Effects of nutritional counselling on anthropometric measures in adult patients with cancer undergoing treatment and their perception and satisfaction level: a comprehensive systematic review.
BACKGROUND
Patients with cancer undergoing treatment often develop malnutrition. Malnutrition can lead to multiple complications. In view of the potential complications, it is important for the patients to maintain good nutritional status. One method to maintain a good nutritional status is to provide frequent nutritional support such as nutritional counselling. The effectiveness of nutritional counselling is commonly indicated by anthropometric measures. Other than anthropometric measures, the value of patients' perception and satisfaction levels towards nutritional counselling are important as well.


OBJECTIVE
The objectives of this systematic review were: (1) to examine the effect of nutritional counselling based on anthropometric measures in adult patients with cancer undergoing treatment, and (2) to determine patients' perceptions and satisfaction levels towards nutritional counselling.


METHODS
Types of participants This review considered adult patients with cancer aged 18 years or over. Patients were at various stages of the disease. Patients were undergoing treatment.Types of intervention This review considered all types of nutritional counselling given to patients with cancer.Types of outcomes The outcome of interest were anthropometric measures, patients' subjective perceptions and patients' satisfaction level.Types of studies This review considered studies that examined the effectiveness of nutritional counselling on anthropometric measures in adult patients with cancer undergoing treatment, as well as their perception and satisfaction levels towards nutritional counselling.


METHODS
A comprehensive search strategy was developed using all identified MeSH headings and key words for quantitative and qualitative studies.


METHODS
Both quantitative and qualitative papers selected for review for methodological validity were assessed by two independent reviewers prior to inclusion in the review. The review was then carried out using the standardised critical appraisal instruments.


METHODS
Following the critical appraisal, data were extracted from the included study using data extraction tools developed by JBI.A total of 11 articles were included in this systematic review, 6 were randomised controlled trials, 3 were comparable cohort studies and 2 qualitative studies.


METHODS
Narrative summary was presented for the quantitative studies as statistical pooling was not possible. For qualitative studies, findings were presented in meta-synthesis form.


RESULTS
From the presented quantitative studies, some patients with cancer were clinically benefited from the effect of nutritional counselling through the improvement or minimisation of the deterioration of body weight and fat free mass at particular time or chemotherapy cycle. Overall, patients were satisfied with the nutritional counselling they received. Patients feel that the ability to eat is important however, patients with cancer developed eating inability as a result of disease process and treatment side effects From the qualitative findings, most participants expressed that counseling was beneficial but highlighted the need for understanding of the individual food preferences when giving nutritional counselling.


CONCLUSIONS
Lastly, from the quantitative finding, no absolute conclusion can be drawn on the effect of nutritional counselling on anthropometric measures. The findings of patients' perceptions and satisfaction levels towards nutritional counselling can provide an improved framework to help health care professionals in implement better nutritional counselling session.
The quantitative findings support the use of individualized and intensive nutritional counselling for patients with cancer to improve body weight and fat free mass measurement. Patient satisfaction with nutritional counselling should be conducted regularly in the clinical area. The qualitative findings highlight the need for minimising eating inability related to treatment side effects and disease process. Furthermore, the qualitative findings indicated the need for more individualized nutritional counselling in the clinical area, taking into account individual dietary differences, concerns, and needs.
There is a need for further research to assess the effectiveness of nutritional counselling based on anthropometric measures, patients' perception and satisfaction.
1. National University Cancer Institute, Singapore 2. Singapore National University Hospital Centre for Evidence Based Nursing: Joanna Briggs Collaborating Centre for Evidence Review 3. Alice Lee Centre for Nursing Studies, National University of Singapore.
Lim Chai
LC
Sean
Emily Ang
EA
Neo Kim
Dr Chan
DC
Moon Fai