scholarly journals Effect of chocolate on older patients with cancer in palliative care: a randomised controlled study

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Josiane C. Vettori ◽  
Luanda G. da-Silva ◽  
Karina Pfrimer ◽  
Alceu A. Jordão ◽  
Paulo Louzada-Junior ◽  
...  
Keyword(s):  
Palliative Care ◽  
Body Composition ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Assessment Tool ◽  
Mini Nutritional Assessment ◽  
Controlled Study ◽  
Functional Domain ◽  
European Organization ◽  
Older Cancer Patients

Abstract Background Older advanced stage cancer patients, with changes in nutritional status, represent an important demand for palliative care. The aim was to determine the effects of 4 weeks of chocolate consumption on the nutritional status of older cancer patients in palliative care. Methods Older cancer patients in palliative care with ambulatory (n = 46) monitoring were randomized to control (CG, n = 15), intervention with 55% cocoa chocolate (IG1, n = 16) and intervention with white chocolate (IG2, n = 15) groups and evaluated before and after 4 weeks for nutritional status (primary outcome), evaluated by the Mini Nutritional Assessment tool (MNA). Food consumption, anthropometry, body composition, laboratory parameters and quality of life (QL) with the European Organization for the Research and Treatment of Cancer instrument were also evaluated. Results IG1 progressed with increased screening (estimated difference [95% CI]: − 1.3 [− 2.2;-0.4], p < 0.01), and nutritional (estimated difference [95% CI]: − 1.3 [− 2.5;-0.1], p = 0.04) scores on the MNA, with no change in anthropometry and body composition. Regarding antioxidant capacity, reduced glutathione levels increased (estimated difference [95% CI]: − 0.8 [− 1.6;-0.02], p = 0.04) and malondealdehyde levels decreased in IG2 (estimated difference [95% CI]:+ 4.9 [+ 0.7;+ 9.1], p = 0.02). Regarding QL, functionality improved in IG1, with higher score in the functional domain (estimated difference [95% CI]:-7.0 [− 13.3;-0.7], p = 0.03). Conclusions The consumption of chocolate with a greater cocoa content may contribute to the improvement of the nutritional status and functionality among older cancer patients in palliative care. The consumption of white chocolate was associated with improved oxidative stress. Trial registration A randomized clinical trial (ClinicalTrials.gov NCT04367493).

scholarly journals Effect of Chocolate on Older Cancer Patients in Palliative Care: A Randomised Controlled Study

2021 ◽  
Author(s):  
Josiane C. Vettori ◽  
Luanda G. da-Silva ◽  
Karina Pfrimer ◽  
Jordão-Junior Alceu A ◽  
Paulo Louzada-Junior ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oxidative Stress ◽  
Palliative Care ◽  
Body Composition ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Controlled Study ◽  
European Organization ◽  
Older Cancer Patients

Abstract Background Older advanced stage cancer patients, with changes in metabolic and nutritional status, represent an important demand for palliative care. The objective of the present study was to determine the effects of 4 weeks of chocolate consumption on the nutritional status, quality of life, body composition, oxidative stress and inflammaory activity of older cancer patients in palliative care. Methods Older cancer patients in palliative care with ambulatory monitoring were randomized to the following groups: control (CG, n = 15), intervention with 55% cocoa chocolate (IG1, n = 16) and intervention with white chocolate (IG2, n = 15) groups and evaluated before and after 4 weeks of treatment for nutritional status, food consumption, anthropometry, body composition, and laboratory parameters, and quality of life using the instrument of the European Organization for the Research and Treatment of Cancer. Results IG1 progressed with increased screening (p < 0.01) and nutritional (p = 0.04) scores on the Mini Nutritional Assessment tool. Anthropometry and body composition did not change. Regarding antioxidant capacity, reduced glutathione levels increased in IG2 (p = 0.04) and were higher than in IG1 (p < 0.01). Malondealdehyde levels were reduced in IG2 (p = 0.02) at the end of the study. Regarding quality of life, functionality improved in IG1, with a higher score in the functional domain (p = 0.03), and in the role functioning (p < 0.01) and in the social (p < 0.01) subdomains. Conclusions The consumption of chocolate with a greater cocoa content may contribute to the improvement of nutritional status and functionality among older cancer patients in palliative care. The consumption of white chocolate was associated with improved oxidative stress. Trial registration: ClinicalTrials.gov NCT04367493 - April 29, 2020. Retrospectively registered.

