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Published in: Supportive Care in Cancer 2/2018

01-02-2018 | Original Article

Acute impact of home parenteral nutrition in patients with late-stage cancer on family caregivers: preliminary data

Authors: Lidia Santarpia, Federico Bozzetti

Published in: Supportive Care in Cancer | Issue 2/2018

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Abstract

Purpose

Since there is no information regarding quality of life of caregivers assisting patients with advanced malignancy on home parenteral nutrition, herewith we report a preliminary series of 19 patients who received total parenteral nutrition at home under the strict supervision of their relatives.

Methods

The relatives of 19 incurable patients with cancer-related cachexia, discharged from the hospital with a home parenteral nutrition program, were prospectively studied. They filled out a validated questionnaire, the Family Strain Questionnaire Short Form, prior to patient discharge and after 2 weeks of home care. The questionnaire included 30 items, which explored different domains regarding the superimposed burden on caregivers in relation to the assistance given to their relatives.

Results

Our findings show that the basal level of strain was relatively high (about three quarters of positive answers) but did not increase after 2 weeks of home care. Similarly, there was no difference in the nutritional status and quality of life of the patients. Eight patients and their relatives could be also analyzed after 2 months and the results maintained unchanged.

Conclusion

This preliminary investigation shows that home parenteral nutrition does not exacerbate the level of strain on caregivers involved in surveillance of such a supportive intervention. It is possible that the perception of an active contribution to the benefit of patients, who maintained unchanged their nutritional status and quality of life, could gratify caregivers despite the objective burden in the constant supervision of administering Parenteral Nutrition.
Literature
1.
go back to reference Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Fearon K, Hütterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, Mühlebach S, Muscaritoli M, Oldervoll L, Ravasco P, Solheim T, Strasser F, de van der Schueren M, Preiser JC (2016) ESPEN guidelines on nutrition in cancer patients. Clin Nutr 36(1):11–48 Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Fearon K, Hütterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, Mühlebach S, Muscaritoli M, Oldervoll L, Ravasco P, Solheim T, Strasser F, de van der Schueren M, Preiser JC (2016) ESPEN guidelines on nutrition in cancer patients. Clin Nutr 36(1):11–48
2.
go back to reference Bozzetti F, Santarpia L, Pironi L, Thul P, Klek S, Gavazzi C, Tinivella M, Joly F, Jonkers C, Baxter J, Gramlich L, Chicharro L, Staun M, Van Gossum A, Lo Vullo S, Mariani L (2014) The prognosis of incurable cachectic cancer patients on home parenteral nutrition: a multi-centre observational study with prospective follow-up of 414 patients. Ann Oncol 25(2):487–493CrossRefPubMed Bozzetti F, Santarpia L, Pironi L, Thul P, Klek S, Gavazzi C, Tinivella M, Joly F, Jonkers C, Baxter J, Gramlich L, Chicharro L, Staun M, Van Gossum A, Lo Vullo S, Mariani L (2014) The prognosis of incurable cachectic cancer patients on home parenteral nutrition: a multi-centre observational study with prospective follow-up of 414 patients. Ann Oncol 25(2):487–493CrossRefPubMed
3.
go back to reference Bozzetti F, Cotogni P, Lo Vullo S, Pironi L, Giardiello D, Mariani L (2015) Development and validation of a nomogram to predict survival in incurable cachectic cancer patients on home parenteral nutrition. Ann Oncol 26(11):2335–2340CrossRefPubMed Bozzetti F, Cotogni P, Lo Vullo S, Pironi L, Giardiello D, Mariani L (2015) Development and validation of a nomogram to predict survival in incurable cachectic cancer patients on home parenteral nutrition. Ann Oncol 26(11):2335–2340CrossRefPubMed
4.
go back to reference Bozzetti F, Cozzaglio L, Biganzoli E, Chiavenna G, De Cicco M, Donati D, Gilli G, Percolla S, Pironi L (2002) Quality of life and length of survival in advanced cancer patients on home parenteral nutrition. Clin Nutr 21(4):281–288CrossRefPubMed Bozzetti F, Cozzaglio L, Biganzoli E, Chiavenna G, De Cicco M, Donati D, Gilli G, Percolla S, Pironi L (2002) Quality of life and length of survival in advanced cancer patients on home parenteral nutrition. Clin Nutr 21(4):281–288CrossRefPubMed
5.
