A qualitative study about cancer outpatients' experiences with selective taste control of bread as a self-care intervention

Exploratory Research: Patient-Reported Factors Contributing to Decreased Oral Intake During Radiotherapy in Head and Neck Cancer

BACKGROUND

Radiotherapy (RT) in head and neck cancer (HNC) can cause multiple side effects such as nausea, pain, taste loss, fatigue, oral mucositis, xerostomia, and acute radiation-associated dysphagia (RAD). These factors threaten patients' oral intake (OI) during this RT. Reduced OI can cause weight loss, dehydration, malnutrition, and various comorbidities. On top, reduced OI significantly affects quality of life and may contribute to RAD through the disuse of swallowing muscles. With the aim of maximizing the retention of a patient's OI, it is important to gain an insight into the factors that have the greatest impact. Therefore, this study aims to identify the impact of contributing factors on decreased OI during RT.

METHODS

During their treatment, 55 HNC patients completed an OI questionnaire at 5 different time points: during weeks 1, 2, 3, and 4 and at the end of RT (week 7). First, patients rated the OI compared to pre-RT on a 100 mm visual analogue scale (VAS). Subsequently, patients reported on separate VAS the degree to which pain, fatigue, loss of taste, loss of smell, loss of interest in food, nausea, and loss of hunger contributed to the decrease in OI (0: no contribution; 100: complete contribution). SPSS version 27 was used to analyze the results.

RESULTS

OI decreased over time during RT, with the lowest OI at the end of RT. During the first 4 weeks of RT, the impact of all factors with pain, loss of taste, loss of interest in food, and loss of hunger pointed out as strongest contributing factors to a decreased OI. The most important patient-reported impacting factor on OI was loss of taste. At the end of RT, the importance of pain and nausea still increases, while the contribution of the other factors drops slightly.

CONCLUSION

This cohort study shows that several factors contribute to a decreased OI in HNC patients during RT. This study is the first prospective analysis to identify self-reported factors contributing to reduced OI. Results demonstrate that taste has the greatest impact on OI followed by loss of interest in food, loss of hunger, and pain.

Effects of selective taste steering of bread and soups on quality of life in adult cancer outpatients who experience chemotherapy-induced taste alterations

PURPOSE

To investigate the effectiveness of selective taste steering (STS) to hyper personalize bread and soup for adult cancer outpatients with chemotherapy-induced taste alterations.

METHODS

This multicentre study included two groups of adult cancer outpatients with CiTA, all receiving dietary advice as standard care. In one group, STS was applied to bread and soups for three months. Outcomes were compared using validated scales and a structured questionnaire at baseline and after one and three months of follow-up.

RESULTS

At baseline, 19.3% of all patients (N = 160) had a normal nutritional status. Compared to the intervention group, undernutrition in the control group increased significantly after 1 month (p < .001) and 3 months (p < .001). In the intervention group, the score for 'appetite loss' decreased after 1 month (p < .001) and remained low after 3 months of follow-up (p < .001). The 'fatigue, ' 'nausea/vomiting' and 'diarrhea' symptom scores in the intervention group decreased significantly (p < .001, <.001 and < .002, respectively).

CONCLUSION

STS decreased loss of appetite and improved palatability and food intake as well as food-related symptoms of QOL in adult cancer outpatients with CiTA These findings are clinically relevant and support a hyper-personalized approach to malnutrition in cancer patients.

Turning a Curve: How People Use Everyday Resources to Negotiate Recovery From Cancer Treatment With Curative Intent

Many more cancers are treated with intent to cure now than in previous decades, but for most, this involves significant effects from which people need to recover psychologically and socially, as well as physically. This longitudinal photo-elicitation interview study uses grounded theory to explain how people discharged from specialist care made use of everyday social and material resources to manage this process at home. Recovery is presented as a curve in life's pathway requiring gradual reorientation, drawing on social worlds and domestic resources to calibrate this process. Findings are described in three stages: (1) responding to diagnosis and treatment, (2) using social resources for meaning-making, and (3) developing assets for recovery. During treatment, participants drew on past identities to reinforce their sense of self, and personalized health care communication supported this process. In the weeks after treatment, new frameworks of understanding were constructed from perspectives on cancer encountered in the family, workplace, and outpatient clinics. Recovery processes included the negotiation of personal change, the renegotiation of close relationships, and the use of everyday resources to regain three sensations: control, comfort, and continuity. Supportive care would benefit from an individualized exploration of the assets that can help people to negotiate this challenging phase as treatment comes to a close. Possibilities for self-care (the maintenance of health and well-being in the context of everyday life) can be explored and assessed through personalized discussion around the identities, social worlds, and everyday resources available to each individual.