School of Public Health, University of Hong Kong, Hong Kong, Hong Kong.
Division of Colorectal Surgery, Department of Surgery, University of Hong Kong, Hong Kong, Hong Kong.
Eur J Cancer Care (Engl). 2019 Nov;28(6):e13159. doi: 10.1111/ecc.13159. Epub 2019 Aug 30.
To explore influences on post-diagnosis dietary decision-making in colorectal cancer survivors (CRC) for future intervention development.
Individual semi-structured interviews were conducted with 30 CRC survivors. All interviews were recorded and transcribed verbatim for grounded theory analysis.
Most CRC survivors interviewed reported making both short- and long-term changes post-diagnosis, influenced by physical symptoms and personal beliefs: short-term treatment-driven changes to facilitate recovery, manage treatment side-effects and avoid disruption in treatment; short-term 'patient role' driven changes heavily influenced by family members and cultural beliefs; long-term changes driven by residual symptoms and illness beliefs, including cancer causal attributions and beliefs about preventing future recurrences. Traditional Chinese medicinal (TCM) beliefs were influential in both short- and long-term dietary decision-making, which may explain why survivors focused on specific food items rather than food patterns.
While our findings suggested that the majority of CRC survivors made dietary changes post-diagnosis, their dietary pattern and motivation may change over the course of their illness trajectory. Also, the types of changes made are often not consistent with existing dietary recommendations. It is necessary to consider illness perception and cultural beliefs when delivering dietary care or developing interventions for this population.
探索影响结直肠癌幸存者(CRC)诊断后饮食决策的因素,为未来的干预措施发展提供依据。
对 30 名 CRC 幸存者进行了个体半结构化访谈。所有访谈均进行了录音,并逐字转录以供扎根理论分析。
大多数接受采访的 CRC 幸存者报告在诊断后都进行了短期和长期的改变,这些改变受到身体症状和个人信念的影响:短期的治疗驱动的改变以促进康复、管理治疗副作用和避免治疗中断;短期的“患者角色”驱动的改变受家庭成员和文化信仰的强烈影响;长期的改变则受到残留症状和疾病信念的影响,包括对癌症病因的归因和预防未来复发的信念。传统中医药(TCM)信念对短期和长期的饮食决策都有影响,这可能解释了为什么幸存者关注特定的食物而不是食物模式。
虽然我们的研究结果表明,大多数 CRC 幸存者在诊断后会改变饮食,但他们的饮食模式和动机可能会随着疾病轨迹的变化而变化。此外,所做的改变类型往往与现有的饮食建议不一致。在为这一人群提供饮食护理或制定干预措施时,有必要考虑疾病认知和文化信仰。