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Nutrition of children and adolescents with cancer
VLKOVÁ, Lucie
Diagnosis and treatment of these diseases are still significantly improving and it turns out that nutrition is a significant part of the outcome. But it can be sometimes difficult or even impossible for the patient to follow dietary guidelines. It's possible that patients can have problems with food intake, their taste can alter altogether, or some food can even raise the need to vomit. Furthermore, food doesn't fulfill just biological needs, but it's a significant for psychological needs, too. It's therefore necessary to look at this issue from broader point of view.The aim of this thesis was to describe the composition and serving methods of nutritious meals in various stages of treatment of children and adolescents with cancer, and to map the experiences as well as view of young patients, their families and their nursing staff on whether and how it is possible to meet the nutritional recommendations while satisfying taste preferences of children. I was looking for answers to two research questions: 1. How has the method of service and the composition of diet been changing throughout the treatment in order to maintain sufficient nutrition? 2. What are the views of young patients, their parents and their attending physicians on the possibilities of maintaining nutritional recommendations? The text is divided into two parts: theory and research. The theoretical part describes the Pediatric Oncology issues and the most common types of cancer in young patients, it also mentions the possibilities of prevention. Then this part deals with side effects of cancer therapy, changes in metabolism, malnutrition, cancer cachexia and anorexia. The biggest part is devoted to nutrition nutritional status assessment, nutritional needs and forms of nutritional support. The last section contains recommendations for situations with food intake complications and the ways of increasing the nutritional contents of diet. Due to complexity of the topic I chose a mixed research strategy, several different methods of collecting and processing of data as well as questioning of various groups of respondents. I was observing 45 oncology patients children and adolescents aged 4 to 18, who are undergoing treatment at the Clinic of Pediatric Oncology in Brno, their parents (7) and their nursing staff (2). The data processing method was qualitative and quantitative analysis of questionnaire responses, interviews content analysis, observation, creation of case study, calculations of menus from the program "Nutriservis Profesional". Results are presented in graphs, tables and plain text. It's divided into three subsections. The composition and method of serving the nutritional meals depends on the needs of patients, their age, diagnosis, treatment and complications, which occur in the course of treatment. It also depends on the cooperation of patients themselves and their families. Different approach is with adolescent patients and with children as well as when they're treated at home or in the hospital. At some stages it is necessary to adjust the nutritional diet to have an adequate nutrition, at other stages the nutritional support is in sipping and when there are complications, which accompany the treatment, the method of service is changed into oral, by probe, or parenterally. Keeping of dietary recommendations represent a significant problem for these patients, which are troubles with food intake during the treatment (95% of patients). Due to children's taste preferences are some forms of nutritional support rejected, even though they are able to maintain the nutritional recommendations. Both young patients as well as their parents have preference for children's taste rather than nutrition. There were some exceptions, however. Opinions of the nursing staff are the same it all depends on the attitude of patients themselves and their families.
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Specifics of feed nutrition to patients in acute and septic state
HOLOUBKOVÁ, Martina
This bachelor thesis describes specifics of nutrition for patients in acute and septic state. It is aimed at improvement of awareness and information of nurses that care about these patients, on the problems of malnutrition and possibilities of specific nutrition. The theoretical part describes malnutrition - imbalanced diet, as a risk factor that complicates the course of disease, extends the hospitalization time and increases mortality. There is also an outline of cooperation with nutrition specialists, diet recommendations and methods of feeding patients in acute disease stage. Enteral end parenteral feeding is analyzed here. The conclusion of the theoretical part deals with the organism inflammatory response syndrome, sepsis, multiorganic dysfunction, like complications threatening a patient in acute state. There are also diet recommendations for patients in septic state. The practical part of this thesis contains results of quantitative research based on data collection by means of an anonymous questionnaire designed for nurses or healthcare rescuers of anaesthetic-resuscitation departments and intensive care units. A nursing care standard focused on assistance in introduction of central venous catheter and consequent patient care was elaborated as the output of the work upon study of the issues of nutrition for patients in acute and septic state, specific possibilities of its administration and evaluation of the research results. The bachelor thesis may also be used as study material for education of healthcare staff caring about patients in acute or septic state.
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