Psychometric properties of the Chinese version of the chemotherapy-induced taste alteration scale

Oral frailty and its influencing factors in patients with cancer undergoing chemotherapy: a cross-sectional study

BACKGROUND

Oral frailty is one of the easily overlooked complications in patients with cancer, which is as important as dietary dysfunction, malnutrition and other complications. However, limited research exists on the factors influencing oral frailty in patients with cancer undergoing chemotherapy. The objective of this study is to investigate the incidence of oral frailty in patients with cancer undergoing chemotherapy and to analyze the factors that influence it.

METHODS

A convenience sampling method was used to select patients with cancer undergoing chemotherapy from three tertiary hospitals in Chengdu, Sichuan Province. The Oral Frailty Index-8 (OFI-8) was utilized to assess the patients' oral frailty status. The Chemotherapy-induced Taste Alteration Scale(CiTAS), the Acceptance of Illness Scale(AIS), and the Family Adaptation, Partnership, Growth, Affection, Resolve Index(APGAR) were used to assess the patients' taste changes, levels of acceptance of illness, and family functioning levels, respectively. Additionally, descriptive analysis, univariate analysis, and multiple linear stepwise regression analysis were conducted.

RESULTS

The incidence of oral frailty among patients with cancer undergoing chemotherapy was found to be 57.58%. Additionally, oral frailty was positively correlated with chemotherapy-induced taste alteration, while it was negatively correlated with acceptance of illness and family functioning. Furthermore, multiple linear stepwise regression analysis revealed that factors such as disease duration, history of radiation therapy, dry mouth, dentures, chemotherapy-induced taste alteration, acceptance of illness, and family functioning significantly influenced oral frailty in these patients, accounting for a total variance of 54.6%.

CONCLUSION

The incidence of oral frailty is notably high among patients with cancer undergoing chemotherapy. Several factors, such as disease duration, history of radiation therapy, dry mouth, the use of dentures, chemotherapy-induced taste alteration, acceptance of illness, and family functioning, significantly affect the degree of oral frailty. This highlights the necessity for healthcare providers to implement preventive management strategies based on these factors, and to modify oral care plans accordingly to prevent or mitigate the onset and progression of oral frailty in patients with cancer undergoing chemotherapy.

Taste dysfunction symptoms experience in head and neck cancer patients undergoing proton and heavy ion therapy: a qualitative study

OBJECTIVE

Exploring the experiences and perceptions of head and neck cancer (HNC) patients undergoing proton heavy ion therapy who develop taste dysfunction during treatment to improve taste dysfunction management for these patients.

DESIGN

A qualitative study design using a descriptive phenomenological approach.

METHOD

Conducted individual face-to-face semi-structured interviews in the Head and Neck Tumor Department of the Shanghai Proton and Heavy Ion Center from February to April 2024.

RESULTS

The experiences of patients with HNC undergoing proton and heavy ion radiotherapy revealed four key themes: the diversity of taste dysfunction (including reduced or lost perception of sweet, sour, bitter, and other tastes, as well as altered and distorted taste of certain foods); the impact of taste dysfunction on quality of life (changes in dietary habits, malnutrition and weight fluctuations, mental health, and social impacts); strategies for coping with taste dysfunction (altering dietary habits and increasing the use of seasonings to compensate for taste reduction, seeking social support, and engaging in mental health activities to manage emotional distress); and expectations from the healthcare team (need for information and support, psychological support services, and monitoring and evaluation).

CONCLUSION

Patients with HNC undergoing proton and heavy ion therapy experience significant taste dysfunction. Therefore, during proton and heavy ion therapy for HNC, it is crucial to closely monitor and effectively manage taste dysfunction to enhance patients' quality of life and treatment outcomes. Future research should further explore the mechanisms of taste dysfunction and develop interventions to better meet patients' needs and improve the individualization of treatment.

