Patient and carer experience of nutrition care throughout treatment for head and neck cancer: a systematic qualitative r
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REVIEW ARTICLE
Patient and carer experience of nutrition care throughout treatment for head and neck cancer: a systematic qualitative review and thematic synthesis Joanne S. Hiatt 1,2
&
Teresa E. Brown 1,2
&
Merrilyn Banks 1,2 & Carrie-Anne Lewis 2 & Judith Bauer 1
Received: 7 April 2020 / Accepted: 11 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Nutrition care plays a critical role in the provision of best practice care to head and neck cancer (HNC) patients, with carers playing an important role in supporting patients to maintain nutrition intake. This qualitative systematic review investigated patient and carer experience of nutrition care throughout and beyond HNC treatment. Five databases were systematically searched for qualitative studies reporting on patient and carer experience of nutrition care throughout HNC. Twenty-five studies including 435 patients and 46 carers were identified, revealing three themes: information and support in the healthcare setting, enteral feeding challenges and management, and life outside hospital. Findings highlight the importance of providing individualised person-centred nutrition care to patients with HNC and their carers. Further qualitative research is needed to inform healthcare professionals about the needs of patients and carers to provide appropriate support throughout the treatment trajectory across and between different treatment modalities. Keywords Carer experience . Patient experience . Nutrition care . Thematic analysis . Head and neck cancer
Introduction Head and neck cancer (HNC) accounts for over 650,000 cases each year [1]. Over the past 30 years, the presentation of HNC has changed from older adults with a history of alcohol and tobacco use to younger adults with human papillomavirus (HPV), which is now an established cause of increasing incidence [2]. Surgery, radiotherapy, and chemotherapy are used in the treatment of HNC, with many patients undergoing an intensive combination of all three methods [3]. Treatment toxicity often causes severe physical and psychosocial side effects. Consequently, problems with eating and drinking are common, resulting in weight loss and malnutrition [4, 5].
* Joanne S. Hiatt [email protected] 1
School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia 4067, Queensland, Australia
2
Department of Nutrition and Dietetics, Royal Brisbane and Women’s Hospital, Herston 4029, Queensland, Australia
Between 3 and 52% of patients are malnourished at diagnosis secondary to lifestyle factors and tumour burden, with rates increasing to 44–88% secondary to the side effects of treatment [4, 5]. Malnutrition may result in impaired wound healing, decreased tolerance to treatment, unplanned treatment breaks, hospital admissions, and increased mortality [6]. While studies have identified methods to decrease the risk of malnutrition including nutrition counselling, supplementation, and enteral nutrition, adherence to nutrition recommendations remain low in thi
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