TITLE: Oncology Pack (name to reference cancer, curative and palliative care details do not detail advanced cancer as this will limit usage)

Transcription

1 Scottish Nutrition & Diet Resources Initiative SNDRí Draft NUTRITION AND DIET RESOURCE SPECIFICATION TITLE: Oncology Pack (name to reference cancer, curative and palliative care details do not detail advanced cancer as this will limit usage) 12/15/01 Draft 4 1

2 SNDRí Draft for a resource to use with the Oncology Pack STAGE 1 RESOURCE PROJECT GROUP S REMIT The Resource Group (RPG) will discuss this and a final remit will be reported to SNDRí s professional reference group (title TBC when Governance will be reviewed in light of BDA merger). Unless agreed by the RPG, this document will remain a working document, not for circulation until it is signed off with the publication prior to printing. 1. Specify remit of the Resource Project Group If the resource is intended for several different disease states, the remit should specify which parts of the resource are common to all the disease states, and how nutrition and diet is essential for: a) General health b) Disease Prevention c) Disease Management d) Disease Treatment e) All Aim: Specify the resource the RPG has to explore Both in survivorship, curative and palliative stages throughout the patient journey. The nutrition and diet resource will provide nutrition advice and symptom management strategies through disease and treatment throughout the cancer continuum. This document contains a list of factors that should be considered when developing a specification for a nutrition and diet resource. Some factors may not be relevant to the resource being produced. If this is the case, a non-applicable (NA) response should be made. SNDRí would be pleased to receive any comments, which would help improve the information contained within the Resource. 12/15/01 Draft 4 2

3 SNDRí Draft STAGE 2 SPECIFICATION TARGET GROUP for a Generic Resource for Oncology Pack Aim: Describe target group (TG) and its characteristics. 1. TG s clinical problem Nutritional problems relating to their cancer, its treatment and for the future. 2. Different disease states or causes of the Under-nutrition TG s clinical problem o Nourishing diet (including nourishing drinks) and how to use your supplements o Soft nourishing o Liquidized Nourishing diet Weight gain/management related to steroid and other drug treatments, reduced mobility (short, acute and late effects) Conflict and nutrition, and cachexia Diarrhoea Loss of appetite and easy meals Feeling sick Taste changes Dry or sore mouth and throat and looking after your mouth and teeth Dry or sore mouth and looking after your mouth and teeth Consider space for personal aims/notes (to comply with BDA outcome measures). The resource will not include details on: Alternative diets Clean diets, food hygiene Neutropenic diets Tube feeding/stent etc Pancreatic/creon considerations Constipation. The resource will offer a recommended resource list to signpost to alternative patient information as appropriate on, for example: Survivorship Stents Specific cancer sub-type detailing Weight Management (TBC) Stents GI Tube feeding Others as noted/identified 12/15/01 Draft 4 3

4 Aim: Describe target group (TG) and its characteristics. Demographic details 3. TG s demographic details and appropriate action to address potential issues a) Gender b) Age c) Other (for example social, residential, level of independence) 4. Factors that may cause issues and appropriate action to address these: a) Communication Factors i Ability to follow verbal and written instruction ii Ability to communicate via speech and writing to enable feedback iii Sight b) Physical Factors i Eating, drinking and swallowing ii Head control, feeding position and limb function iii Level of independence STAGE 2 SPECIFICATION TARGET GROUP for a Generic Resource for Oncology Pack Male and female Over 16 years Standard population variation a) Head and neck cancer may have problems communicating with the professional. May be from more socially deprived groups. b) Sore mouth or throat relating to treatment type, swallowing difficulties relating to tumour site/treatment. Upper GI may require advice on feeding position. Consider nutritional status during journey e.g. smooth foods if there has been a long journey to radiotherapy. 5. Support needed/available to the TG to implement the dietary advice: a) Multidisciplinary liaison Cancer site specific MDT SNDRí Draft 12/15/01 Draft 4 4

5 Aim: Describe target group (TG) and its characteristics. b) Funding identify sources of stateassistance (benefits, prescriptions etc) c) Follow-up i Contact name and number ii Guidance to other contacts 6. Who will issue the resource a) Dietitian b) Other professionals such as health/social care/educational (please specify) c) Available for members of the public to pick-up d) Other 7. Who will use the resource: a) TG b) TG s family or carers c) Staff in TG s care settings (please specify) d) Other 8. TG/Carer s knowledge and experience on the clinical condition and its management Food and drink preparation 9. TG/Carer s cooking knowledge and experience: STAGE 2 SPECIFICATION TARGET GROUP for a Generic Resource for Oncology Pack Free prescriptions for all patients Macmillan cancer benefits for equipments etc Yes box for HPs on back Issued by box Yes to Macmillan, appropriate websites etc, nhs.net highlight credibility notes Combination of all of the above TG and carers Variable assume typical population variance Variable assume typical population variance SNDRí Draft 12/15/01 Draft 4 5

