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Open Access 01-07-2018 | Original Article

Head and neck cancer patient experience of a new dietitian-delivered health behaviour intervention: ‘you know you have to eat to survive’

Authors: Kristen McCarter, Amanda L. Baker, Ben Britton, Sean A. Halpin, Alison Beck, Gregory Carter, Chris Wratten, Judith Bauer, Luke Wolfenden, Katrina Burchell, Erin Forbes

Published in: Supportive Care in Cancer | Issue 7/2018

Abstract

Purpose

The aim of this study was to explore head and neck cancer (HNC) patient experiences of a novel dietitian delivered health behaviour intervention.

Methods

This study is a qualitative study which employed semi-structured individual interviews using open and axial coding and then final selective coding to organise the data. Patients with HNC who had participated in a dietitian delivered health behaviour intervention to reduce malnutrition were invited to discuss their experience of this intervention. Individual interviews were conducted, transcribed and analysed using grounded theory.

Results

Nine patients participated in the interviews. Four dimensions were identified in the initial coding process: ‘information’, which described patients’ desire for tailored advice during their treatment; ‘challenges of treatment experience’, which described the difficulties related to treatment side effects; ‘key messages: importance of eating and maintaining weight’, which covered perceived integral messages delivered to patients by dietitians; and ‘dietitian’s approach’ describing patient experiences of empathic and compassionate dietitians. Two overarching themes resulted from examining the connections and relationships between these dimensions: ‘survival’, a connection between eating and living; and ‘support’, describing the valued working partnership between dietitian and patient.

Conclusions

Dimensions and themes overlapped with the qualitative literature on HNC patient experience of treatment. However, some themes, such as the empowerment of a message linking eating to survival, appeared unique to this study. Patients found this message to be delivered in a supportive manner that motivated change.

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Lees J (1999) Incidence of weight loss in head and neck cancer patients on commencing radiotherapy treatment at a regional oncology centre. Eur J Cancer Care 8(3):133–136. https://doi.org/10.1046/j.1365-2354.1999.00156.x CrossRef

Kruizenga HM, Wierdsma NJ, van Bokhorst MA, Hollander H, Jonkers-Schuitema C, Van Der Heijden E et al (2003) Screening of nutritional status in The Netherlands. Clin Nutr 22(2):147–152. https://doi.org/10.1054/clnu.2002.0611 CrossRefPubMed

Larsson M, Hedelin B, Johansson I, Athlin E (2005) Eating problems and weight loss for patients with head and neck cancer: a chart review from diagnosis until one year after treatment. Cancer Nurs 28(6):425–435. https://doi.org/10.1097/00002820-200511000-00004 CrossRefPubMed

van Leeuwen PA, Kuik DJ, Klop WMC, Sauerwein HP, Snow GB, Quak JJ (1999) The impact of nutritional status on the prognoses of patients with advanced head and neck cancer. Cancer 86(3):519–527CrossRefPubMed

Britton B, Baker A, Clover K, McElduff P, Wratten C, Carter G (2016) Heads up: a pilot trial of a psychological intervention to improve nutrition in head and neck cancer patients undergoing radiotherapy. Eur J Cancer Care 26(4). https://doi.org/10.1111/ecc.12502

Harris JR, Lau H, Surgeoner BV, Chua N, Dobrovolsky W, Dort JC, Kalaydjian E, Nesbitt M, Scrimger RA, Seikaly H, Skarsgard D, Webster MA, Members of the Alberta Provincial Head and Neck Tumour Team (2014) Health care delivery for head-and-neck cancer patients in Alberta: a practice guideline. Curr Oncol 21(5):e704–ee14. https://doi.org/10.3747/co.21.1980. CrossRefPubMedPubMedCentral

National Institute for Health and Clinical Excellence (NICE) (2004) Guidance on cancer services: improving outcomes in head and neck cancers—the manual. NICE, London

Britton B, McCarter K, Baker A, Wolfenden L, Wratten C, Bauer J, Beck A, McElduff P, Halpin S, Carter G (2015) Eating as treatment (EAT) study protocol: a stepped-wedge, randomised controlled trial of a health behaviour change intervention provided by dietitians to improve nutrition in patients with head and neck cancer undergoing radiotherapy. BMJ Open 5(7):e008921. https://doi.org/10.1136/bmjopen-2015-008921 CrossRefPubMedPubMedCentral

McQuestion M, Fitch M, Howell D (2011) The changed meaning of food: physical, social and emotional loss for patients having received radiation treatment for head and neck cancer. Eur J Oncol Nurs 15(2):145–151. https://doi.org/10.1016/j.ejon.2010.07.006 CrossRefPubMed

10.

Britton B, Baker AL, Wolfenden L, Wratten C, Bauer J, Beck AK et al (2017) Eating As Treatment (EAT): a stepped-wedge, randomised controlled trial of a health behaviour change intervention provided by dietitians to improve nutrition in patients with head and neck cancer undergoing radiotherapy. Manuscript submitted for publication

11.

Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 19(6):349–357. https://doi.org/10.1093/intqhc/mzm042 CrossRefPubMed

12.

Glaser ВSA (1967) The discovery of grounded theory. Aldine Publishing, Chicago, IL

13.

Strauss A, Corbin J (1990) Basics of qualitative research. Sage, Newbury Park

14.

Beck AK, Britton B, Baker AL, Wratten C, Bauer J, Wolfenden L et al (2017) ‘EAT’: eating as treatment: training head and neck cancer dietitians in a health behaviour change intervention. Manuscript submitted for publication.

15.

McCarter K, Baker AL, Britton B, Beck AK, Carter G, Bauer J et al Effectiveness of clinical practice change strategies in improving dietitian care for head and neck cancer patients according to evidence based clinical guidelines: a stepped wedge randomised controlled trial. 2017. Transl Behav Med. https://doi.org/10.1093/tbm/ibx016

16.

Linden W, Vodermaier A, MacKenzie R, Greig D Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord 141(2):343–351. https://doi.org/10.1016/j.jad.2012.03.025

17.

Bauer J, Capra S, Ferguson M (2002) Use of the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56(8):779–785. https://doi.org/10.1038/sj.ejcn.1601412 CrossRefPubMed

18.

Miller WR, Rollnick S (2012) Motivational interviewing: helping people change. Guilford Press

19.

Larsson M, Hedelin B, Athlin E (2003) Lived experiences of eating problems for patients with head and neck cancer during radiotherapy. J Clin Nurs 12(4):562–570. https://doi.org/10.1046/j.1365-2702.2003.00751.x CrossRefPubMed

20.

Hancock RE, Bonner G, Hollingdale R, Madden AM (2012) ‘If you listen to me properly, I feel good’: a qualitative examination of patient experiences of dietetic consultations. J Hum Nutr Diet 25(3):275–284. https://doi.org/10.1111/j.1365-277X.2012.01244.x CrossRefPubMed

21.

Goodchild CE, Skinner TC, Parkin T (2005) The value of empathy in dietetic consultations. A pilot study to investigate its effect on satisfaction, autonomy and agreement. J Hum Nutr Diet 18(3):181–185. https://doi.org/10.1111/j.1365-277X.2005.00606.x CrossRefPubMed

22.

MacLellan D, Berenbaum S (2007) Canadian dietitians’ understanding of the client-centered approach to nutrition counseling. J Am Diet Assoc 107(8):1414–1417. https://doi.org/10.1016/j.jada.2007.05.018 CrossRefPubMed

23.

Llewellyn CD, McGurk M, Weinman J (2006) How satisfied are head and neck cancer (HNC) patients with the information they receive pre-treatment? Results from the satisfaction with cancer information profile (SCIP). Oral Oncol 42(7):726–734. https://doi.org/10.1016/j.oraloncology.2005.11.013. CrossRefPubMed

24.

Edwards D (1998) Head and neck cancer services: views of patients, their families and professionals. Br J Oral Maxillofac Surg 36(2):99–102. https://doi.org/10.1016/S0266-4356(98)90175-9 CrossRefPubMed

25.

Mesters I, Van den Borne B, De Boer M, Pruyn J (2001) Measuring information needs among cancer patients. Patient Educ Couns 43(3):255–264. https://doi.org/10.1016/S0738-3991(00)00166-X CrossRef

26.

McDowell ME, Occhipinti S, Ferguson M, Dunn J, Chambers SK (2010) Predictors of change in unmet supportive care needs in cancer. Psycho-Oncology 19(5):508–516. https://doi.org/10.1002/pon.1604 CrossRefPubMed

27.

Wiederholt PA, Connor NP, Hartig GK, Harari PM (2007) Bridging gaps in multidisciplinary head and neck cancer care: nursing coordination and case management. Int J Radiat Oncol Biol Phys 69(2, Supplement):S88–S91CrossRefPubMed

28.

Larsson M, Hedelin B, Athlin EA (2007) Supportive nursing care clinic: conceptions of patients with head and neck cancer. Eur J Oncol Nurs 11(1):49–59. https://doi.org/10.1016/j.ejon.2006.04.033 CrossRefPubMed

29.

Wells M, Donnan PT, Sharp L, Ackland C, Fletcher J, Dewar JA (2008) A study to evaluate nurse-led on-treatment review for patients undergoing radiotherapy for head and neck cancer. J Clin Nurs 17(11):1428–1439CrossRefPubMed

Title: Head and neck cancer patient experience of a new dietitian-delivered health behaviour intervention: ‘you know you have to eat to survive’
Authors: Kristen McCarter
Amanda L. Baker
Ben Britton
Sean A. Halpin
Alison Beck
Gregory Carter
Chris Wratten
Judith Bauer
Luke Wolfenden
Katrina Burchell
Erin Forbes
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 7/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-4029-5

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