Sinais e sintomas relacionados à nutrição de pacientes em cuidados paliativos: uma revisão da literatura.

Abstract

Palliative Care (PC) is defined as active and integral actions that are provided to patients with progressive and irreversible disease, acting in the control, prevention and relief of pain and suffering. The nutritionist must act in a team to ensure and achieve the goals related to food, providing a better quality of life and comfort to patients in PC, because they may present signs and symptoms with varying intensities that may interfere with their nutrition. In view of this, this study aimed to characterize the main signs and symptoms related to nutrition in patients in CP through an integrative review, of a descriptive character. Firstly, a qualitative analysis was carried out to cover relevant studies related to the subject in the databases, based on the established inclusion and exclusion criteria. Subsequently, a quantitative analysis was performed to account for the number of patients included in the included studies, thus providing for the grouping and calculation of the prevalence of the main signs and symptoms related to nutrition in PC. The main signs and symptoms related to nutrition were: anorexia (63,41%), xerostomia (47,84%), constipation (41,76%), dysgeusia (28,95%), dysphagia (28,67%), nausea (27,06%), vomiting (24,47%) and diarrhea (18,41%). These signs and symptoms were mainly attributed by the progression of the disease, cause the side effect of the various types of cancer treatments, which add discomfort and nutritional changes to the patient; administered medications and complications inherent to artificial nutrition (NET and PN). Studies of this nature suggest the importance of researches on prevalence and other signs and symptoms in patients in CP, for the development of more effective nutritional strategies. Thus, nutrition will not only be the energy supply, but part of the PC treatment, in which the nutritionist plays a very valuable technical role in determining and prescribing the diet of these patients, guiding and motivating the patient, taking care of his or her well to strengthen the role of nutrition in the commitment to care of individuals. However, it was not possible, by the study design, to evaluate the functioning or not of the therapies used for each symptom. It is concluded that, in PC, nutrition has a special preventive role, allowing means and feeding pathways, and reducing the adverse effects caused by treatments and disease progression, helping to control symptoms and improve the patient's clinical condition.