Reframing eating during chemotherapy in cancer patients with chemosensory alterations.

PURPOSE: Our purpose was to describe how eating is reframed among cancer patients experiencing chemosensory alterations.
METHODS: Using data collection and analysis strategies from a qualitative design called ethnoscience, we interviewed 12 patients experiencing taste and smell alterations during chemotherapy. We asked participants to provide a description of a meal and the process by which they decide what and how to eat. Each person was interviewed twice. We compared participants' descriptions of eating, and used this comparison to identify some core beliefs about eating. Participants also completed measures of dietary intake, symptom burden and quality of life.
RESULTS: Based on the interviews, we identified specific constraints to eating, beliefs about the value of eating, and behaviours participants used to work around the constraints to eat during chemotherapy. Chemosensory complaints and other symptoms (i.e. pain, anorexia, tiredness), personal experiences and food preferences were the main constraints. Core beliefs about the value of eating included its social benefits, benefits of eating for health per se, and benefits related to preparing for the next chemotherapy cycle. These beliefs reframed the purpose of eating and were used by participants to develop specific strategies to work around the constraints to eating.
CONCLUSION: To date, interventions to promote eating among cancer patients have focused extensively on symptom management and on recommendations for macro/micronutrient intake. This study underscores the importance of understanding beliefs about eating. These beliefs may help clinicians develop patient-centered nutritional interventions.