DOI QR코드

DOI QR Code

Qualitative Study of Compliance with Nutritional Management in Colorectal Cancer Patient Undergoing Chemotherapy

수술 후 보조적 항암화학요법을 받는 대장암 환자의 일상영양관리 순응도에 대한 질적 연구

  • Park, Heejung (Department of Food & Nutrition, Yuhan University) ;
  • Kil, Hyonson (Department of Clinical Nutrition, Gachon University Graduate School of Professional Therapy) ;
  • Cho, Wookyoun (Department of Food & Nutrition, Gachon University)
  • 박희정 (유한대학교 식품영양학과) ;
  • 길현선 (가천대학교 특수치료대학원 임상영양학과) ;
  • 조우균 (가천대학교 바이오나노대학 식품영양학과)
  • Received : 2020.07.17
  • Accepted : 2020.08.22
  • Published : 2020.08.31

Abstract

Objectives: The nutritional status of cancer patients undergoing chemotherapy is closely related to the compliance of nutrition education. However, as chemotherapy is conducted repeatedly, compliance with nutrition management is lowered, leading to malnutrition. Malnutrition is related directly to the quality of life after surgery in cancer patients. Therefore, this study examined the factors related to compliance with nutrition management during chemotherapy. Methods: In this study, five subjects with colorectal cancer undergoing adjuvant chemotherapy were interviewed in-depth using the Giorgi study method. The contents of the nutrition education visits and in-depth interviews were transcribed in the language of the subject after recording, and the appropriateness of the data was improved by reflecting the subject's actions and facial expressions. Results: After conducting the in-depth interviews for each subject, the experience of the subject's diet and adjuvant chemotherapy was drawn into two domains, six elements, and 26 sub-elements. In the cognitive domain, the patients experienced physical and psychological changes, and the need for nutrition management was recognized by analyzing the dietary causes of the diseases. In the domain of practice, a knowing-doing gap was formed, unlike the patient's will. Factors that inhibited compliance with nutritional management included digestive problems, sensory changes, loss of appetite, and social interaction stress. Conclusions: Dietary management is very important for patients receiving periodic anticancer therapy, and step-by-step training and personal monitoring based on the chemotherapy order is necessary to maintain the patient's will and social and environmental support.

