Dornan D M, Semple C J, Moorhead A
School of Nursing and Midwifery, Queen's University, Belfast, UK.
School of Nursing, Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK & Cancer Services, South Eastern Health and Social Care Trust, Belfast, UK.
Support Care Cancer. 2024 Dec 16;33(1):33. doi: 10.1007/s00520-024-09083-0.
After treatment for head and neck cancer (HNC), up to 90% of patients have difficulties eating and drinking. Despite the enormity of challenges explicitly relating to the social dimension of eating, there are limited extant interventions to specifically support social eating, nor any replicable for use in contemporary clinical practice. This study aims to plan, develop and optimise a self-management intervention to promote social eating for patients living with and beyond HNC.
This research was intervention development of a self-management 'Eating with Others' resource, guided by the person-based approach (PBA) framework. Initially, a systematic review was conducted, with 24 included studies exploring HNC patients' social eating experiences, followed by thematically analysed qualitative interviews with patients (n = 14), family members (n = 12) and healthcare professionals (n = 13). Alongside this data, iterative input was sought from an advisory group (n = 22) to culminate in an intervention prototype. The intervention prototype was iteratively user-tested over three cycles for usability and acceptability, using think-aloud interviews (n = 10).
A patient-centred, evidence-based and theory-driven self-management resource, entitled 'Eating with Others', was designed to promote social eating for patients with HNC. Sections included the benefits of social eating; the impact of HNC on social eating, strategies and reflective activities to overcome social eating barriers; and the use of a social eating card for restaurants. The think-aloud interviews revealed that the resource was appropriate and acceptable for patients with HNC.
The systematic and iterative PBA intervention development framework enabled empirical research findings, relevant theory and extensive advisory group involvement to design an acceptable self-management social eating intervention for patients living with and beyond HNC. Mixed-methods evaluation is required to determine feasibility in clinical practice.
头颈部癌症（HNC）患者在接受治疗后，高达90%的患者存在进食和饮水困难。尽管与饮食社会层面相关的挑战巨大，但目前专门支持社交饮食的干预措施有限，且在当代临床实践中没有可复制的措施。本研究旨在规划、开发和优化一种自我管理干预措施，以促进HNC患者及其康复后的社交饮食。
本研究是一项基于以人为本方法（PBA）框架的自我管理“与他人一起进食”资源的干预开发。首先进行了一项系统综述，纳入24项探索HNC患者社交饮食体验的研究，随后对患者（n = 14）、家庭成员（n = 12）和医疗保健专业人员（n = 13）进行了主题分析定性访谈。除了这些数据外，还从一个咨询小组（n = 22）寻求了迭代意见，以最终形成一个干预原型。使用出声思考访谈（n = 10），对干预原型进行了三个周期的迭代用户测试，以评估其可用性和可接受性。
设计了一个以患者为中心、基于证据且理论驱动的自我管理资源，名为“与他人一起进食”，以促进HNC患者的社交饮食。内容包括社交饮食的益处；HNC对社交饮食的影响、克服社交饮食障碍的策略和反思活动；以及餐厅社交饮食卡的使用。出声思考访谈表明，该资源对HNC患者是合适且可接受的。
系统且迭代的PBA干预开发框架使实证研究结果、相关理论和广泛的咨询小组参与能够为HNC患者及其康复后的患者设计出可接受的自我管理社交饮食干预措施。需要进行混合方法评估以确定其在临床实践中的可行性。
