Martinez Leal Isabel, Pillai Ashwathy B, Foreman Jessica T, Siu Kimberly W, Heredia Natalia I, Escalante Carmen, Manzullo Ellen F, Christie Aimee J, Lacourt Tamara E, Razouki Zayd A, Hwang Jessica P
The University of Texas MD Anderson Cancer Center.
University of Washington.
Res Sq. 2023 Sep 4:rs.3.rs-3232672. doi: 10.21203/rs.3.rs-3232672/v1.
Nearly 60% of patients with cancer have metabolic syndrome, which increases the risk of mortality, but there is no clear guidance for oncology providers about its management. Here, we report on the qualitative component of a larger mixed methods study that aimed to understand cancer patients' knowledge, attitudes, and preferences regarding metabolic syndrome.
Adult cancer patients with metabolic syndrome were recruited during 2022-2023 in the MD Anderson General Internal Medicine clinic and participated in semistructured interviews focused on metabolic syndrome and lifestyle interventions. Interviews were audio-recorded and transcribed verbatim. Participants' demographic information was collected. Interviews were analyzed using hybrid thematic analysis and constant comparison involving deductive and inductive coding. Researcher triangulation and debriefing were used to ensure rigor.
There were 19 participants, 12 female and 12 White. Eighteen had solid tumors, including gynecologic (n = 5), genitourinary (n = 4), colorectal (n = 3), and breast (n = 2). Analysis yielded 5 major themes: 1) patients' understanding of metabolic syndrome; 2) attitudes about and approaches to managing metabolic syndrome; 3) capacity and limitations regarding managing metabolic syndrome; 4) patient-led care; and 5) tailored intervention plans. Participants had limited knowledge of metabolic syndrome and its cancer-related consequences; most desired additional education. Many participants reported that their cancer or diabetes diagnosis motivated them to prioritize lifestyle Modifications. Participants expressed strong interest in personalized care plans focused on healthy lifestyle rather than simply weight loss. As part of their tailored intervention plans, participants desired clear communication with their medical team, coordination of care among team members, and collaboration with providers about treatment decisions.
Cancer patients with metabolic syndrome want collaborative, patient-centered care. Shared decision-making based on respect for patients' distinctive needs and preferences is an essential component of the development of such collaborative care. Tailored interventions, practical implementation strategies, and personalized care plans are needed for cancer patients with metabolic syndrome. The study findings contribute to filling the gap in knowledge regarding clear guidance for oncology providers on managing metabolic syndrome and will inform the development of future lifestyle interventions for patients diagnosed with metabolic syndrome.
近60%的癌症患者患有代谢综合征，这增加了死亡风险，但肿瘤学医护人员在其管理方面没有明确的指导意见。在此，我们报告一项更大规模的混合方法研究的定性部分，该研究旨在了解癌症患者对代谢综合征的知识、态度和偏好。
2022年至2023年期间，在MD安德森综合内科诊所招募了患有代谢综合征的成年癌症患者，他们参与了聚焦于代谢综合征和生活方式干预的半结构化访谈。访谈进行了录音并逐字转录。收集了参与者的人口统计学信息。采用混合主题分析和涉及演绎编码与归纳编码的持续比较法对访谈进行分析。运用研究者三角互证和汇报总结来确保研究的严谨性。
共有19名参与者，其中12名女性，12名白人。18人患有实体瘤,包括妇科肿瘤（5例）、泌尿生殖系统肿瘤（4例）、结直肠癌（3例）和乳腺癌（2例）。分析得出5个主要主题：1）患者对代谢综合征的理解；2）对代谢综合征管理的态度和方法；3）代谢综合征管理的能力和局限；4）患者主导的护理；5）量身定制的干预计划。参与者对代谢综合征及其与癌症相关的后果了解有限；大多数人希望获得更多教育。许多参与者表示，他们的癌症或糖尿病诊断促使他们优先进行生活方式的改变。参与者对专注于健康生活方式而非单纯减肥的个性化护理计划表现出浓厚兴趣。作为其量身定制的干预计划的一部分，参与者希望与医疗团队进行清晰的沟通，团队成员之间进行护理协调，并就治疗决策与医护人员合作。
患有代谢综合征的癌症患者希望获得以患者为中心的协作式护理。基于尊重患者独特需求和偏好的共同决策是发展这种协作式护理的重要组成部分。患有代谢综合征的癌症患者需要量身定制的干预措施、切实可行的实施策略和个性化的护理计划。该研究结果有助于填补肿瘤学医护人员在管理代谢综合征方面缺乏明确指导的知识空白，并将为未来为诊断为代谢综合征的患者制定生活方式干预措施提供参考。
