Abstract
BackgroundMalnutrition is frequent in patients with cancer, particularly those in advanced stages of the disease. The aim of the present study was to test the feasibility of a family-centred nutritional intervention, based on the Family Systems theory and past research.MethodsThis was a single-arm trial assessing feasibility (eligibility, recruitment and retention rates); acceptability by patients, family caregivers and health professionals; intervention fidelity, and energy/protein intake (in one site only). Two sites were involved; one each in Australia (AUS) and Hong Kong (HK), with one site delivering the intervention to oncology patients receiving curative treatments in the hospital, and the other to advanced cancer patients in the home.ResultsThe sample included 53 patients (23 from AUS and 30 from HK), 22 caregivers (3 from AUS and 19 from HK) and 30 health professionals (20 from AUS and 10 from HK). Recruitment was difficult in the acute inpatient oncology care setting (AUS) and feasibility criteria were not met. Sufficient recruitment took place in the home care setting with advanced cancer patients in HK. Patients, family members and health professionals found the intervention helpful and acceptable, and patients and families indicated they would take part in the future in a similar study. Energy and protein intake improved from baseline to end of intervention (mean 22 kcal/kg/day to 26 and 0.9 g/kg/day to 1.0 respectively).ConclusionThe new intervention is feasible in a home setting when delivered to patients with advanced cancer, acceptable to patients and families, and has the potential to improve nutritional status in patients. A large randomised trial is warranted in the future.
Highlights
Malnutrition is frequent in patients with cancer, those in advanced stages of the disease
Hong Kong data A total of 30 patients and 30 family members consented to participate in the study
This study provides initial feasibility data of a new intervention, suggesting that providing nutritional family-based education to patients with advanced cancer and their families supplemented by nutritional psychosocial support may be a useful way to enhance the patient-family member dyad’s nutrition-related communication, decrease distress from eating difficulties and possibly can improve nutritional clinical outcomes
Summary
Malnutrition is frequent in patients with cancer, those in advanced stages of the disease. Malnutrition is common in the hospital setting, affecting 20–50% of patients [1, 2], defined as “a state of nutrition in which a deficiency, excess or imbalance of energy, protein, and other nutrients causes measurable adverse effects on tissue/body form (body shape, size, and composition) and function, and clinical outcome” [3] It results in increased risk of mortality [4] and complications such as pressure injury [5], falls [5, 6] and infections [7], Cancer patients are at high risk of malnutrition due to metabolic, physiological, physical and psychological changes associated with cancer treatments and the disease itself. Strategies to improve the nutritional intake of patients with cancer are clearly warranted
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