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- Berggren, E, et al.
(författare)
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Symptom Burden in Patients With Home Care Who Are at Risk for Malnutrition: A Cross-Sectional Study
- 2020
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Ingår i: Journal of palliative care. - : SAGE Publications. - 2369-5293 .- 0825-8597. ; 35:2, s. 103-109
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, patients in early palliative stages of illness are cared for in primary care and often offered home care. Many are older and at risk for malnutrition, but little is known about their symptom burden and nutritional problems. This cross-sectional study divided older patients in home care into those with and without risk for malnutrition and compared symptom burden in the 2 groups. Participants were patients in Stockholm County (n = 121) in early palliative stages of disease cared for at home by primary care professionals from 10 health-care centers. The Mini Nutritional Assessment (MNA) was used to identify risk for malnutrition. Symptoms and/or nutritional status in patients with and without risk were assessed with the Functional Assessment of Anorexia/Cachexia Therapy (FAACT), Patient-Generated Subjective Global Assessment Short Form (PG-SGA), and Edmonton Symptom Assessment System (ESAS). Forty-two percent of the patients were at risk for malnutrition (MNA). Appetite ( P = .012), tiredness ( P = .003), and anxiety ( P = .008) were worse in these patients than in those without risk (ESAS; significance level, P ≤ .015). Patients at risk were also more concerned about how thin they looked ( P = .006), agreed more strongly that their family or friends were pressuring them to eat ( P = .000; FAACT; significance level, P ≤ .029), had a higher symptom burden ( P = .005), had lower physical activity ( P = .000), and more lost weight over time ( P = .032; PG-SGA; significance level, P ≤ .040). This study adds a more detailed picture of the symptom burden in older patients at risk for malnutrition. Such information is needed to identify risk for malnutrition earlier and improve patients’ health.
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- Lövestam, E, et al.
(författare)
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Individual and contextual factors in the Swedish Nutrition Care Process Terminology implementation
- 2024
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Ingår i: Health information management : journal of the Health Information Management Association of Australia. - : SAGE Publications. - 1833-3575. ; 53:2, s. 94-103
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Tidskriftsartikel (refereegranskat)abstract
- Standardised terminologies and classification systems play an increasingly important role in the continuous work towards high quality patient care. Currently, a standardised terminology for nutrition care, the Nutrition Care Process (NCP) Terminology (NCPT), is being implemented across the world, with terms for four steps: Nutrition Assessment (NA), Nutrition Diagnosis (ND), Nutrition Intervention (NI) and Nutrition Monitoring and Evaluation (NME). Objective To explore associations between individual and contextual factors and implementation of a standardised NCPT among Swedish dietitians. Method A survey was completed by 226 dietitians, focussing on: (a) NCPT implementation level; (b) individual factors; and (c) contextual factors. Associations between these factors were explored through a two-block logistic regression analysis. Results Contextual factors such as intention from management to implement the NCPT (OR (odds ratio) ND 15.0, 95% Confidence Interval (CI) 3.9–57.4, NME 3.7, 95% CI 1.1–13.0) and electronic health record (EHR) headings from the NCPT (OR NI 3.6, 95% CI 1.4–10.7, NME 3.8, 95% CI 1.1–11.5) were associated with higher implementation. A positive attitude towards the NCPT (model 1 OR ND 3.8, 95% CI 1.5–9.8, model 2 OR ND 5.0, 95% CI 1.4–17.8) was also associated with higher implementation, while other individual factors showed less association. Conclusion Contextual factors such as intention from management, EHR structure, and pre-defined terms and headings are key to implementation of a standardised terminology for nutrition and dietetic care. Implications for practice Clinical leadership and technological solutions should be considered key areas in future NCPT implementation strategies.
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- Orrevall, Y, et al.
(författare)
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Nutritional support and risk status among cancer patients in palliative home care services
- 2009
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 17:2, s. 153-161
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Tidskriftsartikel (refereegranskat)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.
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- Orrevall, Y
(författare)
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Nutritional support at the end of life
- 2015
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Ingår i: Nutrition (Burbank, Los Angeles County, Calif.). - : Elsevier BV. - 1873-1244 .- 0899-9007. ; 31:4, s. 615-616
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Tidskriftsartikel (refereegranskat)
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- Orrevall, Y, et al.
(författare)
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The use of artificial nutrition among cancer patients enrolled in palliative home care services
- 2009
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Ingår i: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 23:6, s. 556-564
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Tidskriftsartikel (refereegranskat)abstract
- In this study, patients' views and experiences of using home artificial nutrition, and factors associated with use of home parenteral nutrition (HPN) were investigated. Structured telephone interviews with 620 cancer patients enrolled in 21 palliative home care services were analysed. HPN was more common (11%) than home enteral tube feeding (HETF, 3%). Home artificial nutrition (including HPN and HETF) was usually introduced more than four months before death. Three of four HPN recipients also had oral food intake. HPN use was associated with eating difficulties, nausea/vomiting, and fatigue rather than gastrointestinal problems per se. HETF was generally used for patients with problems related to oesophagus and head and neck tumours. In conclusion the results suggest that, contrary to existing guidelines, HPN is used to supplement oral intake, and not only for patients with a non-functioning gastrointestinal tract. Palliative Medicine (2009); 23: 556-564
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- Rydwik, E., et al.
(författare)
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ReCOV : recovery and rehabilitation during and after COVID-19-a study protocol of a longitudinal observational study on patients, next of kin and health care staff
- 2021
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Ingår i: BMC Sports Science, Medicine and Rehabilitation. - : Springer Science and Business Media LLC. - 2052-1847. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The knowledge of the long-term consequences of covid-19 is limited. In patients, symptoms such as fatigue, decreased physical, psychological, and cognitive function, and nutritional problems have been reported. How the disease has affected next of kin, as well as staff involved in the care of patients with covid-19, is also largely unknown. The overall aim of this study is therefore three-fold: (1) to describe and evaluate predictors of patient recovery, the type of rehabilitation received and patients’ experiences of specialized rehabilitation following COVID-19 infection; (2) to study how next of kin experienced the hospital care of their relative and their experiences of the psychosocial support they received as well as their psychological wellbeing; (3) to describe experiences of caring for patients with COVID-19 and evaluate psychological wellbeing, coping mechanisms and predictors for development of psychological distress over time in health care staff.Methods: This observational longitudinal study consists of three cohorts; patients, next of kin, and health care staff. The assessments for the patients consist of physical tests (lung function, muscle strength, physical capacity) and questionnaires (communication and swallowing, nutritional status, hearing, activities of daily living, physical activity, fatigue, cognition) longitudinally at 3, 6 and 12 months. Patient records auditing (care, rehabilitation) will be done retrospectively at 12 months. Patients (3, 6 and 12 months), next of kin (6 months) and health care staff (baseline, 3, 6, 9 and 12 months) will receive questionnaires regarding, health-related quality of life, depression, anxiety, sleeping disorders, and post-traumatic stress. Staff will also answer questionnaires about burnout and coping strategies. Interviews will be conducted in all three cohorts.Discussion: This study will be able to answer different research questions from a quantitative and qualitative perspective, by describing and evaluating long-term consequences and their associations with recovery, as well as exploring patients’, next of kins’ and staffs’ views and experiences of the disease and its consequences. This will form a base for a deeper and better understanding of the consequences of the disease from different perspectives as well as helping the society to better prepare for a future pandemic.
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