Nguyen Grace, Furness Kate, Croagh Daniel, Haines Terry, Hanna Lauren
Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia.
Department of Sport, Exercise and Nutrition Sciences, La Trobe University, Bundoora, Victoria, Australia.
BMJ Support Palliat Care. 2024 Dec 19;14(e3):e3002-e3010. doi: 10.1136/spcare-2024-004836.
Malnutrition is associated with poor quality of life and survival outcomes for patients with cancer, but is challenging to prevent or treat in pancreatic cancer due to the multifactorial drivers of nutritional decline. A novel application of percutaneous endoscopic gastrostomy with a jejunal extension tube to deliver supplementary nutrition may improve outcomes, and will be tested in a randomised controlled trial. This study explored the perspectives of people living with pancreatic cancer regarding the acceptability of this proposed intensive nutrition intervention, to elucidate appropriateness and anticipated barriers, and facilitate informed design of the planned trial.
Participants were patients with pancreatic cancer previously enrolled in a Pancreaticobiliary Cancer Biobank. Qualitative semi-structured interviews were conducted by telephone and transcribed verbatim for deductive thematic analysis. The Framework Model was used, with the Theoretical Framework of Acceptability as the analytical framework.
10 participants were recruited. Four overarching themes were developed from interviews: (1) deterioration in physical and mental well-being are consequences of debilitating nutrition impact symptoms; (2) willingness to participate depends on an individual threshold for nutritional deterioration; (3) predicted perceived effectiveness outweighed anticipated burdens and (4) adequate dietetic support is needed for maintaining a percutaneous endoscopic gastrostomy with jejunal extension feeding tube at home with confidence.
Most participants believed that the intervention would benefit people with advanced pancreatic cancer to maintain their nutrition throughout chemotherapy. Regular and ad hoc support was considered essential, and the degree of individual nutritional deterioration was identified as an important indicator for trial participation.
营养不良与癌症患者的生活质量差和生存结果不佳相关，但由于营养状况下降的多因素驱动，胰腺癌患者的营养不良预防或治疗具有挑战性。经皮内镜胃造口术联合空肠延长管输送补充营养的新应用可能会改善治疗效果，并将在一项随机对照试验中进行测试。本研究探讨了胰腺癌患者对这种拟议的强化营养干预措施可接受性的看法，以阐明其适宜性和预期障碍，并为计划中的试验提供信息，以促进试验设计。
参与者为先前已纳入肝胆胰腺癌生物样本库的胰腺癌患者。通过电话进行定性半结构化访谈，并逐字转录以进行演绎主题分析。使用框架模型，以可接受性理论框架作为分析框架。
招募了10名参与者。访谈形成了四个总体主题：（1）身心健康的恶化是营养影响症状使人虚弱的后果；（2）参与意愿取决于个体对营养恶化的阈值；（3）预计的感知有效性超过了预期负担；（4）在家中自信地维持经皮内镜胃造口术联合空肠延长喂养管需要足够的饮食支持。
大多数参与者认为该干预措施将有利于晚期胰腺癌患者在整个化疗过程中维持营养。定期和临时支持被认为是必不可少的，个体营养恶化程度被确定为试验参与的重要指标。