Evaluating the efficacy of auricular acupuncture for chemotherapy-induced taste alterations: A pilot randomized controlled trial

PURPOSE

Irrespective of the development of acupuncture-based interventions, clinical evidence regarding their efficacy remains controversial owing to issues with the study design and an unclear risk of bias. This study aimed to evaluate the efficacy of auricular acupuncture in managing taste alterations in patients with cancer undergoing platinum-based chemotherapy.

METHODS

We conducted a pilot randomized controlled trial involving 73 patients randomly assigned to an auricular acupuncture or a control group. The primary outcome was the severity of chemotherapy-induced taste alterations, and the secondary outcomes included quality of life and negative emotions of the patients.

RESULTS

A total of 49 participants completed the study. Compared to the control group, patients in the auricular acupuncture group showed significant reductions in discomfort, general taste alterations, and total scores on the Chemotherapy-induced Taste Alteration Scale (all p < 0.05). Furthermore, we observed significant improvements in quality of life, including physical function (p = 0.007), role function (p = 0.006), emotional function (p = 0.016), nausea and vomiting (p = 0.021), appetite loss (p = 0.046), and significant improvements in anxiety and depression (p < 0.01).

CONCLUSIONS

Our findings suggest that auricular acupuncture may be a beneficial intervention for managing chemotherapy-induced taste alterations in patients with cancer receiving platinum-based chemotherapy. It may also contribute to improvements in quality of life and negative emotions. However, these results are preliminary, and further evaluation with larger randomized controlled trials is necessary.

Taste alterations in patients following hematopoietic stem cell transplantation: A qualitative study

Objective

This study aims to explore the experiences and consequences of taste alterations in patients undergoing HSCT, how they respond to these changes, and the factors that influence their responses.

Methods

In this descriptive qualitative study, face-to-face semi-structured individual interviews were conducted with 31 patients undergoing HSCT in a comprehensive hospital in Hubei, China. The interview data were transcribed and analyzed using Colaizzi's seven-step analysis. The Symptom Management Theory was applied to design the study and identify key themes.

Results

Three key themes were identified from the theory: (1) the complexity and diversity of taste experiences; (2) coping strategies; and (3) the multifaceted challenges of coping. Taste alterations in HSCT patients were characterized by diversity and dynamism. Patients employed three distinct coping styles in response to taste alterations: active coping, reluctant submission, and passive coping. These coping styles were influenced by various factors, including the specific treatment modalities of HSCT, individual patient characteristics, and the healthcare environment.

Conclusions

The experience of taste alterations among HSCT patients is intricate and varied, and the importance of addressing this symptom can easily be underestimated. Management of taste alterations is influenced by multiple factors. Nursing staff should give careful attention to taste alterations in HSCT survivors, enhance their expertise in managing taste alterations, provide robust health education, conduct regular screening and assessments, and formulate individualized intervention plans to assist patients in actively and effectively managing taste alterations.

Protocol for the ASTRO study (SSOP-01): a multicentre prospective cohort study investigating adverse events based on electronic patient-reported outcomes in patients with breast cancer after adjuvant chemotherapy

INTRODUCTION

Symptom-related adverse events associated with perioperative chemotherapy in patients with breast cancer include short-term adverse events such as nausea and vomiting. However, changes in the severity and duration of prolonged symptom-related adverse events have not been fully investigated. We present a protocol of a study that aims to clarify the prevalence of symptom-related adverse events in patients with breast cancer 1 year after neoadjuvant or adjuvant chemotherapy using an electronic patient-reported outcomes (ePRO) system.

METHODS AND ANALYSIS

This multicentre prospective observational cohort study will include patients with breast cancer who have received preoperative or postoperative adjuvant chemotherapy. The final injection date of the cytotoxic agent will be the study initiation date. Patients will report every 2 weeks from the initiation date to 12 weeks and every 4 weeks from 12 weeks to 1 year, and they can enter this information into the ePRO system from anywhere. The primary outcome will be the prevalence of symptom-related adverse events according to the ePRO system 1 year after the date of the last injection of the cytotoxic drug used in neoadjuvant or adjuvant chemotherapy for breast cancer. To increase multi-institutional enrolment, two cohorts will be included. Cohort 1 will comprise patients with acquisition of baseline patient information regarding preoperative chemotherapy and presurgery characteristics. Cohort 2 will comprise patients without acquisition of baseline patient information. The target sample size is ≥250 per year.

