Development and Validation of a Logic Model for Utilization of Nutrition Support among Patients with Cancer

Table 3

Elements of included literatures.

Elements	Contents
Demographic information	(i) Gender
	(ii) Age
Cancer types	(i) (Incurable/upper/primary/secondary) gastrointestinal cancer, esophageal cancer, esophageal cancer, rectal carcinoma, colon carcinoma, duodenal carcinoma
	(ii) (Advanced-stage epithelial) ovarian cancer, fallopian tube and primary peritoneal cancer, pancreatic carcinoma, appendix cancer, head and neck cancer, advanced non-small-cell lung cancer, hepatic carcinoma, bladder cancer
	(iii) Abdominal cavity malignancy, cancer-related cachexia, pediatric oncology
Disease stages	(i) Stages I–IV, advanced stage
Surgery	(i) Thoracic surgery
	(ii) Elective esophagectomy, esophageal resection
	(iii) Total gastrectomy, radical gastrectomy
	(iv) Elective major gastrointestinal tract surgery, bowel resection
	(v) Ablative surgery, extended pelvic lymphadenectomy, radical cystectomy, cytoreductive surgery, debulking surgery
Treatments	(i) Chemotherapy (systemic, neoadjuvant), hormonal therapy, paclitaxel and cisplatin/carboplatin treatment, radiotherapy (plus systemic treatment), surgical therapy
Participants	(i) Patient, home health nurse, caregiver, physician, family member, nutrition team, nutritionist, general practitioner, oncologist, medical, nursing and allied health staff, dietitian, psychologist, speech pathologist, radiation oncologist, and medical oncologist.
Nutrition types	(i) EN: enteral nutritional emulsion (TPF-T), isocaloric and isonitrogenous enteral formula, protein EN powder, home enteral nutrition (HEN), omega-3-rich EN
	(ii) PN: home parenteral nutrition (HPN), total parenteral nutrition (TPN), supplemental home parenteral nutrition (sHPN)
	(iii) Other: fiber-free/enriched/and probiotic-enriched nutrition formula, low-nitrogen and low-calorie PN combined with EN
Nutrition routes	(i) EN: nutrition pump, jejunostomy feeding, oral, electronic pump, peripheral intravenous infusion, nasal-intestinal tube, intraoperatively placed nasogastric tube, enteral feeding tube, oral feeding, transnasal tube
	(ii) PN: central venous catheter, subcutaneous port, external central venous catheter, peripheral-venous route, gastrostomy tube, peripherally inserted central catheter
Timing	(i) No specific
	(ii) No more than 7 days prior to chemotherapy administration, after the first chemotherapy cycle, and after the second chemotherapy cycle, day 3 before the initiation of chemotherapy to day 12 of chemotherapy
	(iii) Preoperation: 1 day, 1 week
	(iv) Day of surgery
	(v) Postoperation: 24, 48, and 48-72 hours, 7 days, the day that the patient began eating a postoperative diet
Duration	(i) Days: 2-14
	(ii) Weeks: 1-6
	(iii) Months: 2-6
Health outcomes	(i) Complication rates (postoperative, jejunostomy tube)
	(ii) Nutritional status nutritional assessment
	(iii) Clinical, biochemical, laboratory, and hematological parameters, blood chemistry
	(iv) Anthropometrics, e.g., body weight, body composition, rate of weight loss, fat free mass index, fat free mass, handgrip strength, muscle strength, six-minute walking test, protein-calorie intake, and caloric intake
	(v) Oncological outcomes (short-/long-term), e.g., chemotherapy-related toxicities, response to chemotherapy and survival, and anticancer treatment tolerance
	(vi) Functional outcomes, e.g., functional status (Karnofsky performance status (KPS)), immune function, liver function indexes, intestinal function recovery, functional capacity, bowel movement recovery, and restoration of bowel function
	(vii) Inflammatory markers, such as tumor necrosis factor- (TNF-) a and interleukin- (IL-) 6, immunoglobulins, CD3+, CD4+, CD8+, and natural killer cells, albumin and prealbumin, hemoglobin, inflammatory response, and duration of systematic inflammatory response syndrome
	(viii) Quality of life (generic and disease-specific), e.g., physical/role/emotional functioning, appetite loss, and fatigue
	(ix) Other, e.g., days for first fecal passage, blood glucose (BG) values, adherence to nutrition support, and phase angle
Nonhealth outcomes	(i) Length of hospital stay, length of postoperative hospital stay, hospital readmission rates
	(ii) Cost of hospitalization, cost-effectiveness, initial hospitalization cost
	(iii) Attitude, impact, information, support, and clinical management regarding nutrition support
	(iv) Experiences of living jejunostomy tube and home feeding, level of family strain, psychological status
Adverse reactions	(i) Abdominal pain, vomiting/nausea, anastomotic fistula, and abdominal distension, oral mucositis, diarrhea, bloodstream infection, catheter occlusion, drug extravasation, intravascular thrombosis, bleeding, exudates, swelling, induration
Setting	(i) Different timing/duration (preoperation versus postoperation)
	(ii) Different dose and intensity (rich/free fiber formula)
	(iii) Different nutrition types (EN versus PN)
	(iv) Different routes (nasoenteral feeding tube versus intravenous infusion)
	(v) Different care/counselling (standard care versus nutrition care)
	(vi) Different nutrition support versus control (EN versus placebo)