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Initial Assessment and Monitoring of Nutritional Status and Malignant Pain in Lung Cancer Patients


1 Sandra Karabatić

1 Andreja Šajnić

2 Snježana Čukljek

1 Ivana Lukić Franolić

1 Sanja Pleština

1 Miroslav Samaržija

1 Department for respiratory diseases Jordanovac, University Hospital Center Rebro, Zagreb, Croatia

2 University of Applied Health Sciences, Zagreb, Croatia



Author for correspondence:

Sandra Karabatić

Department for respiratory diseases Jordanovac, Univer- sity Hospital Center Zagreb,

Kišpatićeva 12, Zagreb, Croatia E-mail:


Keywords: lung cancer, nutrition status, pain, a component of nursing documentation





Introduction. Lung cancer is a complex disease and requires a multidisciplinary approach to achieve the best results in treatment, to increase the survival rate while preserving the quality of life of the suf- ferer. The nutritional status of the patient is an im- portant factor affecting outcome and recovery from disease or injury. We question whether there is a link between nutritional status and malignant pain in lung cancer patients.

Aim. A prospective trial was conducted to determine the distribution of respondents by frequency of pain according to a validated Visual Analog Scale (VAS), distribution of respondents who reported reduced food intake and distribution of factors that have led to the reduced food intake.

Methods. A prospective trial was conducted at the Department for respiratory diseases Jordanovac, Uni- versity Hospital Center Zagreb, Croatia, on a sample of patients with advanced non-small cell lung can- cer to determine the frequency, characteristics and treatment of chronic malignant pain (N=76). These are the results from November 2013 to June 2014. For pain assessment, we used a validated VAS. For the identification of patients at risk of malnutrition we used Nutritional risk screening tool (NRS 2002). For a rough estimate of total body adiposity, we measured dermal thicknesses using a standard cal- liper. Monitoring of patients was documented in the form of nursing documentation. A component of nursing documentation was designed to monitor the nutritional status of cancer patients and has been implemented at the Department for respiratory dis- eases Jordanovac as required documentation. The component included collecting the following data: the stage and type of cancer and treatment, demo- graphic characteristics, age, gender, vital signs, body weight and height, body mass index (BMI), subjective symptoms such as pain, fatigue and nausea, reduc- tion ad rezones of food consumption.

Results. During the study 417 measurements were made: 1) 32,1% of patients reported reduced food in- take, and 67,9% of respondents indicated that have not reduced their regular diet; 2) as a reason for the reduced food intake 37,7% respondents stated loss of appetite, 31,2% fatigue and 24,6% pain; 3) 59,5% subjects mainly reported absence of pain, while none of the respondents reported the existence of the highest degree of pain.

Conclusion. By regular monitoring of the intensity of the pain we achieved good control in malignant pain management, which is an important data in the assessment of nutritional status. The fact is that poorly controlled pain is present in 24% of patients and has been the reason for the reduced food intake.