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The use of artificial nutrition among cancer patients enrolled in palliative home care services

Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm; Stockholms Sjukhem Foundation, Stockholm ylva.orrevall{at}ki.se

C Tishelman

Stockholms Sjukhem Foundation, Stockholm; Department of Learning, Informatics, Management and Ethics, Medical Management Center, Karolinska Institutet, Stockholm; University of Manchester, School of Nursing, Midwifery and Social Work, Manchester

J Permert

Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm

T Cederholm

Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala

In this study, patients’ views and experiences of using home artificial nutrition, and factors associated with use of home parenteral nutrition (HPN) were investigated. Structured telephone interviews with 620 cancer patients enrolled in 21 palliative home care services were analysed. HPN was more common (11%) than home enteral tube feeding (HETF, 3%). Home artificial nutrition (including HPN and HETF) was usually introduced more than four months before death. Three of four HPN recipients also had oral food intake. HPN use was associated with eating difficulties, nausea/vomiting, and fatigue rather than gastrointestinal problems per se. HETF was generally used for patients with problems related to oesophagus and head and neck tumours. In conclusion the results suggest that, contrary to existing guidelines, HPN is used to supplement oral intake, and not only for patients with a non-functioning gastrointestinal tract.

Key Words: enteral tube feeding • home care services • neoplasm • nutritional support palliative care • parenteral nutrition

This version was published on September 1, 2009

Palliative Medicine, Vol. 23, No. 6, 556-564 (2009)
DOI: 10.1177/0269216309105811


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