Ganzer Heidi, Rothpletz-Puglia Pamela, Byham-Gray Laura, Murphy Barbara A, Touger-Decker Riva
Department of Nutritional Sciences, Rutgers, The State University of New Jersey, School of Health Related Professions, 65 Bergen Street, Room 157, Newark, NJ, 07107-3001, USA.
Coordinated Program in Nutrition and Dietetics, Rutgers, The State University of New Jersey, School of Health Related Professions, 65 Bergen Street, Room 156, Newark, NJ, 07107-3001, USA.
Support Care Cancer. 2015 Nov;23(11):3257-68. doi: 10.1007/s00520-015-2730-9. Epub 2015 Apr 8.
This study explored the eating experience in long-term survivors of head and neck cancer (HNC) ≥3 years post concurrent chemoradiation. Quality of life (QOL) and the meanings and perceptions survivors had as it related to the eating experience were explored.
Purposive sampling was utilized; 10 long-term survivors of HNC participated in the study. A mixed-methods approach was used; exploratory qualitative research using content analysis and summary statistics was used to describe demographic and clinical characteristics and the Vanderbilt Head and Neck Symptom Survey version 2.0 scores (VHNSS 2.0).
Four categories (psychological, social impact, functional status, and the current eating experience) containing 15 subthemes and 1 overarching theme (adaptation) emerged. Current health status, QOL, and QOL related to eating were viewed favorably despite the impact of treatment late effects on participants' daily lives. Adaptation and maladaptation in regard to food choice and downplaying of symptoms were recognized. Interviews as well as the VHNSS 2.0 scores indicated that xerostomia, mucosal sensitivity, swallowing difficulty, length of time required to eat, and dysgeusia remained problematic.
Psychological, functional, and social losses associated with eating were identified. Participants modify or avoid foods that are challenging yet report enjoyment with eating. Challenges with eating were downplayed. Due to the potential negative nutritional and social implications of avoiding specific food/food groups, standard of care in long-term survivors of HNC should include assessment of the eating experience and functional challenges. Nutrition professional can help patients optimize dietary intake and the eating experience.
本研究探讨了头颈部癌(HNC)长期幸存者在同步放化疗后≥3年的进食体验。研究还探讨了生活质量(QOL)以及幸存者与进食体验相关的意义和认知。
采用目的抽样法;10名头颈部癌长期幸存者参与了本研究。采用混合方法;运用内容分析和汇总统计的探索性定性研究来描述人口统计学和临床特征以及范德比尔特头颈部症状调查2.0版(VHNSS 2.0)得分。
出现了包含15个子主题的四个类别(心理、社会影响、功能状态和当前进食体验)以及一个总体主题(适应)。尽管治疗的晚期效应会对参与者的日常生活产生影响,但参与者对当前的健康状况、生活质量以及与进食相关的生活质量评价良好。在食物选择和对症状的淡化方面,适应和适应不良的情况都得到了确认。访谈以及VHNSS 2.0得分表明,口干、黏膜敏感、吞咽困难、进食所需时间以及味觉障碍仍然是问题。
确定了与进食相关的心理、功能和社会损失。参与者会改变或避免食用具有挑战性的食物,但仍表示享受进食过程。他们淡化了进食方面的挑战。由于避免特定食物/食物组可能会对营养和社会产生潜在的负面影响,头颈部癌长期幸存者的护理标准应包括对进食体验和功能挑战的评估。营养专业人员可以帮助患者优化饮食摄入和进食体验。