go back to reference Nguyen TK, Bauman GS, Watling CJ, Hahn K (2017) Patient- and family-centered care: a qualitative exploration of oncologist perspectives. Support Care Cancer 25(1):213–219CrossRefPubMed Nguyen TK, Bauman GS, Watling CJ, Hahn K (2017) Patient- and family-centered care: a qualitative exploration of oncologist perspectives. Support Care Cancer 25(1):213–219CrossRefPubMed
6.
go back to reference Joly F, Baxter J, Staun M, Kelly DG, Hwa YL, Corcos O, De Francesco A, Agostini F, Klek S, Santarpia L, Contaldo F, Jonker C, Wanten G, Chicharro L, Burgos R, Van Gossum A, Cuerda C, Virgili N, Pironi L; ESPEN HAN CIF group (2017). Five-year survival and causes of death in patients on home parenteral nutrition for severe chronic and benign intestinal failure. Clin Nutr. https://doi.org/10.1016/j.clnu.2017.06.016 Joly F, Baxter J, Staun M, Kelly DG, Hwa YL, Corcos O, De Francesco A, Agostini F, Klek S, Santarpia L, Contaldo F, Jonker C, Wanten G, Chicharro L, Burgos R, Van Gossum A, Cuerda C, Virgili N, Pironi L; ESPEN HAN CIF group (2017). Five-year survival and causes of death in patients on home parenteral nutrition for severe chronic and benign intestinal failure. Clin Nutr. https://​doi.​org/​10.​1016/​j.​clnu.​2017.​06.​016
7.
go back to reference Santarpia L, Pasanisi F, Alfonsi L, Violante G, Tiseo D, De Simone G, Contaldo F (2002) Prevention and treatment of implanted central venous catheter (CVC)-related sepsis: a report after six years of home parenteral nutrition (HPN). Clin Nutr 21(3):207–211CrossRefPubMed Santarpia L, Pasanisi F, Alfonsi L, Violante G, Tiseo D, De Simone G, Contaldo F (2002) Prevention and treatment of implanted central venous catheter (CVC)-related sepsis: a report after six years of home parenteral nutrition (HPN). Clin Nutr 21(3):207–211CrossRefPubMed
8.
go back to reference Rossi Ferrario S, Baiardi P, Zotti AM (2004) Update on the family strain questionnaire: a tool for the general screening of caregiving-related problems. Qual Life Res 13(8):1425–1434CrossRefPubMed Rossi Ferrario S, Baiardi P, Zotti AM (2004) Update on the family strain questionnaire: a tool for the general screening of caregiving-related problems. Qual Life Res 13(8):1425–1434CrossRefPubMed
9.
go back to reference Bozzetti F, Mariani L (2009) Defining and classifying cancer cachexia: a proposal by the SCRINIO Working Group. JPEN J Parenter Enteral Nutr 33(4):361–367CrossRefPubMed Bozzetti F, Mariani L (2009) Defining and classifying cancer cachexia: a proposal by the SCRINIO Working Group. JPEN J Parenter Enteral Nutr 33(4):361–367CrossRefPubMed
10.
go back to reference Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495CrossRefPubMed Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495CrossRefPubMed
11.
go back to reference Vidotto G, Ferrario SR, Bond TG, Zotti AM (2010) Family strain questionnaire-short form for nurses and general practitioners. J Clin Nurs 19(1–2):275–283CrossRefPubMed Vidotto G, Ferrario SR, Bond TG, Zotti AM (2010) Family strain questionnaire-short form for nurses and general practitioners. J Clin Nurs 19(1–2):275–283CrossRefPubMed
12.
go back to reference Cohen R, Leis AM, Kuhl D, Charbonneau C, Ritvo P, Ashbury FD (2006) QOLLTI-F: measuring family carer quality of life. Palliat Med 20:755–767CrossRefPubMed Cohen R, Leis AM, Kuhl D, Charbonneau C, Ritvo P, Ashbury FD (2006) QOLLTI-F: measuring family carer quality of life. Palliat Med 20:755–767CrossRefPubMed
13.
go back to reference Hagedoorn M, Buunk BP, Kuijer RG, Wobbes T, Sanderman R (2000) Couples dealing with cancer: role and gender differences regarding psychological distress and QOL. Psycho Oncol 9:232–242CrossRef Hagedoorn M, Buunk BP, Kuijer RG, Wobbes T, Sanderman R (2000) Couples dealing with cancer: role and gender differences regarding psychological distress and QOL. Psycho Oncol 9:232–242CrossRef
14.
go back to reference Koldjeski D, Kirkpatrick MK, Everett L, Brown S, Swanson M (2007) The ovarian cancer journey of families the first postdiagnostic year. Cancer Nurs 30:232–242CrossRefPubMed Koldjeski D, Kirkpatrick MK, Everett L, Brown S, Swanson M (2007) The ovarian cancer journey of families the first postdiagnostic year. Cancer Nurs 30:232–242CrossRefPubMed
15.
go back to reference Lewis FM (1986) The impact of cancer on the family: a critical analysis of the research literature. Patient Educ Couns 8:269–289CrossRef Lewis FM (1986) The impact of cancer on the family: a critical analysis of the research literature. Patient Educ Couns 8:269–289CrossRef
16.
