The purpose of this research was to explore the nutrition practices among post-treatment cancer survivors across Ireland. Cancer survivors aged 18+ years living across Ireland, who were not ...palliative and had completed active cancer treatment at least six months previous, were recruited to complete an online survey assessing dietary quality, food choice and satisfaction with food-related life as well as clinical and nutrition status. It was circulated by cancer support networks and on social media. Descriptive statistics are presented. The cohort (n = 170) was predominantly female (85.9%) and had breast cancer (64.7%). Mean age was 51.5 ± 10.9 years and 42.7% of the cohort were >five years post-treatment. Only 20% and 12% of the cohort had been assessed by a dietitian during and post-treatment, respectively. The mean dietary quality score was 10.3 ± 1.7, which was measured by the Leeds short-form food frequency questionnaire (SFFFQ). Using a 5-point Likert scale, the median satisfaction with food-related life score was 19 (3.3), which evaluates cognitive judgements on the person's food-related life. The food choice questionnaire (FCQ) assesses the relative importance of a range of factors related to dietary choice to individuals. The primary determinant of food choice in this cohort was the natural content (31.7%) followed by health (24.7%). Vitamin and mineral supplement use was reported by 69.8% of the cohort; the most consumed was Vitamin D. Four themes emerged from an optional open-ended question: awareness of nutritional importance; desire for specific nutritional advice and dietetic referral; cancer and treatment nutrition impacts were highlighted; as well as struggles with weight gain. This research provides useful insight into the nutrition practices of Irish cancer survivors. A desire and need for individualised and specific advice are evident.
The aims of this study were to (1) document currently available guidelines aimed at healthcare professionals and including some information on the nutritional management of cancer survivors in ...Europe; (2) assess the quality of these guidelines and (3) document the nutrition recommendations promoted.
Four search strategies were implemented in 2018 and updated in 2021 to locate guidelines. Papers were included if they described a European guideline or recommendation for cancer survivors that contained nutrition guidance and there were no language restrictions. Two reviewers independently assessed guideline quality using the AGREE II instrument and nutrition content was extracted and summarised.
Five guidelines (of 593 documents located through the searches) met the inclusion criteria. The ESPEN guidelines were deemed to have the highest methodological quality. Limited information on nutrition was available in these guidelines with the majority of focus being on the promotion of fruit, vegetables and wholegrains and reducing fat, red meat and alcohol. Weight management was mentioned by all five guidelines. There was no detailed information available for cancer survivors or their healthcare team and no practical strategies for the implementation of recommendations.
There is a need for nutrition guidelines specific for cancer survivors in a European setting. Current guidelines are limited and focus on broad recommendations, while lacking in practical strategies for implementation. There is also a tendency to recommend cancer prevention guidelines be used for cancer survivors rather than developing specific guidance for this group.
BackgroundLittle is known about how cancer survivors perceive nutrition through the cancer experience and how those perceptions may influence their diet.AimsThis study aimed to capture the meaning of ...nutrition for cancer survivors who are post-cancer treatment using a participatory photography method known as photovoice.MethodsWang and Burris’s photovoice procedure was followed. Recruitment took place via email through existing links with participants from a previous quantitative study. The participants were tasked with taking photographs to represent the meaning of nutrition for them post-treatment. Group workshops and semistructured interviews were conducted to facilitate reflection, dialogue and analysis. Data analysis followed Braun and Clarke’s six-phase thematic analysis.ResultsOne man and seven women (n=8) across the Island of Ireland were recruited. Participants identified six themes (illustrated with photographs): (1) Fresh is Best, (2) Be kind to yourself, (3) Building Blocks. Be Informed., (4) Post-Treatment Healing Changes, (5) Chemo Rituals and (6) Food for the Soul–Healthy Mind. Healthy Body.ConclusionsParticipants displayed a holistic approach to a healthy lifestyle for recovery post-treatment and maintaining health. While diverse, participants made post-treatment nutritional changes by introducing and eliminating certain foods or food groups. All agreed that being informed and building nutrition knowledge are essential. It is important to clarify the implications cancer has had on diet and health when providing nutrition guidance to ensure that it is appropriate and specific.
Nutrition plays a critical role in the development of non-communicable diseases, with several dietary-related risk factors associated with these diseases. The purpose of this study was to explore ...what doctors and dietitians believe the role of the doctor should be in the delivery of nutrition-related advice and care to patients. A total of 16 participants participated in focus groups and completed a short demographic questionnaire. The data collected from the questionnaires were analysed using SPSS version 26 statistical analysis software. Thematic analysis was conducted using Braun and Clarke's six-step process. Participants were working in a variety of specialities (including general medicine, medical endocrinology, and geriatrics). All participants indicated that doctors have an important role to play, with 90% stating that they would be interested in receiving additional training in nutrition. Three themes emerged from the focus groups: (1) Role, (2) Barriers, and (3) Supports. The main roles of the doctor in the provision of nutrition advice are to act as the first point of contact, to identify those in need of dietetic support and refer and finally, to advocate for and support nutrition in the clinical setting. Barriers to this were lack of knowledge and resources, while access to physical resources, guidelines, and easy-to-use materials that their patients could be signposted to, and in-house education sessions with dietitians, were outlined as necessary supports. Thus, a collaboration between nutrition experts and the medical profession is key.
