Bernhardson Britt-Marie, Tishelman Carol, Rutqvist Lars Erik
Department of Neurobiology, Division of Nursing, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden.
Cancer Nurs. 2009 Jan-Feb;32(1):45-54. doi: 10.1097/01.NCC.0000343368.06247.74.
Few studies have described how patients receiving chemotherapy experience taste/smell changes (TSCs). Food and meal situations have important meaning beyond nutrition, so these common symptoms may affect daily lives. This study aims to investigate distress and impact on daily life from TSCs in patients receiving cancer chemotherapy, analyze reported levels of distress and impact on daily life from TSCs with regard to sociodemographic and clinical factors, and explore patients' reports of self-care strategies and communication with staff. The 340 patients reporting TSCs on a multicenter survey (n = 518) were grouped into subsets by level of TSC-related distress and impact on daily life, which served as the basis for statistical comparison. Written comments were analyzed inductively using content analysis. Nearly one-third of participating patients reported both high levels of distress and impact on daily life (high distress and high impact on daily life [HDHI]) from TSCs. The HDHI subset reported other symptoms more often than others did (P = .01) and also more often responded to open questions about distress, impact, and self-care strategies (P = .01). Taste/smell changes were not always reported to staff, even in the HDHI subset. The specific aspects of TSCs resulting in distress and impact on daily life varied greatly, affecting both psychological and somatic aspects, with little consensus and great individual differences described in self-care strategies. The variety of distress, impact, and strategies used to alleviate TSCs clarifies the importance of situational meaning.
很少有研究描述接受化疗的患者味觉/嗅觉变化（TSCs）的体验。食物和用餐情况的意义远不止于营养，因此这些常见症状可能会影响日常生活。本研究旨在调查癌症化疗患者TSCs引起的痛苦及其对日常生活的影响，分析报告的TSCs引起的痛苦程度及其对日常生活的影响与社会人口统计学和临床因素的关系，并探索患者关于自我护理策略以及与医护人员沟通的报告。在一项多中心调查（n = 518）中报告有TSCs的340名患者，根据TSC相关痛苦程度及其对日常生活的影响分为不同子集，作为统计比较的基础。采用内容分析法对书面评论进行归纳分析。近三分之一的参与患者报告称TSCs引起了高度痛苦和对日常生活的严重影响（高度痛苦和对日常生活的高度影响[HDHI]）。HDHI子集比其他子集更频繁地报告了其他症状（P = .01），并且在回答关于痛苦、影响和自我护理策略的开放性问题时也更频繁（P = .01）。即使在HDHI子集中，味觉/嗅觉变化也并非总是会告知医护人员。导致痛苦和对日常生活产生影响的TSCs的具体方面差异很大，同时影响心理和身体方面，在自我护理策略方面几乎没有共识且个体差异很大。TSCs引起的痛苦、影响以及用于缓解TSCs的策略的多样性，阐明了情境意义的重要性。
