Abstract
Background
Head and neck cancer (HNC) survivors may face an array of nutrition impact symptoms
(NIS), including dysphagia, xerostomia, taste alterations, and difficulty chewing,
which occur as a result of tumor location and treatment with radiation. Few qualitative
studies have assessed the chronic impact of NIS on everyday life.
Objective
The aim of this study was to obtain a comprehensive understanding of the lived experience
of chronic NIS burden on HNC survivors.
Design and participants
Semi-structured, face-to-face interviews were conducted with 31 HNC survivors to address
the research aims and objectives. An interview guide was utilized to consider themes
that had been generated through the review of literature and through the researchers’
clinical experience within the field. There were probes within the interview for participants
to raise unanticipated issues and flexibility to follow such leads. Interviews were
conducted between March 2018 and May 2019.
Analysis
A single researcher conducted the interviews to maintain consistency in data collection.
Interviews lasted approximately 1 hour and were audio-recorded. All interview transcripts
were professionally transcribed verbatim and checked for accuracy to ensure a complete
account of participants’ responses. Two researchers applied qualitative thematic content
analysis to identify major themes.
Results
The following 4 major thematic categories emerged from the interview data: symptom
presence, dietary preferences, eating adjustments, and addressing symptoms. The most
common symptoms were dysphagia, xerostomia, taste alterations, and bothered chewing.
As a result of dietary preferences, survivors avoided citrus fruits, dry foods, raw
vegetables, sweets, and meats. Survivors preferred soft and moist foods, spices or
seasonings, and sauces or gravies. Eating adjustments were described as increased
time to consume meals, cutting food into smaller pieces, consuming less food, and
consuming more fluid. As a result of food preference changes and eating adjustments,
survivors reported dietary pattern changes from pre to post treatment. All survivors
experienced 1 or more chronic NIS, yet nearly 40% were unaware before treatment that
NIS had the potential to persist chronically.
Conclusions
The results of this study provide unique qualitative insight into the lived experience
of chronic NIS burden on HNC survivors. By recognizing the daily challenges, health
care team members can better support HNC survivors in the transition from active treatment
to follow-up care.
Keywords
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Biography
S. L. Crowder is a doctoral candidate, Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign.
Biography
N. Najam is an undergraduate research assistant, Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign.
Biography
A. E. Arthur is an assistant professor, Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign.
Biography
B. H. Fiese is director of the Family Resiliency Center, and a professor, Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign.
Biography
K. P. Sarma is a radiation oncologist, Carle Cancer Center, Carle Foundation Hospital, Urbana, IL.
Article info
Publication history
Published online: July 07, 2020
Accepted:
April 15,
2020
Received:
February 14,
2020
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This study was supported by an Academy of Nutrition and Dietetics Colgate Palmolive Fellowship in Nutrition and Oral Health, US Department of Agriculture, National Institute of Food and Agriculture, Hatch project 1011487, a Division of Nutritional Sciences Vision 20/20 grant, and a Carle-Illinois Cancer Scholars for Translational and Applied Research Fellowship. S. L. Crowder was supported by the Carle Illinois Cancer Scholars for Translational and Applied Research Fellowship.
AUTHOR CONTRIBUTIONS S. L. Crowder, K. P. Sarma, and A. E. Arthur designed the astudy. S. L. Crowder and A. E. Arthur contributed to the development of the topic guide. S. L. Crowder conducted the study. S. L. Crowder and N. Najam performed data analysis. S. L. Crowder wrote the first draft of the manuscript with contributions from all authors. All authors reviewed and commented on subsequent drafts of the manuscript.
Identification
Copyright
© 2020 by the Academy of Nutrition and Dietetics.
