Introduction: Nutritional disturbances in patients with chronic obstructive pulmonary disease (COPD) are very common. Symptomatology and functionality in chronic diseases could be related with the nutrition. Malnutrition could aggravate the disease. Objectives: Therefore, the aims of this study were 1) to evaluate the profile of the patient with COPD and malnutrition, and 2) to determine the relationship between the nutritional status with functionality and symptomatology in COPD patients. Methods: An observational study was conducted in patients with severe COPD. The independence levels, quality of life was evaluated, comorbidities and anxiety and depression were evaluated. Respiratory function was assessed with spirometry, forced expiratory volume in 1 second (FEV 1) was recorded, and Borg modified scale was used to determine de dyspnea perception. The Mini Nutritional Assessment questionnaire (MNA) evaluated the nutritional status. Finally, the simptomatology was assessed with Leicester Cough Questionnaire, and with London Chest Activity of Daily Living Scale. Results: A sample of 154 subjects was included in this study, 98 of them were males. A group of 71 subjects showed malnutrition and a group of 83 patients a normal nutritional status. The comparison between the groups showed significant differences in the clinical characteristics (p < 0.05). The analysis showed significant differences in dyspnea (p = 0.043), and the subscales of functionality related to respiratory symptoms self-care (p = 0.040) and leisure (p = 0.019) and the total score (p = 0.031). The worst results were shown in the patients with malnutrition. Conclusion: Our investigation shows that patients with COPD and malnutrition have worse results in symptomatology and functionality than patients with COPD without malnutrition.
Clinical Nutrition Experimental 26 (2019) 1e7 policies level. Knowing that the relation between human rights and nutritional care is a new issue, more research is warranted to ascertain its precise nature.
Introducción: el cuidado nutricional fue reconocido como un derecho humano en la Declaración de Cartagena del 3 de mayo de 2019. Este artículo analiza la Declaración de Cartagena desde la perspectiva y fundamentación ética. Metodología: se hace un análisis desde la ética teniendo en cuenta los principios de la bioética o "principialismo" y los de la Declaración de Bioética y Derechos Humanos de la UNESCO. Resultados: se reconoce que el derecho al cuidado nutricional implica alimentar a la persona enferma en condiciones que respeten su dignidad, teniendo en cuenta la vulnerabilidad de la persona desnutrida o en riesgo de desnutrición y respetando los principios de la bioética. Por lo tanto, se deben respetar los principios de autonomía, beneficencia, no maleficencia y justicia. Reconocer este derecho y el fundamento ético de la Declaración no implica que se esté aceptando la obligación de alimentar a todos los pacientes en cualquier etapa de la vida y bajo cualquier costo. Por el contrario, reconocer este derecho implica desde el punto de vista ético, que se debe tomar la mejor decisión para el paciente y esto puede incluir la decisión de no alimentar. Conclusión: la Declaración de Cartagena tiene un componente ético estructural fundamental el cual se basa en los conceptos de dignidad y vulnerabilidad, el respeto a la autonomía, la beneficencia, la no maleficencia y la justicia como condición para el ejercicio de la nutrición clínica. Además, promueve los valores de justicia y equidad en el cuidado nutricional.
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