How do healthcare workers judge pain in older palliative care patients with delirium near the end of life?

2015 ◽  
Vol 14 (2) ◽  
pp. 151-158 ◽  
Author(s):  
Lucia Gagliese ◽  
Rebecca Rodin ◽  
Vincent Chan ◽  
Bonnie Stevens ◽  
Camilla Zimmermann
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Medical Records ◽  
Healthcare Workers ◽  
Care Setting ◽  
Assessment Tool ◽  
Self Report ◽  
Palliative Care Setting ◽  
Older Cancer Patients ◽  
Nurses And Physicians

AbstractObjective:Pain and delirium are commonly reported in older people with advanced cancer. However, assessing pain in this population is challenging, and there is currently no validated assessment tool for this task. The present retrospective cohort study was conducted to understand how healthcare workers (HCWs; nurses and physicians) determine that older cancer patients with delirium are in pain.Method:We reviewed the medical records of consecutive palliative care inpatients, 65 years of age and above (N= 113), in order to identify patient-based cues used by HCWs to make pain judgments and to examine how the cues differ by delirium subtype and outcome.Results:We found that HCWs routinely make judgments about pain in older patients with delirium using a repertoire of strategies that includes patient self-report and observations of spontaneous and evoked behavior. Using these strategies, HCWs judged pain to be highly prevalent in this inpatient palliative care setting.Significance of results:These novel findings will inform the development of valid and reliable tools to assess pain in older cancer patients with delirium.

Nutritional status and quality of life in patients with gastric cancer in China.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15508-e15508
Author(s):  
Hongli Li ◽  
Shaohua Ge ◽  
Yi Ba
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Assessment Tool ◽  
Subjective Global Assessment ◽  
Preliminary Assessment ◽  
European Organization ◽  
Gastric Cancer Patients

e15508 Background: The incidence of gastric cancer is much higher in China than in any other country. Although the overall survival rate of patients with gastric cancer has increased due to the advancements in multimodality management. However, significant morbidity, including loss of appetite, dysphagia, nausea, and vomiting is still associated with gastric cancer patients. These symptoms have a profound impact on nutritional status and quality of life in these patients. The primary objective of the present study was to assess the nutritional status and quality of life in gastric cancer patients. Methods: A preliminary assessment of patients’ nutritional status, quality of life, and medical characteristics was conducted using the Patient Generated Subjective Global Assessment (PG-SGA) and the European Organization for Research and Treatment of Cancer quality of life (QOL-C30, version 3) questionnaires. The PG-SGA is a clinical nutrition assessment tool used to evaluate oncology patients. The nutritional status of the patients fell into three groups by a score of PG-SGA-A, -B, and C. Results: A preliminary assessment of patients’ nutritional status, quality of life, and medical characteristics was conducted using the Patient Generated Subjective Global Assessment (PG-SGA) and the European Organization for Research and Treatment of Cancer quality of life (QOL-C30, version 3) questionnaires. The PG-SGA is a clinical nutrition assessment tool used to evaluate oncology patients. The nutritional status of the patients fell into three groups by a score of PG-SGA-A, -B, and C. Conclusions: These results suggest that the nutritional status of the patients with stomach cancer may impact on their QoL. It is necessary to develop nutritional intervention to improve QoL in gastric cancer patients.

scholarly journals Cognitive Impairment in Older Cancer Patients Treated with First-Line Chemotherapy

Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6171
Author(s):  
Mélanie Dos Santos ◽  
Idlir Licaj ◽  
Carine Bellera ◽  
Laurent Cany ◽  
Giulia Binarelli ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cancer Patients ◽  
Predictive Factors ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
First Line ◽  
European Organization ◽  
Elderly Cancer Patients ◽  
Older Cancer Patients ◽  
Line Chemotherapy

