Browsing by Subject "NUTRITIONAL-STATUS"

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  • Saarela, R. K. T.; Savikko, N. M.; Soini, H.; Muurinen, S.; Suominen, M. H.; Kautiainen, H.; Pitkälä, K. H. (2019)
    Objectives Poor oral health may complicate eating and deteriorate nutritional status. However, little is known about how the burden of oral symptoms (OS) is associated with the health-related quality of life (HRQoL) of vulnerable older people in institutional settings. This study explores how the burden of certain OS (chewing problems, swallowing difficulties, dry mouth) is associated with functioning, morbidity, nutritional status and eating habits. It also examines the association between the OS burden and HRQoL. Design A cross-sectional study in 2017. Setting All long-term care wards in Helsinki, Finland. Participants 2401 older residents (74% females, mean age 83.9). Measurements Nurses assessed the residents and completed questionnaires on the participants' demographics, functional status, diagnoses, OS and eating habits. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) and HRQoL with a 15-dimensional instrument (15D). Results Of the residents, 25.4% had one OS and 16.6% two or three OS. OS burden was associated linearly with poorer cognitive and physical functioning and a higher number of comorbidities, edentulousness without dentures, and less frequent teeth brushing/denture cleaning. OS burden was also associated with malnutrition, lower BMI and eating less during main meals. In the multivariate analyses adjusted for various confounding factors, a higher number of OS was associated with lower HRQoL. OS burden correlated with nearly all dimensions of HRQoL. Conclusion Oral symptoms are associated with generic HRQoL. Therefore, OS should be regularly assessed and managed in daily care.
  • Tuominen, L; Ritmala-Castren, M; Nikander, P; Makela, S; Vahlberg, T; Leino-Kilpi, H (2021)
    Background: Chemotherapy-induced side effects may have a negative effect on nutrition intake, thus increasing the risk of malnutrition and consequently, other serious complications for patients with cancer. The prevalence of malnutrition is common among patients with colorectal cancer. Nurse-led empowering education may have a positive effect on self-care activity in this patient group. Therefore, our purpose is to develop an empowering educational nursing intervention and test its effect on self-care activation and knowledge level among patients with colorectal cancer during chemotherapy. Secondary outcomes are quality of life and risk of malnutrition. Methods: An interdisciplinary expert group developed a face-to-face empowering educational intervention using teach-back method. A two-arm, single-centre, superiority trial with stratified randomisation (1:1) and pre-post measures will be used to assess the effect of the intervention compared to standard care. Patients (N = 40 + 40) will be recruited in one university hospital outpatient clinic in Finland. Eligibility criteria are adult patients diagnosed with colorectal cancer starting oral fluoropyrimidine or combination chemotherapy treatment. A registered nurse experienced in oncology will deliver the intervention 2 weeks after the first chemotherapy. Outcomes are measured before intervention (M0) and after a two-month follow-up period (M1). Discussion: This study will assess whether nurse-led empowering education using teach-back method is effective on self-care activity among patients with colorectal cancer. If the intervention has a positive effect, it may be implemented into patient education in a corresponding context.
  • Salminen, K. S.; Suominen, M. H.; Kautiainen, H.; Roitto, H. M.; Pitkala, K. H. (2019)
    Our aim was to investigate how energy intake modifies the association of the stage of dementia with health related quality of life (HRQoL) among institutionalized older people. A cross-sectional sample of 538 older long-term care residents with dementia in Helsinki, Finland were assessed with HRQoL (15D), energy intake (from one to two days), and the stage of dementia by the clinical dementia rating (CDR) scale. The energy intakes were standardized by z-scores to include both men and women in the same analyses. Severity of dementia was associated with HRQoL (15D index in CDR 0.5-1: 0.65 (0.11), CDR 2: 0.60 (0.10), CDR 3: 0.52 (0.10)). When the three groups of dementia severity were divided according to their energy intake quartiles, there was an association between the HRQoL and the stage of dementia (p <0.001) and energy intake (p = 0.013); however, no interaction was observed (p = 0.30). While partial correlation analysis showed that energy intake correlated with HRQoL among residents with very mild/mild or moderate dementia, this was not observed among those with severe dementia. In moderate dementia, the dimensions of mobility and usual activities correlated significantly with higher energy intake. Both energy intake and severity of dementia are associated with HRQoL.