go back to reference Mellon S (2002) Comparisons between cancer survivors and family members on meaning of the illness and family quality of life. Oncol Nurs Forum 29:1117–1125CrossRefPubMed Mellon S (2002) Comparisons between cancer survivors and family members on meaning of the illness and family quality of life. Oncol Nurs Forum 29:1117–1125CrossRefPubMed
17.
go back to reference Northouse LL, Mood D, Templin T, Mellon S, George T (2000) Couples’ patterns of adjustment to colon cancer. Soc Sci Med 50:271–284CrossRefPubMed Northouse LL, Mood D, Templin T, Mellon S, George T (2000) Couples’ patterns of adjustment to colon cancer. Soc Sci Med 50:271–284CrossRefPubMed
18.
go back to reference Osse BHP, Vernooij-Dassen MJFJ, Schade E, Grol RPTM (2006) Problems experienced by the informal caregivers of cancer patients and their needs for support. Cancer Nurs 29:378–388CrossRefPubMed Osse BHP, Vernooij-Dassen MJFJ, Schade E, Grol RPTM (2006) Problems experienced by the informal caregivers of cancer patients and their needs for support. Cancer Nurs 29:378–388CrossRefPubMed
19.
go back to reference Papadopoulos A, Vrettos I, Kamposioras K et al (2011) Impact of cancer patients’ disease awareness on their family members’ health-related quality of life: a cross-sectional survey. Psycho Oncol 20(3):294–301CrossRef Papadopoulos A, Vrettos I, Kamposioras K et al (2011) Impact of cancer patients’ disease awareness on their family members’ health-related quality of life: a cross-sectional survey. Psycho Oncol 20(3):294–301CrossRef
20.
go back to reference Pitceathly C, Maguire P (2003) The psychological impact of cancer on patients’ partners and other key relatives: a review. Eur J Cancer 39:1517–1524CrossRefPubMed Pitceathly C, Maguire P (2003) The psychological impact of cancer on patients’ partners and other key relatives: a review. Eur J Cancer 39:1517–1524CrossRefPubMed
21.
go back to reference Swanberg JE (2006) Making it work: informal caregiving, cancer, and employment. J Psychosoc Oncol 24:1–18CrossRefPubMed Swanberg JE (2006) Making it work: informal caregiving, cancer, and employment. J Psychosoc Oncol 24:1–18CrossRefPubMed
22.
go back to reference Weitzner MA, Jacobsen PB, Wagner H, Friedland JJ, Cox C (1999) The Caregiver Quality of Life Index–Cancer (CQOLC) scale: development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer. Qual Life Res 8:55–63CrossRefPubMed Weitzner MA, Jacobsen PB, Wagner H, Friedland JJ, Cox C (1999) The Caregiver Quality of Life Index–Cancer (CQOLC) scale: development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer. Qual Life Res 8:55–63CrossRefPubMed
23.
go back to reference Mercadante S (1995) Bowel obstruction in home-care cancer patients: 4 years experience. Support Care Cancer 3(3):190–193CrossRefPubMed Mercadante S (1995) Bowel obstruction in home-care cancer patients: 4 years experience. Support Care Cancer 3(3):190–193CrossRefPubMed
24.
go back to reference Porzio G, Aielli F, Verna L, Galletti B, Shoja E, Razavi G, Ficorella C (2011) Can malignant bowel obstruction in advanced cancer patients be treated at home? Support Care Cancer 19(3):431–433CrossRefPubMed Porzio G, Aielli F, Verna L, Galletti B, Shoja E, Razavi G, Ficorella C (2011) Can malignant bowel obstruction in advanced cancer patients be treated at home? Support Care Cancer 19(3):431–433CrossRefPubMed
25.
go back to reference Orrevall Y, Tishelman C, Permert J (2005) Home parenteral nutrition: a qualitative interview study of the experiences of advanced cancer patients and their families. Clin Nutr 24(6):961–970CrossRefPubMed Orrevall Y, Tishelman C, Permert J (2005) Home parenteral nutrition: a qualitative interview study of the experiences of advanced cancer patients and their families. Clin Nutr 24(6):961–970CrossRefPubMed
27.
go back to reference Bozzetti F, Ammatuna M, Migliavacca S, Bonalumi MG, Facchetti G, Pupa A, Terno G (1987) Total parenteral nutrition prevents further nutritional deterioration in patients with cancer cachexia. Ann Surg 205(2):138–143CrossRefPubMedPubMedCentral Bozzetti F, Ammatuna M, Migliavacca S, Bonalumi MG, Facchetti G, Pupa A, Terno G (1987) Total parenteral nutrition prevents further nutritional deterioration in patients with cancer cachexia. Ann Surg 205(2):138–143CrossRefPubMedPubMedCentral
Metadata
Title
Acute impact of home parenteral nutrition in patients with late-stage cancer on family caregivers: preliminary data
Authors
Lidia Santarpia
Federico Bozzetti
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 2/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3884-4

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