J Acad Nutr Diet. 2023 Mar;123(3):407-416. doi: 10.1016/j.jand.2022.08.128. Epub 2022 Aug 21.
Dietary changes often accompany management of a cancer diagnosis, but how and why patients with colorectal cancer (CRC) make dietary decisions requires further investigation.
To learn about patients' food-related beliefs and understand whether and why dietary changes were made by patients starting chemotherapy after a CRC diagnosis.
A qualitative semi-structured interview study was conducted as a secondary analysis among a subset of patients with stages II-IV CRC enrolled at baseline in a randomized controlled trial.
PARTICIPANTS/SETTING: Twenty-nine patients participated in the interview. Data were collected at the University of Alberta (Edmonton, Alberta, Canada) from 2016-2019 before any trial intervention.
Audio-recorded interviews were transcribed verbatim then coded inductively by two research team members. Qualitative content analysis was applied to capture emergent themes.
Patients reported varied degrees of dietary change that stemmed from internal and external influences. Four main themes emerged to describe patients' dietary decisions after a CRC diagnosis: 1) Medical Influences: eating to live; 2) Health Beliefs: connecting lived experiences with new realities; 3) Static Diets: no changes postdiagnosis; and 4) Navigating External Influences: confluence of personal agency and social constraints.
The extent to which patients altered their dietary choices depended on perspectives and beliefs. These included the degree to which dietary decisions provided some agency (ie, feeling of control) for dealing with physical ramifications of cancer treatment, individuals' personal understandings of healthy foods, and the role of diet in managing their new physical reality postdiagnosis. This information provides registered dietitian nutritionists and health care providers with insight into dietary intentions of select patients being treated for CRC. These findings can guide future research focused on effective strategies for streamlined nutritional support that aligns with patient needs.
癌症诊断通常伴随着饮食的改变，但结直肠癌（CRC）患者如何以及为何做出饮食决策需要进一步调查。
了解患者与食物相关的信念，并理解患者在诊断为 CRC 后开始化疗时为何以及为何做出饮食改变。
这是一项在随机对照试验的基线阶段入组的 II-IV 期 CRC 患者亚组中进行的定性半结构式访谈研究。
参与者/地点：29 名患者参加了访谈。数据于 2016-2019 年在加拿大阿尔伯塔省埃德蒙顿的阿尔伯塔大学收集，当时尚无任何试验干预。
对录音采访进行逐字转录，然后由两名研究团队成员进行归纳式编码。采用定性内容分析来捕捉出现的主题。
患者报告了不同程度的饮食改变，这些改变源自内部和外部影响。有四个主要主题描述了患者在 CRC 诊断后的饮食决策：1）医疗影响：为了生存而进食；2）健康信念：将生活经历与新现实联系起来；3）静态饮食：诊断后没有变化；4）应对外部影响：个人能动性与社会约束的融合。
患者改变饮食选择的程度取决于观点和信念。这些包括饮食决策为应对癌症治疗的身体后果提供多大程度的能动性（即控制感）、个人对健康食品的理解程度，以及饮食在管理诊断后新的身体现实中的作用。这些信息为注册营养师和医疗保健提供者提供了有关特定接受 CRC 治疗的患者饮食意图的见解。这些发现可以指导未来的研究，重点关注与患者需求一致的简化营养支持的有效策略。