6 Aim: Describe target group (TG) and its characteristics. 10. TG/Carer s knowledge and experience for food preparation for this diet: STAGE 2 SPECIFICATION TARGET GROUP for a Generic Resource for Oncology Pack Variable assume typical population variance SNDRí Draft 12/15/01 Draft 4 6

7 SNDRí Draft STAGE 3 SPECIFICATION Content* for a Generic Resource for Oncology Pack Aim: Describe the diet-sheet content and how it will be developed Evidence-base Evidence-base. Specify recommendations for dietary management by reviewing literature systematically to ensure evidence-based practice. a) Key words for literature search b) Follow Guideline for Completing.doc for reviewing evidence c) List evidence to be used and note grade of classification according to SIGN/NICE/FSA evidence-level as appropriate. a) Nourishing drinks Pureed diet Vitamin and mineral stability in a pureed diet Mousse consistency diet Soft diet Mucositis and oral intake Taste changes and diet Nutritional suuplements role in treatment of cancer Odynaphagia and oral intake Preventing weight loss during cancer treatment Nutritional management of cancer cachexia Dry mouth and oral intake Food fortification Energy dense foods in cancer patients Texture modification Nausea and oral intake GI symptoms and cancer treatment Omega 3 and cancer Anti-oxidants and cancer Immunonutrition and cancer Diet and cancer b) c) Iversen PO, Wisløff F, Gulbrandsen N. Reduced nutritional status among multiple myeloma patients during treatment with high-dose chemotherapy and autologous stem cell support. 12/15/01 Draft 4 7

8 Aim: Describe the diet-sheet content and how it will be developed STAGE 3 SPECIFICATION Content* for a Generic Resource for Oncology Pack Clin Nutr Aug;29(4): Epub 2009 Dec 30. SNDRí Draft Levine ME, Gillis MG, Koch SY, Voss AC, Stern RM, Koch KL. Protein and ginger for the treatment of chemotherapy-induced delayed nausea. J Altern Complement Med Jun;14(5): Isenring EA, Bauer JD, Capra S. Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake compared with standard practice. J Am Diet Assoc Mar;107(3): Abayomi J, Kirwan J, Hackett A. Coping mechanisms used by women in an attempt to avoid symptoms of chronic radiation enteritis. Journal Of Human Nutrition And Dietetics: The Official Journal Of The British Dietetic Association [serial on the Internet]. (2009, Aug), 22(4): Guren M, Tobiassen L, Trygg K, Drevon C, Dueland S. Dietary intake and nutritional indicators are transiently compromised during radiotherapy for rectal cancer. European Journal Of Clinical Nutrition [serial on the Internet]. (2006, Jan), [cited January 9, 2011]; 60(1): Ravasco P, Monteiro-Grillo I, Marques Vidal P, Camilo M. Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head & Neck [serial on the Internet]. (2005, Aug), 27(8): /15/01 Draft 4 8

9 Aim: Describe the diet-sheet content and how it will be developed STAGE 3 SPECIFICATION Content* for a Generic Resource for Oncology Pack SNDRí Draft Pauloski B, Rademaker A, Logemann J, Newman L, MacCracken E, Stachowiak L, et al. Relationship between swallow motility disorders on videofluorography and oral intake in patients treated for head and neck cancer with radiotherapy with or without chemotherapy. Head & Neck [serial on the Internet]. (2006, Dec), 28(12): Dietary patterns in patients with advanced cancer: implications for anorexia-cachexia therapy.(includes abstract); Hutton JL; Martin L; Field CJ; Wismer WV; Bruera ED; Watanabe SM; Baracos VE; American Journal of Clinical Nutrition, 2006 Nov; 84 (5): Inga Andrew, Graeme Kirkpatrick, Keith Holden, Colette Hawkins. Audit of symptoms and prescribing in patients with the anorexia-cachexia syndrome Pharmacy World & Science. Dordrecht:Oct Vol. 30, Iss. 5, p (8 pp.) Donald C McMillan. An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer The Proceedings of the Nutrition Society. Cambridge:Aug Vol. 67, Iss. 3, p (6 pp.) HOPKINSON J.B. (2007) How people with advanced cancer manage changing eating habits. Journal of Advanced Nursing 59(5), Susan E McClement; Lesley F Degner; Mike Harlos, Family 12/15/01 Draft 4 9

