Emily Hazzard1,2, Jennifer Haughton3, Janaye Fish4, Marianna Milosavljevic5, Vhari Dickson6, Jessica Boehm7, Karen Walton8, Bruce Ashford5. 1. Department of Nutrition and Dietetics, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia. emily.hazzard1@health.nsw.gov.au. 2. School of Medicine, University of Wollongong, Wollongong, NSW, 2522, Australia. emily.hazzard1@health.nsw.gov.au. 3. Department of Nutrition and Dietetics, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia. 4. Research Central, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia. 5. Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia. 6. Illawarra and Shoalhaven Cancer Care Centres, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia. 7. Department of Speech Pathology, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia. 8. School of Medicine, University of Wollongong, Wollongong, NSW, 2522, Australia.
Abstract
PURPOSE: Malnutrition is a co-morbidity of head and neck cancer (HNC) that has negative consequences for patients. Evidence-based guidelines (EBGs) provide recommendations to prevent and manage malnutrition. A clinic that combines the services of a dietitian, specialist oncology nurse and speech pathologist may promote the implementation of nutritional EBGs in regional Australia. This study aimed to explore the nutritional care experience that patients with HNC had in this setting. METHODS: A qualitative longitudinal study collected data via semi-structured interviews with HNC patients who were treated in one regional cancer care network in Australia. Interviews were conducted at key points in their HNC journey from diagnosis to 4 months post-radiotherapy. Data was analysed using a grounded theory approach. RESULTS: Ten participants completed a total of thirty-six interviews. The findings were grouped into four categories: "preparing for nutritional challenges", "multidisciplinary care directed by patient needs", "the battle to eat", and "incongruence between patient values and nutritional priorities". CONCLUSION: These findings highlight the nutritional burden associated with HNC and barriers to patients accepting nutritional support from healthcare professionals. Information provided by doctors and nurses prior to treatment may help patients prepare for the nutritional challenges ahead and accept support from dietitians. Furthermore, clinics that promote continuity through treatment and allow dietitians to lead aspects of nutritional care, in collaboration with nurses, speech pathologists and doctors, may also enhance the nutritional care experience. More qualitative research within HNC teams would provide further insight on enhancing the implementation of nutritional EBGs to improve outcomes for these patients.
PURPOSE:Malnutrition is a co-morbidity of head and neck cancer (HNC) that has negative consequences for patients. Evidence-based guidelines (EBGs) provide recommendations to prevent and manage malnutrition. A clinic that combines the services of a dietitian, specialist oncology nurse and speech pathologist may promote the implementation of nutritional EBGs in regional Australia. This study aimed to explore the nutritional care experience that patients with HNC had in this setting. METHODS: A qualitative longitudinal study collected data via semi-structured interviews with HNC patients who were treated in one regional cancer care network in Australia. Interviews were conducted at key points in their HNC journey from diagnosis to 4 months post-radiotherapy. Data was analysed using a grounded theory approach. RESULTS: Ten participants completed a total of thirty-six interviews. The findings were grouped into four categories: "preparing for nutritional challenges", "multidisciplinary care directed by patient needs", "the battle to eat", and "incongruence between patient values and nutritional priorities". CONCLUSION: These findings highlight the nutritional burden associated with HNC and barriers to patients accepting nutritional support from healthcare professionals. Information provided by doctors and nurses prior to treatment may help patients prepare for the nutritional challenges ahead and accept support from dietitians. Furthermore, clinics that promote continuity through treatment and allow dietitians to lead aspects of nutritional care, in collaboration with nurses, speech pathologists and doctors, may also enhance the nutritional care experience. More qualitative research within HNC teams would provide further insight on enhancing the implementation of nutritional EBGs to improve outcomes for these patients.
Entities:
Keywords:
Cancer treatment; Head and neck cancer; Longitudinal research qualitative research; Multidisciplinary teams; Nutritional care; Patient experience
Authors: Heidi Ganzer; Riva Touger-Decker; Laura Byham-Gray; Barbara A Murphy; Joel B Epstein Journal: Oral Oncol Date: 2015-04-29 Impact factor: 5.337
Authors: Nicole K Kiss; Meinir Krishnasamy; Jenelle Loeliger; Alba Granados; Gaelle Dutu; June Corry Journal: Support Care Cancer Date: 2011-11-16 Impact factor: 3.603
Authors: Valentina Bressan; Annamaria Bagnasco; Giuseppe Aleo; Gianluca Catania; Milko P Zanini; Fiona Timmins; Loredana Sasso Journal: Support Care Cancer Date: 2017-02-15 Impact factor: 3.603
Authors: J A E Langius; S Bakker; D H F Rietveld; H M Kruizenga; J A Langendijk; P J M Weijs; C R Leemans Journal: Br J Cancer Date: 2013-08-08 Impact factor: 7.640