Keywords

References

  1. Jung KW, Won YJ, Kong HJ, Lee ES. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2016. Cancer Res Treat 2019; 51(2): 417-430. https://doi.org/10.4143/crt.2019.138
  2. Statistics Korea. Cancer registration statistics [internet]. Statistics Korea; 2017 [cited 2020 Mar 19]. Available from: http://kosis.kr/eng/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ETITLE&parmTabId=M_01_01&statId=1997018&themaId=#SelectStatsBoxDiv
  3. Mizota Y, Kanemitsu Y, Tsukamoto S, Shida D, Ochiai H, Yamamoto S. ROK study-C (Rainbow of KIBOU studycolorectum): a colorectal cancer survivor cohort study on food, nutrition, physical activity, psychosocial factors and its influences on colorectal cancer recurrence, survival and quality of life in Japan. BMC Cancer 2018; 18(1): 953-961. https://doi.org/10.1186/s12885-018-4830-7
  4. Hong KY, Choi YJ, Yan WQ, L im HS, Chyun JH. Study on the improvement of dietary life of cancer patients during treatment by nutrition counseling. Korean J Community Nutr 2016; 21(1): 93-101. https://doi.org/10.5720/kjcn.2016.21.1.93
  5. Matsumoto K, Takahashi M, Sato K, Osaki A, Takano T, Naito Y et al. A double-blind, randomized, multicenter phase 3 study of palonosetron vs granisetron combined with dexamethasone and fosaprepitant to prevent chemotherapy-induced nausea and vomiting in patients with breast cancer receiving anthracycline and cyclophosphamide. Cancer Med 2020; 9(10): 3319-3327. https://doi.org/10.1002/cam4.2979
  6. Mardas M, Madry R, Stelmach-Mardas M. Link between diet and chemotherapy related gastrointestinal side effects. Contemp Oncol (Pozn) 2017; 21(2): 162-167.
  7. Gangadharan A, Choi SE, Hassan A, Ayoub NM, Durante G, Balwani S et al. Protein calorie malnutrition, nutritional intervention and personalized cancer care. Oncotarget 2017; 8(14): 24009-24030. https://doi.org/10.18632/oncotarget.15103
  8. Kurk SA, Peeters PHM, Dorresteijn B, de Jong PA, Jourdan M, Creemers GM et al. Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer: Secondary analysis of the phase 3 CAIRO3 trial. Cancer Med 2020; 9(3): 1033-1043. https://doi.org/10.1002/cam4.2787
  9. Brown JC, Caan BJ, Meyerhardt JA, Weltzien E, Xiao J, Cespedes-Feliciano EM et al. The deterioration of muscle mass and radiodensity is prognostic of poor survival in stage I-III colorectal cancer: a population-based cohort study (C-SCANS). J Cachexia Sarcopenia Muscle 2018; 9(4): 664-672. https://doi.org/10.1002/jcsm.12305
  10. Ravasco P. Nutrition in cancer patients. J Clin Med 2019; 8(8): 1211-1223. https://doi.org/10.3390/jcm8081211
  11. Silva FR, de Oliveira MG, Souza AS, Figueroa JN, Santos CS. Factors associated with malnutrition in hospitalized cancer patients: a cross-sectional study. Nutr J 2015; 14: 123-130. https://doi.org/10.1186/s12937-015-0113-1
  12. Hebuterne X, Lemarie E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. J Parenter Enteral Nutr 2014; 38(2): 196-204. https://doi.org/10.1177/0148607113502674
  13. Freijer K, Tan SS, Koopmanschap MA, Meijers JM, Halfens RJ, Nuijten MJ. The economic costs of disease related malnutrition. Clin Nutr 2013; 32(1): 136-141. https://doi.org/10.1016/j.clnu.2012.06.009
  14. Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D et al. Cancer-related fatigue, version 2. 2015. J Natl Compr Canc Netw 2015; 13(8): 1012-1039. https://doi.org/10.6004/jnccn.2015.0122
  15. Carayol M, Ninot G, Senesse P, Bleuse JP, Gourgou S, Sancho-Garnier H et al. Short- and long-term impact of adapted physical activity and diet counseling during adjuvant breast cancer therapy: the "APAD1" randomized controlled trial. BMC Cancer 2019; 19(1): 737-756. https://doi.org/10.1186/s12885-019-5896-6
  16. Demark-Wahnefried W, Morey MC, Sloane R, Snyder DC, Miller PE, Hartman TJ et al. Reach out to enhance wellness home-based diet-exercise intervention promotes reproducible and sustainable long-term improvements in health behaviors, body weight, and physical functioning in older, overweight/obese cancer survivors. J Clin Oncol 2012; 30(19): 2354-2361. https://doi.org/10.1200/JCO.2011.40.0895
  17. Rock CL, Flatt SW, Byers TE, Colditz GA, Demark-Wahnefried W, Ganz PA et al. Results of the exercise and nutrition to enhance recovery and good health for You (ENERGY) trial: a behavioral weight loss intervention in overweight or obese breast cancer survivors. J Clin Oncol 2015; 33(28): 3169-3176. https://doi.org/10.1200/JCO.2015.61.1095
  18. Tozer RG, Tai P, Falconer W, Ducruet T, Karabadjian A, Bounous G et al. Cysteine-rich protein reverses weight loss in lung cancer patients receiving chemotherapy or radiotherapy. Antioxid Redox Signal 2008; 10(2): 395-402. https://doi.org/10.1089/ars.2007.1919
