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

Abstract

PurposeThe aim of this study was to explore head and neck cancer (HNC) patient experiences of a novel dietitian delivered health behaviour intervention.MethodsThis 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.ResultsNine 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.ConclusionsDimensions 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.Electronic supplementary materialThe online version of this article (10.1007/s00520-017-4029-5) contains supplementary material, which is available to authorized users.

Exercise and Nutrition Interventions in Patients with Head and Neck Cancer during Curative Treatment: A Systematic Review and Meta-Analysis

“…All studies reported dietary intake in accordance with estimated needs indicating high adherence. This supports the assumption that individualized dietary counselling promote adherence to dietary advices [ 40 ]. The study of Ravasco et al [ 27 ] also found that counselling resulted in a higher intake of macronutrients than just using ONS.…”

“…In the present review, this approach was used in five of 11 studies with nutritional intervention [ 23 , 25 , 26 , 29 , 31 ] while one used only dietary counselling [ 28 ] and a pilot study used only ONS [ 9 ]. Dietary counselling is considered the best approach to promote adherence to dietary advices [ 39 , 40 ] since it allows an individual tailoring of the diet to personal needs and desires [ 40 , 41 ]. An indication of this was also found in one of the selected studies, designed to compare effect on dietary intake after dietary counselling, use of ONS and eating ad libitum [ 27 ].…”

Best Evidence to Best Practice: Implementing an Innovative Model of Nutrition Care for Patients with Head and Neck Cancer Improves Outcomes

“…To date, one Australian study has reported on the successful delivery of a dietitian-led behavior change intervention to increase adherence to the HNC EBGs, demonstrating improvements in nutritional status, quality of life and treatment completion [ 25 , 26 , 27 ]. Few other published studies have taken a multistrategic, patient-centred approach to implementing best-practice nutrition care for patients with HNC addressing barriers and facilitators at the individual, team and system levels which are then tested in a real-world setting.…”

Nutritional experiences in head and neck cancer patients

“…A later published study has highlighted the physical, emotional and social losses associated with decreased nutritional intake in patients with HNC (McQuestion, Fitch, & Howell, ). A recently published study explored the experiences from participating in a dietitian‐delivered health behaviour intervention during radiotherapy, by focusing on the patient's working relationship with the dietitian, specific components of the intervention and suggestions for improving the intervention (McCarter et al, ).…”

“…A recently published study explored the experiences from participating in a dietitian-delivered health behaviour intervention during radiotherapy, by focusing on the patient's working relationship with the dietitian, specific components of the intervention and suggestions for improving the intervention (McCarter et al, 2018).…”