Epsylon Laboratory EA 4556, Paul-Valéry University of Montpellier, France.
Epidaure Prevention Department of the Montpellier Cancer Institute, France.
Br J Health Psychol. 2019 May;24(2):381-395. doi: 10.1111/bjhp.12358. Epub 2019 Mar 1.
Why do patients practice fasting? The effects of fasting before treatment with chemotherapy for cancer in humans are currently unknown. However, there is an apparent enthusiasm for fasting among cancer patients. This qualitative study provides data on the motivations to fast and the experience of fasting among a population of women with breast cancer.
Sixteen semi-structured interviews were conducted, and two researchers independently performed a thematic analysis. To ensure the internal validity of the study, patients had the possibility to rate their agreement with the study results through a satisfaction questionnaire.
Six main themes were identified in this study: main reasons to fast, alternative authorities to the oncologist, adapting the fast to social and lifestyle constraints, fasting effects felt during chemotherapy, barriers and facilitators of fasting during chemotherapy, and seeking for a more integrative medicine. Patients' primary motivation to fast was to lower the negative side effects of chemotherapy. Fasting was also reported as a coping strategy to give them a greater sense of control over their treatment and to reduce their anxiety.
Results from the study suggest that, if discouraged from fasting, patients may turn to complementary health care practitioners for support. Medical professionals may thus not know of patients' fasting practice. Health psychologists could play a key role fostering the dialogue between different health professionals and the patient. They could also help to meet patients' needs during cancer treatment to reduce treatment anxiety. Statement of contribution What is already known on this subject? Fasting diet in cancer treatment has become an important topic since Raffaghello et al. published their study on mice in 2008. While the (positive) effects of fasting in humans remain to be proven, there has been a significant enthusiasm for this practice among patients in the last few years. However, patients' motivations to fast remain unclear to the scientific community and clinicians. What does this study add? This study is the first to investigate patients' motivations to fast and patients' experience of fasting in a cancer population. Patients' primary motivation to fast was to lower the side effects of chemotherapy. Fasting acts as an active coping strategy that helps to reduce anxiety. Unsupported patients may turn to complementary health care practitioners.
患者为什么要禁食？目前，人类在接受癌症化疗前禁食的效果尚不清楚。然而，癌症患者对禁食表现出明显的热情。本定性研究提供了乳腺癌患者群体禁食动机和禁食体验方面的数据。
进行了 16 次半结构式访谈，由两名研究人员独立进行主题分析。为确保研究的内部有效性，患者有机会通过满意度问卷对研究结果的认同程度进行评分。
本研究确定了 6 个主要主题：禁食的主要原因、替代肿瘤医生的权威、使禁食适应社会和生活方式的限制、化疗期间感受到的禁食效果、化疗期间禁食的障碍和促进因素、寻求更具整体性的医学。患者禁食的主要动机是降低化疗的负面副作用。禁食也被报告为一种应对策略，使他们对治疗有更大的控制感，并减轻他们的焦虑。
研究结果表明，如果患者被劝阻禁食，他们可能会寻求补充医疗保健从业者的支持。因此，医务人员可能不知道患者的禁食实践。健康心理学家可以在促进不同卫生专业人员与患者之间的对话方面发挥关键作用。他们还可以帮助满足患者在癌症治疗期间的需求，以减轻治疗焦虑。
关于这个主题，目前科学界和临床医生已经了解哪些内容？自 Raffaghello 等人 2008 年发表关于老鼠的研究以来，癌症治疗中的禁食饮食已成为一个重要话题。虽然禁食对人类的（积极）影响仍有待证实，但近年来，患者对此做法表现出了极大的热情。然而，患者禁食的动机仍然不为科学界和临床医生所了解。
这项研究有哪些新发现？这项研究首次调查了癌症患者群体禁食的动机和禁食体验。患者禁食的主要动机是降低化疗的副作用。禁食作为一种积极的应对策略，可以帮助减轻焦虑。得不到支持的患者可能会转向补充医疗保健从业者。