  19. Murphy RA, Mourtzakis M, Chu QS, Baracos VE, Reiman T, Mazurak VC. Nutritional intervention with fish oil provides a benefit over standard of care for weight and skeletal muscle mass in patients with nonsmall cell lung cancer receiving chemotherapy. Cancer 2011; 117(8): 1775-1782. https://doi.org/10.1002/cncr.25709
  20. Langius JA, Zandbergen MC, Eerenstein SE, van Tulder MW, Leemans CR, Kramer MH et al. Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo) radiotherapy: a systematic review. Clin Nutr 2013; 32(5): 671-678. https://doi.org/10.1016/j.clnu.2013.06.012
  21. Bicakli DH, Ozveren A, Uslu R, Dalak RM, Cehreli R, Uyar M et al. The effect of chemotherapy on nutritional status and weakness in geriatric gastrointestinal system cancer patients. Nutrition 2018; 47: 39-42. https://doi.org/10.1016/j.nut.2017.09.013
  22. Van Blarigan EL, Fuchs CS, Niedzwiecki D, Zhang S, Saltz LB, Mayer RJ et al. Association of survival with adherence to the American cancer society nutrition and physical activity guidelines for cancer survivors after colon cancer diagnosis: The CALGB 89803/Alliance trial. JAMA Oncol 2018; 4(6): 783-790. https://doi.org/10.1001/jamaoncol.2018.0126
  23. Min HS, Hwang WH. The effects of nutritional education program on nausea and vomiting, anorexia, food intake, and nutritional status of GI cancer patients undergoing chemotherapy. Asian Oncol Nurs 2010; 10(1): 38-47.
  24. Custodio ID, Marinho Eda C, Gontijo CA, Pereira TS, Paiva CE, Maia YC. Impact of chemotherapy on diet and nutritional status of women with breast cancer: a prospective study. PLoS One 2016; 11(6): e0157113. https://doi.org/10.1371/journal.pone.0157113
  25. Yang YH. Anorexia, nausea and vomiting, and food intake patterns in patients on chemotherapy. J Korean Acad Fundam Nurs 2004; 11(2): 177-185.
  26. Park JS. A qualitative case study on the coping experiences of cancer survivors in their middle years. Health Soc Welfare Rev 2017; 37(2): 525-561. https://doi.org/10.15709/HSWR.2017.37.2.525
  27. Shin KR. Criteria for critique of qualitative nursing research. J Korean Acad Nurs 1996; 26(2): 497-506.
  28. Kim BH, Kim KJ, Park IS, Lee KJ, Kim JK, Hong JJ et al. A comparison of phenomenological research methodology. J Korean Acad Nurs Adm 1999; 29(6): 1208-1220. https://doi.org/10.4040/jkan.1999.29.6.1208
  29. Giorgi A. Phenomenology and psychological research. Pittsburgh: Duquesne University Press; 1985.
  30. Oh PJ, Lim SY. Change of cancer symptom, depression and quality of life based on phases of chemotherapy in patients with colorectal or stomach cancer: a prospective study. Korean J Adult Nurs 2017; 29(3): 313-322. https://doi.org/10.7475/kjan.2017.29.3.313
  31. Kim JH, Choi KS, Kim TW, Hong YS. Quality of life in colorectal cancer patients with chemotherapy-induced peripheral neuropathy. J Korean Oncol Nurs 2011; 11(3): 254-262. https://doi.org/10.5388/jkon.2011.11.3.254
  32. Choi YJ, Myung SK, Lee JH. Light alcohol drinking and risk of cancer: a meta-analysis of cohort studies. Cancer Res Treat 2018; 50(2): 474-487. https://doi.org/10.4143/crt.2017.094
  33. Vieira AR, Abar L, Chan DSM, Vingeliene S, Polemiti E, Stevens C et al. Foods and beverages and colorectal cancer risk: a systematic review and meta-analysis of cohort studies, an update of the evidence of the WCRF-AICR Continuous Update Project. Ann Oncol 2017; 28(8): 1788-1802. https://doi.org/10.1093/annonc/mdx171
  34. Turner ND, Lloyd SK. Association between red meat consumption and colon cancer: A systematic review of experimental results. Exp Biol Med (Maywood) 2017; 242(8): 813-839. https://doi.org/10.1177/1535370217693117
  35. Alkhaldy AA, Aljahdli ES, Mosli MH, Jawa HA, Alsahafi MA, Qari YA. Adherence to the Saudi dietary guidelines and its relation to colorectal polyps: A university hospital-based study. J Taibah Univ Med Sci 2019; 15(1): 25-31. https://doi.org/10.1016/j.jtumed.2019.11.001
  36. Lee J, Shin A, Oh JH, Kim J. Colors of vegetables and fruits and the risks of colorectal cancer. World J Gastroenterol 2017; 23(14): 2527-2538. https://doi.org/10.3748/wjg.v23.i14.2527
  37. Kumari A, Ermilov AN, Grachtchouk M, Dlugosz AA, Allen BL, Bradley RM et al. Recovery of taste organs and sensory function after severe loss from Hedgehog/Smoothened inhibition with cancer drug sonidegib. Proc Natl Acad Sci USA 2017; 114(48): E10369-E10378. https://doi.org/10.1073/pnas.1712881114
  38. Jeong GH, Kim KH, Kwak YH. Quality of life in colorectal cancer patients according to the severity of symptom clusters classification. Asian Oncol Nurs 2014; 14(2): 74-83. https://doi.org/10.5388/aon.2014.14.2.74