High-emetogenic chemotherapy tends to cause nausea, vomiting, and mucosity. As a result of receiving such treatment, adolescents and young adults (AYAs) with cancer tend to lose their appetite. This is a major concern for their caregivers, as insufficient nutrition can inhibit both their growth and clinical outcomes. However, qualitative literature on the matter is limited.
A team of researchers launched a phenomenological study of AYAs from 3 oncology departments at a university hospital in Denmark to learn more about the significance of food and meals for AYAs with cancer, their family members, and the healthcare professionals who administer and oversee their treatment. Their findings were published in the European Journal of Oncology Nursing.
The researchers logged 140 hours of observation and informal conversations related to eating meals with AYA patients with cancer, their family/caregivers, and healthcare providers from August 2019 to March 2020. They identified 3 themes that defined the relationships each has with food.
Many young people with cancer felt that eating during treatment had become a duty, particularly when in the hospital. While hospitalized, AYAs did not experience the triggers for eating, such as the smells of cooking food, and thereby lost their desire for food. Although these patients occasionally experienced temporary cravings for specific foods, that disappeared quickly.
Family members perceived food as a matter of love — that is, feeding the patient was one thing they could do to help and show their love — and often became frustrated when the patient was reluctant to eat.
Health professionals were found to be more focused on other treatment issues such as managing adverse effects and ensuring clinical outcomes. Some even delegated the responsibility of meals to other professionals. This preoccupation with other aspects of patient care is part of a more traditional model that may need to be reconsidered.
Observation of and informal dialogues with the participants in this study demonstrated the complex relationship between meals and AYA patients, and their family caregivers, and their healthcare team. “The findings in our study highlight how important it is that doctors and nurses take all aspects of the AYA health into consideration, as reflected in the biopsychosocial model,” the researchers explained, adding that “the importance of acknowledging meals [is] more than simply a matter of potential weight loss or nutritional deficiencies in the clinical setting.”
This study had a sample size of only 12 patients, who were recruited after their first chemotherapy session; however, a small sample size is common within phenomenological research. Another limitation discussed in the study was that all participants hailed from one Western European country. Cultural settings can influence the importance of meals and may affect patients’ perceptions of eating meals, the researchers pointed out.
“Our findings revealed that adopting a holistic approach including aesthetic aspects to meals had the potential to further increase AYA’s food intake,” the researchers concluded.
Christensen ME, Haahr A, Olsen PR, Rose HK, Norlyk A. Love, joy and necessity – a phenomenological study of food and meals in adolescents and young adults with cancer receiving high-emetogenic chemotherapy. Eur J Oncol Nurs. Published online Aug. 24, 2021. doi:10.1016/j.ejon.2021.102020