight of PC patients, investigating the impact of such changes on such patients, in addition to determining whether nutritional recommendations were followed1313 Hasenberg T, Essenbreis M, Herold A, Post S, Shang E. Early supplementation of parenteral nutrition is capable of improving quality of life, chemotherapy-related toxicity and body composition in patients with advanced colorectal carcinoma undergoing palliative treatment: results from a prospective, randomized clinical trial. Colorectal Dis. 2010;12(10):e190-e9.. |
Qualitative study using semistructured interviews. |
A recurrent theme was change and uncertainty. Four major areas subject to variation were: disease status, symptoms, oral ingestion and weight. Each change could control or be controlled by patients. When patients were unable to control they accepted the change, be it voluntarily or not1313 Hasenberg T, Essenbreis M, Herold A, Post S, Shang E. Early supplementation of parenteral nutrition is capable of improving quality of life, chemotherapy-related toxicity and body composition in patients with advanced colorectal carcinoma undergoing palliative treatment: results from a prospective, randomized clinical trial. Colorectal Dis. 2010;12(10):e190-e9.. |
The article shows that nutritional guidance given to palliative care patients by means of standardized nutritional requirements may fail by not addressing the real meaning of nutritional care for such patients. So, nutritional interventions with these patients should give more importance to offering counseling and support instead of focusing on calculated nutritional requirements. |
| Hasenberg, Essenbreis, Herold, et al.1313 Hasenberg T, Essenbreis M, Herold A, Post S, Shang E. Early supplementation of parenteral nutrition is capable of improving quality of life, chemotherapy-related toxicity and body composition in patients with advanced colorectal carcinoma undergoing palliative treatment: results from a prospective, randomized clinical trial. Colorectal Dis. 2010;12(10):e190-e9.
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Evaluate the effect of parenteral nutrition supplementation on body composition, QL, secondary effects associated to chemotherapy and survival in patients with advanced colorectal cancer. |
Quantitative retrospective randomized study. |
Groups receiving parenteral supplementation or oral nutrition have improved gastrointestinal symptoms, resulting in significantly increased appetite. |
Nutritional therapy as oral or parenteral supplementation improves QL, prolongs survival and decreases weight loss. |
