Issledovaniâ i Praktika v Medicine (Sep 2019)
THE EFFECT OF NUTRITIONAL THERAPY ON QUALITY OF LIFE INDICATORS FOR PATIENTS WITH GASTRIC CANCER AT THE STAGE OF SURGICAL TREATMENT
Abstract
Purpose of the study. To determine the effect of nutritional deficiency and nutritional therapy on the quality of life of patients with gastric cancer at the stage of surgical treatment.Patients and methods. In Thoracoabdominal Department of P. Herzen Moscow Oncology Research Institute within 2017– 2019 the quality of life at the stage of surgical treatment of gastric malignant neoplasms was evaluated in 62 patients (36 men and 26 women) aged 34 to 79 years (mean age 61.9 ± 9.55). At the outpatient stage, patients were divided into 2 groups: in the 1st (main) group, patients received nutritive support with specialized mixtures for 10 days before hospitalization, in the 2nd (control) group, patients were asked to follow a high-protein diet without adding specialized mixtures. The quality of life assessment was carried out on the basis of the EORTC-QLQ-C30 Questionnaire, which patients received on the day of hospitalization. Patients repeatedly filled in EORTC-QLQ-C30 Questionnaire before discharge from the hospital, which allowed to assess the dynamics of the quality of life indicators of the studied patients. The study groups were comparable in social and medical indicators.Results. The analysis of the survey results showed that the “general state of health” in the studied groups at the stage of hospitalization is estimated above average. Also, in both groups there is a positive dynamics in the values of the above indicator before discharge. Patients of the 1st group who received specialized nutritional mixtures, developed the statistical significance of the differences in the assessment of the quality of life upon admission and before discharge. Thus, it can be argued that nutritional therapy had a significant positive impact on the quality of life in terms of “general health”, in contrast to the control group of patients who did not receive specialized nutritional therapy. There was a general tendency toward an increase in the quality of life indicators at admission and before discharge on all scores of the questionnaire in groups. This is a positive assessment by patients of their condition after providing them with medical services. In this case, the discomfort from the symptoms accompanying the disease is reduced, which is confirmed by the scoring results. Statistically significant differences in the assessment of symptoms occur in the study group. Patients having received nutritional therapy noted a decrease in pain, an improvement in the processes of assimilation of food, as well as an improvement in well-being, physical condition, an increase in general tone and energy, a surge of strength and a sense of vitality. In “decreased appetite”score the indices of patients in the main group decreased by more than 3 times, i. e. their appetite improved significantly under treatment. Improving appetite in patients of the main group led to an improvement in the functioning of the gastrointestinal tract as a whole. Patients in this group noted an improvement in digestion and bowel movements.Conclusion The study showed that the quality of life of patients with gastric cancer largely depends on their nutritional deficiency, and nutritional therapy at the stages of surgical treatment, in turn, can significantly improve its results, including in the aspect of their perception by patients. Using the general EORTC QLQ-C30 questionnaire is one of the available methods for assessing the quality of life in patients with gastric cancer.
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