Introduction: Enteral nutritional therapy (ENT) in patients with advanced cancer in palliative care should be directed towards a better quality of life, being important its monitoring so that the patient has access to the best that the therapy can offer. The objective of this study was to apply the quality indicators of ENT in patients with advanced cancer in palliative care. Methods: Descriptive, observational study with a quantitative approach. Seven ENT quality indicators proposed by the International Life Sciences Institute in Brazil were applied and the reasons for the suspension or interruption of the enteral diet during hospitalization were quantified. Results: 51 patients admitted from May to November 2019 participated in the study. The frequencies of inadvertent exit of enteral nutrition tube (0.02%), the days of adequate administration of the prescribed volume versus infused volume (92.6%) and diarrhea (2%) are within the goal used. The administration of protein (25.5%) and energy (57.4%), the frequency of episodes of abdominal distension (33.3%) and constipation (86.3%) were inadequate. The diet was interrupted or suspended mainly due to the occurrence of vomiting, end-of-life care or tube obstruction. Conclusion: The use of quality indicators of nutritional therapy proved to be viable in this group of patients. Some inadequacies found in this population may be associated with the change in the objective of nutritional therapy in patients with shorter life expectancy. Adaptations based on the prognosis may be necessary, in addition to the application of new indicators, or adjustments to the proposed goals.
Introdução: Pacientes com câncer são mais suscetíveis à infecção e à maior gravidade da doença causada pelo novo coronavírus (Covid-19). Objetivo: Apresentar o cenário da assistência nutricional e o perfil clínico-nutricional de pacientes hospitalizadas com Covid-19 em uma instituição de tratamento de câncer de mama. Método: Foram apresentadas as práticas da assistência nutricional realizadas no Hospital do Câncer III do Instituto Nacional de Câncer José Alencar Gomes da Silva (HC III/INCA) durante a pandemia da Covid-19. Os dados clínicos das pacientes com câncer de mama e Covid-19 foram coletados em prontuários. Resultados: Algumas mudanças na rotina foram a suspensão das visitas dos nutricionistas em casos confirmados; a utilização de equipamentos de proteção individual; e as alterações na avaliação nutricional. Um total de 23 pacientes foi incluído, sendo hipertensão a comorbidade mais comum (56,5%) e o estadiamento clínico IV o mais frequente (43,5%). Dispneia (60,9%), febre (30,4%), tosse (13%), anemia, neutrofilia, proteína C reativa elevada, hipoalbuminemia e necessidade de oxigenioterapia durante a internação (73,9%) foram as principais características encontradas. A maioria recebeu dieta via oral líquida (52,2%) e, para 43,5%, foi prescrito suplemento nutricional. O excesso de peso foi o estado nutricional mais prevalente. Conclusão: Além do câncer de mama, podem se associar ao aumento do risco de complicações por Covid-19 nessas pacientes a alta prevalência de comorbidades, o excesso de peso e a metástase pulmonar. A presença de sintomas que influenciam na ingestão alimentar levou à necessidade de modificações na dieta para melhor aceitação alimentar.
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