Older cancer patients are vulnerable to chemotherapy-related cognitive impairment. We prospectively evaluated cognitive impairment and its predictive factors during first-line chemotherapy in elderly cancer patients (≥70 years). Cognitive function was evaluated by the Mini-Mental State Examination (MMSE) with adjusted scores for age and sociocultural level. Multidimensional geriatric assessment was performed at baseline and during chemotherapy including the MMSE, Instrumental Activities in Daily Living (IADL), Mini-Nutritional Assessment (MNA), and the Geriatric Depression Scale (GDS15). Quality of life (QoL) was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire (QLQ-C30). Of 364 patients included, 310 had two MMSE evaluations including one at baseline and were assessed. Among these patients, 86 (27.7%) had abnormal MMSE, 195 (62.9%) abnormal MNA, 223 (71.9%) abnormal IADL, and 137 (43.1%) had depressive symptoms at baseline. MMSE impairment during chemotherapy was observed in 58 (18.7%) patients. Abnormal baseline MNA (odds ratio (OR) = 1.87, p = 0.021) and MMSE (OR = 2.58, p = 0.022) were independent predictive factors of MMSE impairment. These results suggest that pre-existing cognitive impairment and malnutrition are predictive factors for cognitive decline during chemotherapy in elderly cancer patients. Detection and management of these risk factors should be systematically considered in this population before starting chemotherapy.

scholarly journals Clinical Impact of Highly Purified, Whey Proteins in Patients Affected With Colorectal Cancer Undergoing Chemotherapy: Preliminary Results of a Placebo-Controlled Study

2019 ◽  
Vol 18 ◽  
pp. 153473541986692 ◽  
Author(s):  
Federica Mazzuca ◽  
Michela Roberto ◽  
Giulia Arrivi ◽  
Elena Sarfati ◽  
Francesca Matilde Schipilliti ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Whey Protein ◽  
Nutritional Assessment ◽  
Univariate Analysis ◽  
Whey Proteins ◽  
Mini Nutritional Assessment ◽  
Controlled Study ◽  
Severe Toxicity

Background and Aims: Sarcopenia, the loss of both lean body and skeletal muscle mass, may interfere in cancer patients outcome. As investigated, whey proteins could prevent the onset of sarcopenia. We have conducted a study to evaluate the effects of whey protein in colorectal cancer patients, undergoing 5-fluorouracil-based chemotherapy. Methods: After written informed consent, patients were blind randomized 1:1 to whey protein (ProLYOtin; arm A) versus placebo (arm B). The patients were assessed both physically and nutritionally before chemotherapy and after 3 (T2) and 6 months (T3) by body impedance assessment, L3-computed tomography scan, Mini Nutritional Assessment (MNA), and Malnutrition Universal Screening Tool (MUST) tests. Results: Forty-seven patients were included in this preliminary analysis. Baseline characteristics were well balanced between the 2 arms. During chemotherapy, 33 patients were reevaluated: anthropometric parameters (lean body mass from 68.5% to 71.2% vs 68.7% to 66.3%, and sarcopenia from 84% to 54% and 83% to 77% from baseline to T2 evaluation in arms A and B, respectively), nutritional status (MNA >24 = 100% [A] vs 73.7% [B]), and toxicity (no adverse effects in 86% [A] vs 29% [B] and 94% [A] vs 29% [B] for hematological and gastrointestinal toxicities, respectively) resulted to be significantly different. At univariate analysis, a condition of malnutrition risk according to MUST (relative risk [RR] = 7.5, P = .02) or MNA (RR = 1.45, P = .02) and ProLYOtin intake (RR = 0.12, P = .01) were found to be significantly predictive of chemotherapy toxicity. Conclusions: At present, our study shows how whey protein could be an important therapeutic option to improve nutritional status, and particularly to prevent severe toxicity during chemotherapy.

scholarly journals Factors Influencing the Willingness of Palliative Care Utilization among the Older Population with Active Cancers: A Case Study in Mandalay, Myanmar

2021 ◽  
Vol 18 (15) ◽  
pp. 7887
Author(s):  
Aye Tinzar Myint ◽  
Sariyamon Tiraphat ◽  
Isareethika Jayasvasti ◽  
Seo Ah Hong ◽  
Vijj Kasemsup
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Rural Areas ◽  
Psychosocial Support ◽  
Care Utilization ◽  
Severe Illness ◽  
Cross Sectional Survey ◽  
Care Services ◽  
Palliative Care Services ◽  
Older Cancer Patients

