An RCN Education Grant supports targeted research to help patients recover faster
Jonathan Di Tomasso presents his research findings at a Palliative Care in Oncology Symposium. [ ©Jonathan Buchanan / ASCO ]
Cancer patients suffer from one of the highest rates of malnutrition among hospitalized patients. Malnutrition has been linked to frequent and severe complications during cancer treatments, including decreased quality of life and an increased mortality rate. As the inaugural recipients of the RCN Kuok Fellowship, registered dietitian Jonathan di Tomasso is conducting research to determine how to improve nutritional cancer care.
Di Tomasso, a member of the McGill University Health Centre’s (MUHC) Cancer Rehabilitation Clinic explains that patients currently receive nutritional counselling to help combat the symptoms of poor appetite, weight loss, diminished function and fatigue. However, as Di Tomasso notes, “presently, there is no systematic assessment of patients’ nutrition status. If there were, we would be able to make more timely interventions giving patients the care they need sooner.”
His research, which will earn him a master’s degree in Human Nutrition from McGill University, is looking at how changes in a patient’s nutrition status, measured by a patient-completed questionnaire, impacts outcomes such as quality of life and survival.
The questionnaire is the abridged Patient-Generated Subjective Global Assessment (aPGSGA) which is recommended for use in cancer patients by the American Dietetic Association and the Oncology Nursing Society. His research will look at aPGSGA scores over time to see how they relate to outcomes. Most of the research to date in this area does not have information about how patients evolve and progress.
Di Tomasso’s research will fill a void by analyzing data from the assessment tool already used with cancer patients referred to the MUHC’s cancer rehabilitation clinic.
“Nutrition is important, because if it deteriorates, so do health and survival. In Canada, and even internationally, health professionals rarely follow patients’ nutrition status over time and see how that relates to changes in quality of life and survival. We can be leaders in this area.”
He says studies show that when palliative care doctors ask patients to complete a symptom questionnaire that asks about things like lack of appetite, patients identify 10 times more health and wellness issues than through an interview alone.
“Profiling patients’ experiences of nutrition, performance and quality of life can help clinicians identify what patients need and develop strategies to aid in distinguishing who may benefit from rehabilitation, medical and nursing interventions and even palliative care,” explains Di Tomasso.
Di Tomasso has already presented findings related to his research at four conferences, including the American Society of Clinical Oncology’s (ASCO) Palliative Care in Oncology Symposium. Upon the completion of his degree in the spring, Mr. di Tomasso will share his research with other RCN’s partner hospitals. And he hopes to implement a nutrition assessment tool, such as the aPGSGA, in outpatient oncology settings across the MUHC.
“I plan to seize further opportunities for research and become a resource person for other allied health professionals interested in research that will improving cancer care.”