ETHICS AND DISSEMINATION

The study protocol has been approved by the ethics committee at each participating institution. The results will be presented at major national and international conferences and submitted to peer-reviewed journals.

TRIAL STATUS

Registration was started in October 2021. By August 2022, a total of 132 participants were enrolled. Follow-up will be continued through December 2024.

TRIAL REGISTRATION NUMBER

UMIN000045422.

Taste alterations and oral discomfort in patients receiving chemotherapy

PURPOSE

Taste alterations (TA) and oral discomfort in cancer patients are neglected side effects of the disease and treatments. They contribute to poor appetite, decrease food intake and affect quality of life, leading to adverse outcomes such as malnutrition and depression. The study aimed to explore TAs in relation to other oral conditions causing discomfort in cancer patients. Additionally, the correlation between patients' acidity of saliva and experienced TAs and oral discomfort was evaluated.

METHODS

A case study including 100 patients diagnosed with cancer receiving chemotherapy or immunotherapy. Data were collected using two questionnaire forms: the Chemotherapy-induced Taste Alteration Scale (CiTAS) and an additional information questionnaire. Saliva samples were collected for each patient and measured with a pocket pH meter. Data were analysed using descriptive statistics, and comparisons were performed using the Kruskal-Wallis H test, Mann-Whitney U test and Fisher's exact test.

RESULTS

The prevalence of reported TAs was 93%. Patient age, oral discomfort and swallowing difficulty were found to be significant factors for experienced TAs (p < 0.05). No correlation between patients' acidity of saliva and reported TAs and oral discomfort was found.

CONCLUSION

CiTAS proved to be a convenient tool to collect information about TAs in cancer patients. Using the CiTAS tool, a high prevalence (93%) of reported TAs in cancer patients receiving chemo- or immunotherapy was found. CiTAS provides a fast and cheap recognition of symptoms and causes of TAs that can be addressed.

Validation of the Chinese version of chemotherapy-induced Taste Alteration Scale among patients with head and neck cancer undergoing radiotherapy

PURPOSE

To validate the Chinese version of the Chemotherapy-induced Taste Alteration Scale (CiTAS) among patients with head and neck cancer (HNC) undergoing radiotherapy (RT).

METHODS

Patients with HNC undergoing RT were enrolled from a cancer hospital. Data were collected by face-to-face interview. Patients' subjective taste alterations (TAs) were assessed by the CiTAS. The content validity was evaluated by five experts. Confirmatory and exploratory factor analysis were used to assess construct validity. Convergent validity was assessed by the correlation between the CiTAS score and the Quality of Life Questionnaire-Core 30 (QLQ-C30) score. A single-item subjective intensity taste alteration question and quartiles of RT duration were used to assess the discriminant validity. The reliability was assessed by the Cronbach's alpha and test-retest reliability.

RESULTS

253 patients participated this investigation and 25 patients completed twice. Confirmatory factor analysis showed that the original CiTAS structure with four dimensions was not applicable to patients with HNC undergoing RT. The Chinese version of modified-CiTAS (m-CiTAS) retained 17 items (the item "bothered by the smell of food" was deleted) loading onto three factors: decline in taste, discomfort, and phantogeusia and parageusia. The m-CiTAS showed acceptable correlations with the QLQ-C30. It could effectively discriminate the intensity of subjective TAs according to the single-item question and quartiles of RT duration. The m-CiTAS showed acceptable internal consistency (Cronbach's alpha = 0.573-0.958) and test-retest reliability (r = 0.726-0.831, P < 0.05).

CONCLUSIONS

The Chinese version of m-CiTAS is an acceptable and applicable instrument to evaluate TAs among patients with HNC undergoing RT.