J Acad Nutr Diet. 2020 Oct;120(10):1643-1653. doi: 10.1016/j.jand.2020.04.016. Epub 2020 Jul 7.
Head and neck cancer (HNC) survivors may face an array of nutrition impact symptoms (NIS), including dysphagia, xerostomia, taste alterations, and difficulty chewing, which occur as a result of tumor location and treatment with radiation. Few qualitative studies have assessed the chronic impact of NIS on everyday life.
The aim of this study was to obtain a comprehensive understanding of the lived experience of chronic NIS burden on HNC survivors.
Semi-structured, face-to-face interviews were conducted with 31 HNC survivors to address the research aims and objectives. An interview guide was utilized to consider themes that had been generated through the review of literature and through the researchers' clinical experience within the field. There were probes within the interview for participants to raise unanticipated issues and flexibility to follow such leads. Interviews were conducted between March 2018 and May 2019.
A single researcher conducted the interviews to maintain consistency in data collection. Interviews lasted approximately 1 hour and were audio-recorded. All interview transcripts were professionally transcribed verbatim and checked for accuracy to ensure a complete account of participants' responses. Two researchers applied qualitative thematic content analysis to identify major themes.
The following 4 major thematic categories emerged from the interview data: symptom presence, dietary preferences, eating adjustments, and addressing symptoms. The most common symptoms were dysphagia, xerostomia, taste alterations, and bothered chewing. As a result of dietary preferences, survivors avoided citrus fruits, dry foods, raw vegetables, sweets, and meats. Survivors preferred soft and moist foods, spices or seasonings, and sauces or gravies. Eating adjustments were described as increased time to consume meals, cutting food into smaller pieces, consuming less food, and consuming more fluid. As a result of food preference changes and eating adjustments, survivors reported dietary pattern changes from pre to post treatment. All survivors experienced 1 or more chronic NIS, yet nearly 40% were unaware before treatment that NIS had the potential to persist chronically.
The results of this study provide unique qualitative insight into the lived experience of chronic NIS burden on HNC survivors. By recognizing the daily challenges, health care team members can better support HNC survivors in the transition from active treatment to follow-up care.
头颈部癌症（HNC）幸存者可能会面临一系列营养影响症状（NIS），包括吞咽困难、口干、味觉改变和咀嚼困难，这些症状是由于肿瘤位置和放射治疗引起的。很少有定性研究评估 NIS 对日常生活的慢性影响。
本研究旨在全面了解 HNC 幸存者慢性 NIS 负担对日常生活的影响。
对 31 名 HNC 幸存者进行了半结构化的面对面访谈，以解决研究目的和目标。使用访谈指南考虑了通过文献回顾和研究人员在该领域的临床经验产生的主题。访谈中还设置了探针，以便参与者提出意外问题，并灵活跟进这些线索。访谈于 2018 年 3 月至 2019 年 5 月进行。
一名研究人员进行了访谈，以保持数据收集的一致性。访谈持续约 1 小时，并进行了录音。所有访谈记录均由专业人员逐字转录，并进行准确性检查，以确保参与者回答的完整记录。两名研究人员应用定性主题内容分析来确定主要主题。
访谈数据中出现了以下 4 个主要主题类别：症状存在、饮食偏好、饮食调整和症状处理。最常见的症状是吞咽困难、口干、味觉改变和咀嚼不适。由于饮食偏好，幸存者避免食用柑橘类水果、干燥食物、生蔬菜、甜食和肉类。幸存者喜欢软而湿润的食物、香料或调味料以及酱汁或肉汁。饮食调整包括进食时间延长、将食物切成小块、减少进食量以及增加液体摄入量。由于食物偏好改变和饮食调整，幸存者报告治疗前后饮食模式发生了变化。所有幸存者都经历了 1 种或多种慢性 NIS，但近 40%的幸存者在治疗前并不知道 NIS有可能持续存在。
本研究的结果提供了对 HNC 幸存者慢性 NIS 负担对日常生活影响的独特定性见解。通过认识到日常挑战，医疗保健团队成员可以更好地支持 HNC 幸存者从积极治疗过渡到随访护理。
