Nutrition Care in Patients With Head and Neck or Esophageal Cancer: The Patient Perspective

Nutr Clin Pract. 2017 Oct;32(5):664-674. doi: 10.1177/0884533617725050. Epub 2017 Aug 25.

Abstract

Background: Patients with head/neck or esophageal (HNE) cancer are likely to develop malnutrition throughout the course of their disease and its treatment. Although nutrition care is considered a cornerstone of disease management, clinical practices to treat malnutrition vary. The objective of this qualitative study is to understand the patients' experiences with nutrition care in the context of their treatment and recovery.

Methods: A descriptive qualitative study design was used to explore patients' experiences. Ten patients with head and neck (HN) cancer and 10 patients with esophageal cancer were interviewed near the completion of their cancer treatment using a semistructured interview guide. The data sets were analyzed separately using qualitative content analysis. The preliminary findings from each data set were compared and contrasted; 3 themes that crossed both data sets were identified.

Results: Three themes were identified: (1) coping with physical and psychosocial aspects of illness and nutrition; (2) understanding the nature of the illness, treatment, and nutrition pathway; and (3) being supported during the trajectory of care. The major differences between HN and esophageal groups were identified in the context of understanding and being supported: the lack of coordination throughout the trajectory of care and conflicting messages from healthcare providers were a source of uncertainty, confusion, and isolation in the HN group. The need for timely and ongoing patient-focused nutrition care, with formal and informal support, was identified in both groups.

Conclusion: Models for nutrition care should support provision of consistent information across health professionals and throughout the treatment trajectory.

Keywords: cancer; enteral nutrition; esophageal neoplasms; head and neck neoplasms; nutritional status; nutritional support; oncology.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adaptation, Psychological
  • Aged
  • Alberta
  • Combined Modality Therapy / adverse effects
  • Cost of Illness
  • Esophageal Neoplasms / physiopathology
  • Esophageal Neoplasms / therapy*
  • Evidence-Based Medicine
  • Feeding and Eating Disorders / etiology
  • Feeding and Eating Disorders / physiopathology
  • Feeding and Eating Disorders / psychology
  • Feeding and Eating Disorders / therapy*
  • Female
  • Head and Neck Neoplasms / physiopathology
  • Head and Neck Neoplasms / therapy*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Malnutrition / etiology
  • Malnutrition / prevention & control*
  • Malnutrition / therapy
  • Middle Aged
  • Needs Assessment
  • Nutritional Support*
  • Patient-Centered Care*
  • Practice Guidelines as Topic
  • Psychosocial Support Systems
  • Qualitative Research
  • Stress, Psychological / etiology
  • Stress, Psychological / prevention & control
  • Stress, Psychological / psychology