Bernhardson Britt-Marie, Tishelman Carol, Rutqvist Lars Erik
Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, R & D Unit, Stockholms Sjukhem Foundation, Mariebergsgatan 22, 112 35 Stockholm, Sweden.
J Pain Symptom Manage. 2007 Oct;34(4):403-12. doi: 10.1016/j.jpainsymman.2006.12.010. Epub 2007 Jul 5.
Few studies explore patients' experiences of smell and taste changes during cytotoxic chemotherapy. Issues, such as how such changes impact daily life, their consequences, and how patients respond to chemotherapy-induced chemosensory changes, have not previously been systematically addressed. The aim of this study was to examine these questions by exploring experiences of chemotherapy-induced chemosensory changes. In this qualitative longitudinal study, semistructured interviews were conducted with 14 women and 7 men with a variety of cancer diagnoses, who were known to have smell and taste changes. The participants were chosen for heterogeneity in regard to factors that might impact on experiences of chemotherapy. Participants were followed monthly until chemosensory changes ceased. There was great individual variation in patterns, intensity and impact of smell and/or taste changes, with changes reported to have ceased in all participants within 3.5 months after treatment ended. While not all participants found reported changes "bothersome," those who did reported predominantly emotional and social consequences. Smell and taste changes were said to be influenced by, or to influence, other symptoms, for example, appetite loss, early satiation, nausea, and oral problems. Although participants said they lacked ways to manage chemosensory changes, coping strategies described included frequent oral hygiene, searching for tolerable food, relying on smell and taste memory, and acceptance of changes. Although chemosensory changes resolved in all participants within several months after completed chemotherapy, the reported variation in experiences of taste and smell changes makes these side effects especially challenging to assess and alleviate.
很少有研究探讨细胞毒性化疗期间患者嗅觉和味觉变化的经历。诸如这些变化如何影响日常生活、其后果以及患者如何应对化疗引起的化学感觉变化等问题,以前尚未得到系统解决。本研究的目的是通过探索化疗引起的化学感觉变化的经历来研究这些问题。在这项定性纵向研究中,对14名女性和7名男性进行了半结构化访谈,他们患有各种癌症诊断,已知有嗅觉和味觉变化。根据可能影响化疗经历的因素,选择参与者以体现异质性。每月对参与者进行随访,直到化学感觉变化停止。嗅觉和/或味觉变化的模式、强度和影响存在很大的个体差异,据报告所有参与者的变化在治疗结束后3.5个月内停止。虽然并非所有参与者都认为报告的变化“烦人”,但那些认为烦人的参与者主要报告了情感和社会方面的后果。据说嗅觉和味觉变化会受到其他症状的影响,或者会影响其他症状,例如食欲不振、早饱、恶心和口腔问题。尽管参与者表示他们缺乏应对化学感觉变化的方法,但描述的应对策略包括频繁口腔卫生、寻找可耐受的食物、依靠嗅觉和味觉记忆以及接受变化。尽管在完成化疗后的几个月内所有参与者的化学感觉变化都得到了解决,但报告的味觉和嗅觉变化经历的差异使得这些副作用在评估和缓解方面特别具有挑战性。