10 Aim: Describe the diet-sheet content and how it will be developed STAGE 3 SPECIFICATION Content* for a Generic Resource for Oncology Pack Responses to Declining Intake and Weight Loss in a Terminally Ill Relative: Part 1 Fighting Back, Journal of Palliative Care; Summer 2004; 20, 2 SNDRí Draft Karen Poole, Katherine Froggatt Head, Loss of weight and loss of appetite in advanced cancer: a problem for the patient, the carer, or the health professional? Palliative Medicine 2002; 16: Inga M Andrew,Kerry Waterfield, Anthony J Hildreth, Graeme Kirkpatrick, Colette Hawkins, Quantifying the impact of standardized assessment and symptom management tools on symptoms associated with cancer-induced anorexia cachexia syndrome, Palliative Medicine 23(8) , 2009 Jeremy E Shragge, Wendy V Wismer, Karin L Olson, Vickie E Baracos, Shifting to conscious control: psychosocial and dietary management of anorexia by patients with advanced cancer, Palliative Medicine 2007; 21: Department of Health, Improving Outcomes: A Strategy for Cancer January 2011 Care Aim(s) and Learning Outcomes 2. Overall care aim(s) Relieving cancer symptoms, providing reassurance and improving quality of life 3. TG/Carer s learning outcomes on their Understand how to plan easy and nourishing disease state and its management. meals. Consider points such as: Understand how to prepare a suitable textured - Aetiology diet. - Symptoms and disorders Understand the effects of treatment and - Secondary complications (focus on tumour site on nutritional status and develop 12/15/01 Draft 4 10

11 Aim: Describe the diet-sheet content and how it will be developed nutritional risks) - Dietary Management STAGE 3 SPECIFICATION Content* for a Generic Resource for Oncology Pack self-management strategies to improve health and well-being. SNDRí Draft Awareness of potential consequences of tumour site and treatment side-effects. 4. Nutrient adequacy/considerations for TG: a) Nutrition recommendations should be based on the eatwell plate and the DRVs. Where and when to go for symptom management advice/information. Based on drvs and tailored to patient needs by dietitian and MDT For healthy eating advice, FSA 8 steps to eating well can be used. b) Foods or ingredients to be avoided c) Consideration of alcohol intake 5. Learning outcomes to assist the TG to achieve their recommended diet. Practical advice can be given for example: a) Food choices b) Recipe suggestions Consider chemotherapy interactions with food stuffs such as fruit juices. Caution due to medication interaction and head and neck cancers liver failure. /sign post and modify and enriching 12/15/01 Draft 4 11

12 Aim: Describe the diet-sheet content and how it will be developed c) Purchasing (raw ingredients, ready meals) d) Eating e) Freezing and reheating f) Eating out /Social situations STAGE 3 SPECIFICATION Content* for a Generic Resource for Oncology Pack ready meals and tinned OK comfortable environment and posture TV etc food safety, raw eggs travel to treatment/away from home, liquidised diet, most won t eat out. *For guidance on completing these sections refer to Guideline for Completing.doc SNDRí Draft 12/15/01 Draft 4 12

13 SNDRí Draft STAGE 4 SPECIFICATION Publication* for a Generic Resource for Oncology Pack Aim: Describe the format and style of the completed resource (cross-refer to Stage 2, points 4-8 to meet TG s needs). 1. Format of the Resource a) Printed leaflet, for example i Magazine style sections can be read independently ii Pack with multiple leaflets or loose leaf sheets iii Book style consecutive text. b) Available on internet, for example i SAMPLE ii text-only free download iii other download/interactive format c) Other 2. Design Features* a) Required design features, for example paper weight, size, illustrations, colour, font size (complete following SNDRí Design Brief). b) Does the draft design need to be considered for review? If yes, explain why. Pack with multiple leaflets Printed format * For guidance on completing these sections refer to Guideline for Completing.doc Note nutricia in cancer to demonstrate support, cheery and support. 12/15/01 Draft 4 13

14 SNDRí Draft STAGE 5 SPECIFICATION Review Criteria with Other Resources Produced/in Production for a Generic Resource for Oncology Pack Aim: Review other resources to check if others fit the criteria defined in the specification to ensure effort is not duplicated List resources reviewed Comments on suitability Review of Resources Review existing and new resources against resource specification; consider those that meet with criteria defined in this document. 12/15/01 Draft 4 14

15 STAGE 6 SPECIFICATION Reviewing and Updating Resource (to be completed at the end of the project) Category of material Review frequency Named reviewers To be completed with rolling programme SNDRí Draft 12/15/01 Draft 4 15