The path from oral nutrition to home parenteral nutrition: a qualitative interview study of the experiences of advanced cancer patients and their families

Orrevall, Ylva

doi:10.1016/s0261-5614(04)00064-0

Cited by 28 publications

(89 citation statements)

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“…Next-of-kin also claimed that newer medical devices, better designed and adapted for home use, implied more freedom of movement, while patients in the study by Lehoux et al (2004) showed ambivalence, as the opportunity to participate in social life increased, but also restricted their daily life. In our study, the next-of-kin were grateful for the nutrition pumps supporting daily nutritional needs, which were confirmed by other nextof-kin (Orrevall et al 2004) who experienced the nutrition drip as a positive alternative, rather than experiencing it with desperation and helplessness when the patient cannot eat because of nausea and swallowing disorders. Nevertheless, the nutrition pumps gave rise to anxiety and powerlessness when the next-of-kin saw the patient tied to and dependent on the medical device and considered it an impossible decision for them to make, withdrawing this life-sustaining treatment in a terminal stage.…”

Section: Discussionsupporting

confidence: 77%

Next‐of‐kin’s conceptions of medical technology in palliative homecare

Munck

Sandgren

Fridlund

et al. 2012

Journal of Clinical Nursing

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Section: Discussionsupporting

confidence: 77%

Next‐of‐kin’s conceptions of medical technology in palliative homecare

Munck

Sandgren

Fridlund

et al. 2012

Journal of Clinical Nursing

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“…The nutritional issues raised by these patients and their family members could serve as a basis for designing questions for inclusion in quality-of-life instruments to be used in evaluations of treatments that might affect patients' food intake and nutritional status. 53 During the very final phase of life, hydration with 1000-1500 mL (i.v. or s.c.) of isotonic saline is often sufficient.…”

Section: Palliative Situationmentioning

confidence: 99%

Review article: anorexia and cachexia in gastrointestinal cancer

Ockenga

Valentini

2005

Aliment Pharmacol Ther

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Summary In patients with gastrointestinal malignancies, i.e. cancers of the stomach, colon, liver, biliary tract or pancreas, progressive undernutrition can be regularly observed during the course of illness. Undernutrition significantly affects the patients’ quality of life, morbidity and survival. Pathogenetically, two different causes are relevant in the development of undernutrition in patients with gastrointestinal cancer. One cause is reduced nutritional intake. This condition is referred to as anorexia and can be worsened by the side effects of cancer therapy. The other cause is the release of endogenous transmitters and/or other products of the tumour leading to the cachexia syndrome, which is characterized by loss of body weight, negative nitrogen balance and fatigue. Cancer anorexia and cancer cachexia may have synergistic negative effects in affecting the patients’ status. In this review, current nutritional support strategies with respect to different clinically relevant situations are described. An algorithm of the treatment strategies, including dietetic counselling, oral supplements, enteral and parenteral nutritional support is given. One focus is the approach of nutrition‐focused patient care, which shows promising results. In addition, the possibilities of pharmacological intervention are discussed.

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“…We have previously reported a rate of 0.21 per 1000 catheter days for all patients discharged from our service subsequent to 2011 (21) , whereas other studies have reported rates as high as 11.5 per 1000 catheter days (22)(23)(24)(25)(26)(27)(28)(29)(30)(31) . Studies demonstrating the improvement in quality of life with the use of palliative HPN report that reduced readmission rates are of particular importance, such that avoidance of HPN-related complications, including catheter infections, remains a very pertinent issue (5)(6)(7)10,11,32) . Thus, the CRBSI rate of 0.169 per 1000 catheter days reported in the present study is key to avoiding admissions and maintaining quality of life, at the same time as emphasising the importance of meticulous catheter care protocols.…”

Section: Figurementioning

confidence: 99%

A novel discharge pathway for patients with advanced cancer requiring home parenteral nutrition

Bond

Teubner

Taylor

et al. 2019

J Human Nutrition Diet

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Background The use of home parenteral nutrition (HPN) for palliative indications is increasing internationally and is the leading indication in some countries. Discharge on HPN can be complex in metabolically unstable patients and requires intestinal failure expertise. Methods Between 2012 and 2018, we performed a retrospective analysis aiming to assess the impact of a novel remote discharge pathway for palliative HPN patients. This was evaluated using a quality improvement approach. Results One hundred and twenty‐five patients with active malignancy [mean (range) age 58 (25–80) years] were referred to the intestinal failure unit (IFU) for remote discharge. Of 82 patients were discharged from the oncology Centre on HPN using the pathway. The remaining 43 patients either declined HPN or the Oncology team felt that the patient became too unwell for HPN or died prior to discharge. There was an increase in patients referred for remote discharge from 13 in 2012 to 43 in 2017. The mean number of days between receipt of referral by the IFU to discharge on HPN from the oncology centre reduced from 29.4 days to 10.1 days. Following remote discharge, the mean number of days on HPN was 215.9 days. Catheter‐related blood stream infection rates in this cohort were very low at 0.169 per 1000 catheter days. Conclusions This is the first study to demonstrate the remote safe, effective and rapid discharge of patients requiring palliative HPN between two hospital sites. This allows patients with a short prognosis more time in their desired location.

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The path from oral nutrition to home parenteral nutrition: a qualitative interview study of the experiences of advanced cancer patients and their families

Cited by 28 publications

References 0 publications

Next‐of‐kin’s conceptions of medical technology in palliative homecare

Next‐of‐kin’s conceptions of medical technology in palliative homecare

Review article: anorexia and cachexia in gastrointestinal cancer

A novel discharge pathway for patients with advanced cancer requiring home parenteral nutrition

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