Introduction
Ascertaining cancer survivors’ specific needs and preferences regarding nutrition information delivery is important in developing and designing future health interventions in oncology. ...The present study aimed to explore the nutrition information needs of cancer survivors and their preferences regarding intervention delivery.
Methods
The present study is a mixed‐methods study comprising a cross‐sectional survey and focus groups. Participants were eligible for inclusion if they were aged ≥ 18 years, living in Ireland with a cancer diagnosis and had completed treatment at least 6 months previously. Cancer support centres promoted the online survey on social media. Focus groups were conducted with 20 individuals.
Results
The cohort (n = 56) was predominantly female (n = 50; 89.3%) breast cancer survivors (n = 42; 75%). Seven (12.5%) had received nutrition advice from a dietitian. Most were interested in receiving nutrition advice (n = 52; 92.9%), with variability in delivery mode. There was interest in improving sleep quality (n = 35; 62.5%), making positive lifestyle changes (n = 28; 50%) and accessing cancer‐specific physical activity classes (n = 27; 48.2%). The best time to deliver information was throughout the cancer journey (n = 31; 55.4%). Time and motivation (n = 15; 26.8%) were the main barriers. Facilitators were keeping healthy (n = 42; 75%) and weight maintenance (n = 31; 55.4%). Four themes emerged from thematic analysis: lack of nutrition guidance, an abundance of misinformation, one size does not fit all and dietitians as the preferred source of advice.
Conclusions
There is a desire for evidence‐based nutrition advice and for dietitians to be integrated into cancer clinics and cancer survivorship care. This research guides future nutrition interventions to improve cancer survivorship outcomes.
Key points
The majority of the cohort were interested in receiving nutrition advice with variability in preference of delivery method. Information should be available throughout the cancer journey.
There was also interest in education around improving sleep quality and making positive lifestyle changes.
During treatment, coping with side effects, dealing with fatigue, eating a balanced diet, improving cardiovascular health, eating problems and maintaining and building muscle mass were ranked as important/very important.
After completing cancer treatment, coping with side effects, dealing with fatigue, eating a balanced diet, improving cardiovascular health and weight management were considered to be important/very important.
Themes arising from the qualitative component of this research were: (1) distinct lack of nutrition guidance; (2) an abundance of misinformation; (3) one size does not fit all; and (4) dietitian as the preferred source of advice.
In Ireland, one in every 25 individuals is living with and beyond cancer, placing survivorship care at the forefront of strategic planning and service requirements. Several unmet needs of cancer ...survivors were identified in the National Cancer Strategy 2017–2026. Further reports from national bodies have highlighted how these unmet needs, including those of a nutritional nature, have not been prioritised. In Ireland, little information is available on how cancer diagnosis changes cancer survivors’ perceptions of food and nutrition. Thus, this study aimed to describe cancer survivors’ relationship with nutrition. Survivors who lived on the Island of Ireland and were at least 6 months post‐treatment were eligible. Five semi‐structured focus groups and two individual interviews were conducted online (n = 20). Focus groups and interviews were analysed using thematic analysis. The cohort was mostly female breast cancer survivors (n = 12) with an average age of 51.3 ± 12 years. Emergent themes illustrated how a cancer diagnosis appears to motivate cancer survivors to immediate positive dietary changes. Many new dietary introductions were in line with cancer survivor recommendations, while dietary supplement use and some nonevidence‐supported actions were revealed. A minority of participants continued their original dietary intake prior to their diagnosis. Participants reported the impact of treatment‐related side effects on their relationship with nutrition. The participants emphasised a desire to receive dietary advice from health professionals while undergoing treatment and survivorship.