Palliative care is an effective, multidisciplinary healthcare service to alleviate severe illness patients from physical, psychological, and spiritual pain. However, global palliative care has been underutilized, especially in developing countries. This cross-sectional survey aimed to examine the factors associated with older cancer patients’ willingness to utilize palliative care services in Myanmar. The final sample was composed of 141 older adults, 50-years of age and above who suffered from cancers at any stage. Simple random sampling was applied to choose the participants by purposively selecting three oncology clinics with daycare chemotherapy centers in Mandalay. We collected data using structured questionnaires composed of five sections. The sections include the participant’s socio-economic information, disease status, knowledge of palliative care, psychosocial and spiritual need, practical need, and willingness to utilize palliative care services. The study found that approximately 85% of older cancer patients are willing to receive palliative care services. The significant predictors of willingness to utilize palliative care services include place of living, better palliative care knowledge, more need for spiritual and psychosocial support, and practical support. This study can guide health policymakers in increasing the rate of palliative care utilization. The suggested policies include developing community-level palliative care services in Myanmar, especially in rural areas, promoting palliative care knowledge, applying appropriate religious and spiritual traditions at palliative treatment, and developing suitable medicines for the critically ill.

scholarly journals Nutritional status and dietary quality index of head and neck cancer patients undergoing chemo radiotherapy

2020 ◽  
Vol 8 (1) ◽  
pp. 14-14
Author(s):  
Shirin Fattahi ◽  
Farshad Seyyednejad ◽  
Sarvin Sanaie ◽  
Tahereh Parhizkar ◽  
Elnaz Faramarzi
Keyword(s):  
Head And Neck Cancer ◽  
Nutritional Status ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Quality Index ◽  
Dietary Diversity ◽  
Mini Nutritional Assessment ◽  
Dietary Quality ◽  
Quality Indices

Introduction: Considering the important role of early detection of malnutrition in patients with cancer and its negative effects on the outcome, as well as the lack of any published article (to the best of our knowledge) about the dietary quality index in head and neck cancer patients treated with chemoradio therapy, we decided to evaluate the nutritional status and dietary quality index in these patients. Methods: In this study, thirty-seven volunteer patients with head and neck cancer were recruited. Nutritional status of the patients was evaluated by Mini Nutritional Assessment (MNA) questionnaire. Dietary diversity score, dietary variety score, and diet quality index–international were calculated to assess the dietary quality of the patients. Results: Our findings indicated that about half of the patients were well nourished and 48.6%were at the risk of malnutrition. We did not find any significant differences between variousdietary quality indices and nutritional status of the patients. However, a significant reverse correlation was observed between dietary quality indices and nutritional status of the patients. Conclusion: According to our findings, the evaluation of nutritional status and the prediction of the patients at higher risks of chemoradio therapy-induced adverse events, may have a major role in the prevention of treatment gaps.

Development of a spiritual pain assessment sheet for terminal cancer patients: Targeting terminal cancer patients admitted to palliative care units in Japan

2006 ◽  
Vol 4 (2) ◽  
pp. 179-188 ◽  
Author(s):  
KEIKO TAMURA ◽  
KAORI ICHIHARA ◽  
EIKO MAETAKI ◽  
KEIKO TAKAYAMA ◽  
KUMI TANISAWA ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Pain Assessment ◽  
Assessment Tool ◽  
Three Dimensions ◽  
Terminal Cancer ◽  
Philosophical Perspective ◽  
Terminal Cancer Patients ◽  
Assessment Sheet ◽  
Palliative Care Units

Objective: This research explores the potential benefit of a spiritual pain assessment sheet to clinical practice. With spiritual pain defined as “pain caused by extinction of the being and meaning of the self,” the spiritual pain assessment sheet was developed by Hisayuki Murata from his conceptual framework reflecting the three dimensions of a human being as a being founded on temporality, a being in relationship, and a being with autonomy. The assessment sheet was developed from reviews of the literature and examinations from a philosophical perspective on the structure of spiritual pain.Methods: Patients admitted to palliative care units in Japan were interviewed using the assessment sheet. The responses were analyzed qualitatively. The usefulness of the assessment sheet and the burden placed on the patients by its use were also investigated.Results: The spiritual pain elucidated by the assessment sheet was the same as that revealed in the earlier research of Morita. The patients reported that they did not find the use of the assessment sheet a burden, and more than half reported that it was useful. The burden of the assessment sheet on the subjects was thus determined to be low. Positive feedback on the assessment sheet was also received from the nurses who conducted the patient interviews, who said the assessment sheet made it easier to talk with the patients about their spiritual pain.Significance of research: The research results indicate that the spiritual pain assessment sheet provided an appropriate assessment of spiritual pain among terminal cancer patients, showing that such a sheet could be used as an assessment tool in the future.

