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Improvement of feeding independence in end-stage cancer patients under palliative care—a prospective, uncontrolled study

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Abstract

Purpose

Feeding independence is important to improve the quality of life (QOL) of patients receiving palliative care. Studies on feeding independence among cancer patients under palliative care are unavailable. This study aimed to evaluate the effectiveness of occupational therapy in promoting feeding independence in end-stage cancer patients in palliative care.

Patients and methods

Thirty-six end-stage cancer inpatients with feeding difficulties attributable to improper positioning (58.3%), one-handedness (22.2%), and upper limb impairment (11.1%) were enrolled from two hospitals in Hong Kong. The feeding independence level (level 1≥25% assistance; level 2<25% assistance) of patients was assessed weekly for 3 weeks. Major treatment modalities included positioning (58%), feeding aid support (25%), and upper limb support (11%). Multilevel models were used for comparing feeding independence levels at baseline and weekly intervals.

Results

There was a significant improvement in feeding independence from baseline to week 1 (P<0.0001). Multilevel models showed that there were no significant differences in the level of feeding independence between weeks 1 and 2 (P=0.246) and between weeks 1 and 3 (P=0.165) among the subjects after controlling for age and sex, indicating that the improved feeding independence in week 1 was sustainable through weeks 2 and 3.

Conclusion

The prospective study showed for the first time that the provision of appropriate feeding supports could markedly enhance feeding independence in end-stage cancer patients receiving palliative care, which might improve activities of daily living and QOL, and minimize excessive disability. Furthermore, it merits cooperation among occupational therapists, caregivers, and ward staff to promote feeding independence in this group of patients.

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Author information

Author notes

  1. Warren Tak Keung Lee

    Present address: School of Biomedical and Molecular Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK

Authors and Affiliations

  1. Postgraduate Program of Epidemiology and Biostatistics, School of Public Health, The Chinese University of Hong Kong, Shatin, Hong Kong, China

    Warren Tak Keung Lee

  2. Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, 5/F Prince of Wales Hospital, Shatin, Hong Kong, China

    Warren Tak Keung Lee

  3. Occupational Therapy Department, Grantham Hospital, Wong Chuk Hang, Hong Kong, China

    Hung Fai Chan

  4. Centre for Epidemiology and Biostatistics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China

    Eric Wong

Authors
  1. Warren Tak Keung Lee
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  2. Hung Fai Chan
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  3. Eric Wong
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Corresponding author

Correspondence to Warren Tak Keung Lee.

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Lee, W.T.K., Chan, H.F. & Wong, E. Improvement of feeding independence in end-stage cancer patients under palliative care—a prospective, uncontrolled study. Support Care Cancer 13, 1051–1056 (2005). https://doi.org/10.1007/s00520-005-0859-7

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  • DOI: https://doi.org/10.1007/s00520-005-0859-7

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