BackgroundEvidence-based hospital design could significantly improve patient safety and make patient, staff and family environments healthier. This systematic review aims to determine which neonatal ...intensive care unit design features lead to improved neonatal, parental and staff outcomes.MethodsMedline, CINAHL, Web of Science Citation Index and Cochrane Central Register of Controlled Trials Registry, were searched in January 2017. Using combinations of the relevant key words, review was performed following the recommended guidelines for reporting systematic reviews. English language limitation was applied and term limited to 2006–2016. Pre-piloted forms were used by one reviewer and cross verified by second reviewer. Included studies were assigned a grade based upon their level of evidence and critically appraised using defined tools. Data were not synthesized for metanlysis due to nature of literature reviewed and heterogeneity.Results3,592 titles were screened with 43 full-texts assessed for eligibility. 30 studies were deemed eligible for inclusion. These included 19 cohort studies, two qualitative studies, seven cross-sectional studies, one systematic review (peer reviewed articles up to January 2011) and one randomised control trial. Grey literature search from guidelines, catalogues and repositories yielded additional 10 guidelines.ConclusionsOptimally designed neonatal unit has many possible health implications, including improved breastfeeding, infection and noise control, reduced length of stay, hospitalisation rates and potentially improved neonatal morbidity and mortality. ‘Single family room’ design for neonatal units is recommended. Consideration should be given to infection prevention and control, including sink frequency and positioning, and airborne isolation facilities. Support areas for families, staff and breastfeeding mothers are also recommended. High quality, family centred neonatal care could be assisted through well grounded, future proofed and technology enabled design concepts that have the potential to impact upon early life development. Nature of the topic poses inherent limitations for conduct of randomized trials; however observational studies using standardised methodologies could add further evidence.
Background
The present study aimed to explore malnutrition risk, handgrip strength and quality of life (QOL) in cancer survivors.
Methods
In total, 232 individuals completed a demographic ...questionnaire, Patient‐Generated Subjective Global Assessment Short Form and the European Organization for Research and Treatment of Cancer QOL Questionnaire (EORTC QLQ‐C30). Handgrip strength was determined using a spring‐loaded handgrip dynamometer and anthropometric measurements were taken by an oncology nurse. Frequencies and distribution data, analysis of variance and chi‐squared tests were then conducted.
Results
The majority of the cohort were female (n = 141; 60.8%) had breast cancer (n = 62; 26.7%) and the mean ± SD body mass index (BMI) was 26.6 ± 6.2 kg m–2. Less than a one‐third reported seeing a dietitian (n = 68; 29.3%). Over one‐third reported recent weight loss (n = 88; 37.3%). Some 40.9% (n = 95) were at moderate to high risk of malnutrition, with women more likely than men to be classified as high risk (p < 0.05). Mean ± SD handgrip strength was 25 ± 15 kg and this differed significantly by gender (p = 0.00), cancer type (p = 0.01) and BMI classification (p = 0.01). One‐fifth of individuals were classified as having dynapenia (n = 48; 21.1%). Median (interquartile range) QOL score was 66.7 (33.3). The proportion of individuals meeting the threshold for clinical importance for QOL subscales ranged from 12.5% (constipation) to 42.7% (physical functioning). Females were more likely than males to meet the threshold for physical functioning (p = 0.00), fatigue (p = 0.02) and pain (p = 0.01).
Conclusions
Females are more likely than males to be at high risk of malnutrition and meet the threshold for clinical significance for several QOL subscales.
Females living with and beyond cancer are more likely than males to be at risk of malnutrition and meet the threshold for clinical importance for a number of quality of life subscales.
Objectives:
The objective of this study was to evaluate the prevalence and severity of clozapine-induced hypersalivation, and assess the impact hypersalivation has on global functioning.
Methods:
...Participants attending a dedicated clozapine clinic were invited to undertake a structured interview regarding their experiences of clozapine-induced hypersalivation. Two psychometric instruments to measure hypersalivation, the Nocturnal Hypersalivation Rating Scale and the Drooling Severity and Frequency Scale were used.
Results:
Clozapine-induced hypersalivation was experienced by 92% of participants, with nocturnal hypersalivation more prevalent compared to daytime hypersalivation (85% versus 48%). Daytime drooling was severe in 18% of cases and was present on a frequent or constant basis for 20% of individuals. Hypersalivation had at least a moderate impact on the quality of life of 15% of study participants.
Conclusions:
Clozapine-induced hypersalivation is the most prevalent adverse effect experienced by patients treated with clozapine and negatively impacts on quality of life, particularly if daytime drooling is present. The development of further strategies to ameliorate this adverse effect is required given the demonstrated lack of success to date in managing this condition.
This systematic review investigated qualitative and quantitative studies exploring patients and healthcare professionals' (HCP) experience of nutrition care throughout the cancer journey.
Five ...databases were systematically searched for studies reporting on patient and healthcare professionals' experience of nutrition advice.
Fifteen studies including 374 patients and 471 healthcare professionals were included. Findings indicate that patients desire more specific nutrition advice supported by members of the multidisciplinary team and delivered in appropriate and understandable language. Healthcare professionals have highlighted a lack of time, funding, dietetic roles, and knowledge as barriers to integrating nutrition as a standard part of cancer care. Five themes were identified (current provision of nutrition advice, optimal provision of nutrition advice, tension between patient values and nutritional or HCP priorities, providing evidence-based nutrition care, and practical barriers to nutrition advice provision).
Further work is essential to better understand and address identified barriers and improve the provision of nutrition advice to this population.
Findings from this review will guide the delivery of nutrition advice for cancer survivors.
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