  • Jauhiainen, L.; Mannisto, S.; Ylostalo, P.; Vehkalahti, M.; Nordblad, A.; Turunen, A. W.; Suominen, A. L. (2017)
    To study differences in consumption of foods and intake of nutrients attributable to denture status. Data from a cross-sectional, nationally representative Health 2000 Survey, subjects aged 55-84 years (n=2,241). Denture status (edentulous with full dentures, own dentition with removable dentures, own dentition with no removable dentures) was used as an explanatory variable. The consumption of foods and intake of nutrients was used as an outcome variable and was measured using a validated Food Frequency Questionnaire. Denture status associated with food choices. Full denture wearers consumed less vegetables (p = 0.013 among men and p = 0.001 among women) and fruits (p = 0.001 among women), more sugary products (p = 0.012 among men and p = 0.008 among women), and their balance in fatty acids was less favourable than among dentate participants. Among dentate participants, the differences between the two groups were small and statistically significant differences were seen mostly in women. Wearing full dentures appears to be associated with unhealthier food choices, lower consumption of some foodstuffs and lower intake of certain nutrients when compared to the food choices of dentate persons.
  • Spencer, Ana Sofia; da Silva Dias, David; Capelas, Manuel Luis; Pimentel, Francisco; Santos, Teresa; Neves, Pedro Miguel; Mäkitie, Antti; Ravasco, Paula (2021)
    IntroductionLung cancer (LC) is highly prevalent worldwide, with elevated mortality. In this population, taste and smell alterations (TSAs) are frequent but overlooked symptoms. The absence of effective therapeutic strategies and evidence-based guidelines constrain TSAs' early recognition, prevention and treatment (Tx), promoting cancer-related malnutrition and jeopardizing survival outcomes and quality of life. ObjectivesTo systematically review the literature on TSAs in LC patients, understand the physiopathology, identify potential preventive and Tx strategies and to further encourage research in this area. MethodsLiterature search on English language articles indexed to PubMed, CINALH, SCOPUS and Web of Science using MeSH terms "Lung neoplasms","Dysgeusia", "Olfaction Disorders", "Carcinoma, Small Cell","Carcinoma, Non- Small-Cell Lung "Adenocarcinoma of Lung","Carcinoma, Large Cell", and non-MeSH terms "Parageusia", "Altered Taste", "Smell Disorder", "Paraosmia", "Dysosmia","Lung Cancer" and "Oat Cell Carcinoma". ResultsThirty-four articles were reviewed. TSAs may follow the diagnosis of LC or develop during cancer Tx. The estimated prevalence of self-reported dysgeusia is 35-38% in treatment-naive LC patients, and 35-69% in those undergoing Tx, based on studies involving LC patients only.One prospective pilot trial and 1 RCT demonstrated a clinically significant benefit in combining flavor enhancement, smell and taste training and individualized nutritional counselling; a systematic review, 1 RCT and 1 retrospective study favored using intravenous or oral zinc-based solutions (150mg 2-3 times a day) for the prevention and Tx of chemotherapy (CT) and radiotherapy (RT) -induced mucositis and subsequent dysgeusia. ConclusionsThis is the first review on dysgeusia and dysosmia in LC patients to our knowledge. We propose combining taste and smell training, personalized dietary counselling and flavor enhancement with oral zinc-based solutions (150mg, 2-3 times a day) during CT and/or RT in this population, in order to prevent and help ameliorate Tx-induced dysgeusia and mucositis. However due to study heterogeneity, the results should be interpreted with caution. Developing standardized TSA measurement tools and performing prospective randomized controlled trials to evaluate their effect are warranted.