Depression in Geriatric Inpatients: Correlations with Nutritional State and Cognitive Functions

2016 ◽  
Vol 33 (S1) ◽  
pp. S472-S472
Author(s):  
I. Bonfitto ◽  
G. Moniello ◽  
L. Ariano ◽  
M. Pascucci ◽  
M.D. Zanasi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Nutritional Status ◽  
Rating Scale ◽  
Assessment Tool ◽  
Mini Nutritional Assessment ◽  
Average Score ◽  
Depressed Patients ◽  
Increased Risk ◽  
Geriatric Inpatients

BackgroundAlthough the prevalence of malnutrition is relatively low among elderly people, the risk increases significantly among inpatients and even more in those with mental deterioration.AimsTo evaluate the possible association between the severity of depressive symptoms, the nutritional status and the cognitive decline in a sample of geriatric inpatients.MethodsFifty-one geriatric inpatients completed the following tests:– Hamilton Depression Rating Scale (HAM-D), to assess the severity of depressive symptoms;– Mini Nutritional Assessment (MNA), as a nutrition screening and assessment tool;– Mini Mental State Examination (MMSE), to assess the cognitive impairment.ResultsThere is a negative proportional relationship between HAM-D and MMSE scores (P = 0.001) and between HAM-D and MNA scores (P = 0.023). Depressed patients found to have a greater cognitive impairment and a worse nutritional status. Considering a HAM-D cut-off point of 14, distinguishing mild than moderate depression, it shows a significant correlation with the MNA scores (P = 0.008). Patients with HAM-D scores ≥ 14 have an average MNA score of 19.8, while patients with HAM-D scores < 14 have an MNA average score of 23.6. Euthymic or mildly depressed patients are not at risk of malnutrition, while those with moderate or severe depression have an increased risk of malnutrition.ConclusionsOur study shows significant correlations between the severity of depressive symptoms and the risk of malnutrition or cognitive impairment. A mild depression state does not seem to be associated with an increased risk of malnutrition.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Long-Term Changes of Symptoms of Anxiety, Depression, and Fatigue in Cancer Patients 6 Months After the End of Yoga Therapy

2019 ◽  
Vol 18 ◽  
pp. 153473541882209 ◽  
Author(s):  
Anna Lundt ◽  
Elisabeth Jentschke
Keyword(s):  
Cancer Patients ◽  
Controlled Study ◽  
Life Questionnaire ◽  
Long Term Effects ◽  
European Organization ◽  
Yoga Therapy ◽  
Randomized Controlled ◽  
Long Term Changes ◽  
Anxiety Depression

Background: Symptoms of anxiety, depression, and cancer-related fatigue are commonly associated with cancer. Cancer patients increasingly use complementary and alternative treatments, such as yoga, to cope with psychological and physical impairments. In the present article, long-term changes of anxiety, depression, and fatigue in cancer are examined 6 months after a yoga intervention. Method: We used an observational design based on a randomized controlled study in cancer patients with mixed diagnoses to evaluate long-term changes of symptoms of anxiety, depression, and fatigue 6 months after the end of yoga therapy. We measured anxiety symptoms with the Generalized Anxiety Disorder scale (GAD-7), depressive symptoms with the Patient Health Questionnaire–2 (PHQ-2), and fatigue with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Fatigue Scale (EORTC QLQ-FA13). Yoga therapy was provided in yoga classes of 60 minutes each once a week for 8 weeks in total. The exercises provided contained both body and breathing activities as well as meditation. Results: A total of 58 patients participated in the study. Six months after the end of yoga therapy, symptoms of anxiety, depression, and fatigue were significantly reduced compared with baseline. However, symptoms of anxiety and fatigue slightly increased during the follow-up period, whereas symptoms of depression remained stable. Conclusion: Our results are promising and support the integration of yoga interventions in supportive cancer treatment concepts but should be confirmed by randomized controlled trials. Long-term effects of yoga therapy on cancer patients should be the subject of further research.

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