Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. 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. 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):487–493

    Article  CAS  PubMed  Google Scholar 

  3. 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):2335–2340

    Article  CAS  PubMed  Google Scholar 

  4. 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):281–288

    Article  CAS  PubMed  Google Scholar 

  5. 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):213–219

    Article  PubMed  Google Scholar 

  6. 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. 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):207–211

    Article  PubMed  Google Scholar 

  8. 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):1425–1434

    Article  PubMed  Google Scholar 

  9. Bozzetti F, Mariani L (2009) Defining and classifying cancer cachexia: a proposal by the SCRINIO Working Group. JPEN J Parenter Enteral Nutr 33(4):361–367

    Article  PubMed  Google Scholar 

  10. 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):489–495

    Article  PubMed  Google Scholar 

  11. 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):275–283

    Article  PubMed  Google Scholar 

  12. Cohen R, Leis AM, Kuhl D, Charbonneau C, Ritvo P, Ashbury FD (2006) QOLLTI-F: measuring family carer quality of life. Palliat Med 20:755–767

    Article  PubMed  Google Scholar 

  13. 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 9:232–242

    Article  CAS  Google Scholar 

  14. Koldjeski D, Kirkpatrick MK, Everett L, Brown S, Swanson M (2007) The ovarian cancer journey of families the first postdiagnostic year. Cancer Nurs 30:232–242

    Article  PubMed  Google Scholar 

  15. Lewis FM (1986) The impact of cancer on the family: a critical analysis of the research literature. Patient Educ Couns 8:269–289

    Article  Google Scholar 

  16. Mellon S (2002) Comparisons between cancer survivors and family members on meaning of the illness and family quality of life. Oncol Nurs Forum 29:1117–1125

    Article  PubMed  Google Scholar 

  17. Northouse LL, Mood D, Templin T, Mellon S, George T (2000) Couples’ patterns of adjustment to colon cancer. Soc Sci Med 50:271–284

    Article  CAS  PubMed  Google Scholar 

  18. 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 29:378–388

    Article  PubMed  Google Scholar 

  19. 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):294–301

    Article  CAS  Google Scholar 

  20. Pitceathly C, Maguire P (2003) The psychological impact of cancer on patients’ partners and other key relatives: a review. Eur J Cancer 39:1517–1524

    Article  CAS  PubMed  Google Scholar 

  21. Swanberg JE (2006) Making it work: informal caregiving, cancer, and employment. J Psychosoc Oncol 24:1–18

    Article  PubMed  Google Scholar 

  22. 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 8:55–63

    Article  CAS  PubMed  Google Scholar 

  23. Mercadante S (1995) Bowel obstruction in home-care cancer patients: 4 years experience. Support Care Cancer 3(3):190–193

    Article  CAS  PubMed  Google Scholar 

  24. 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):431–433

    Article  PubMed  Google Scholar 

  25. 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):961–970

    Article  PubMed  Google Scholar 

  26. Miles SH (1989) Nourishment and the ethics of lament. Linacre Q 56(3):64–69

    Article  PubMed  Google Scholar 

  27. 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):138–143

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Internal Medicine and Clinical Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Via Pansini, 5, 80131, Naples, Italy

    Lidia Santarpia

  2. Faculty of Medicine, University of Milan, Milan, Italy

    Federico Bozzetti

Authors
  1. Lidia Santarpia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Federico Bozzetti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lidia Santarpia.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Santarpia, L., Bozzetti, F. Acute impact of home parenteral nutrition in patients with late-stage cancer on family caregivers: preliminary data. Support Care Cancer 26, 667–671 (2018). https://doi.org/10.1007/s00520-017-3884-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-017-3884-4

Keywords

Search

Navigation