Background The role of hydration in causing or alleviating suffering in advanced cancer is poorly understood. The evidence for the efficacy of clinically assisted hydration in advanced cancer is inconclusive. Bioelectrical impedance vector analysis (BIVA) is an accurate validated method of assessing hydration status. Previous work with BIVA demonstrates significant relationships with hydration status, symptoms and survival in advanced cancer. However, further work is needed to study these associations in the dying.
Aim This feasibility study aimed to develop the necessary methodology to evaluate hydration and its relationship with clinical symptoms and quality-of-life in dying cancer patients.
Methodology An observational study of thirty patients with advanced cancer in a hospice and hospital-based specialist palliative care inpatient unit. An advanced consent methodology was used to conduct assessments in the dying phase. Assessments involved hydration (BIVA), symptoms, physical signs, quality of life, myoclonus and survival. Family-caregivers experiences of hydration were evaluated via questionnaire.
Results The feasibility aspect of the study was successful in recruiting patients and caregivers across the research sites. The overall recruitment rate for patients was 60% (30 out of 48 approached agreeing to participate) with six (20%) of those recruited receiving a further hydration assessment in the dying phase of their illness. Eighteen caregivers completed questionnaires.
Conclusion It is feasible to use BIVA to assess hydration in the dying. This study will support the next phase of the study which include recruitment from additional palliative care units. The outcomes from this work will help to identify hydration-associated variables to support development of a clinical hydration assessment tool. Ultimately, this will help to develop a framework to clinically assess and manage hydration states patients with cancer.
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