Experiences and perceptions of social eating for patients living with and beyond head and neck cancer: a qualitative study

Investigating oral somatosensory perception and oral symptoms of head and neck cancer patients: insights on eating behaviour

PURPOSE

Sensory alterations and oral manifestations are prevalent among head and neck cancer (HNC) patients. While taste and smell alterations have been thoroughly investigated, studies on their oral somatosensory perception remain limited. Building upon our previous publication that primarily focused on objective somatosensory measurements, the present work examined self-reported sensory perception, including somatosensation and oral symptoms, in HNC patients and evaluated their link with eating behaviour.

METHODS

A cross-sectional study was conducted using self-reported questionnaires on sensory perception, oral symptoms, sensory-related food preference, and eating behaviour among HNC patients (n = 30). Hierarchical clustering analysis was performed to categorise patients based on their sensory perception. Correlations between oral symptoms score, sensory perception, sensory-related food preference, and eating behaviour were explored.

RESULTS

Two distinct sensory profiles of patients were identified: no alteration (n = 14) and alteration (n = 16) group. The alteration group showed decreased preference towards several sensory modalities, especially the somatosensory. Concerning eating behaviour, more patients in the alteration group agreed to negatively connotated statements (e.g. having food aversion and eating smaller portions), demonstrating greater eating difficulties. In addition, several oral symptoms related to salivary dysfunction were reported. These oral symptoms were correlated with sensory perception, sensory-related food preference, and eating behaviour.

CONCLUSION

This study presented evidence demonstrating that sensory alterations in HNC patients are not limited to taste and smell but cover somatosensory perception and are linked to various aspects of eating. Moreover, patients reported experiencing several oral symptoms. Those with sensory alterations and oral symptoms experienced more eating difficulties.

Patient-reported outcomes of taste alterations and quality of life in patients with nasopharyngeal carcinoma

Objective

To investigate patient-reported outcomes of taste alterations and quality of life (QoL) in patients with nasopharyngeal carcinoma (NPC).

Methods

In this single-center retrospective study medical records of 191 patients with NPC undergoing chemoradiotherapy (CRT) in the Department of Radiotherapy, Jiangsu Cancer Hospital, the Affiliated Cancer Hospital of Nanjing Medical University from January 2021 to December 2021 were reviewed. A total of 120 patients met eligibility criteria and were included. The taste alterations and QoL at multiple time points during radiotherapy (RT) were compared.

Results

There were significant differences in the intensity of taste, discomfort, phantogeusia and parageusia or overall taste alterations at multiple time points during CRT (p-Value<0.001). These four parameters were significantly higher two or four weeks after CRT, or at the end of CRT compared to before CRT (p-Value <0.001). The intensity of taste, discomfort, phantogeusia and parageusia or overall taste alterations were all significantly higher four weeks after CRT compared to two weeks after CRT (p-Value <0.001), and at the end of CRT compared to four weeks after CRT (p-Value <0.001). The chemotherapy-induced taste alteration scale (CiTAS) scores were highest at the end of CRT (p-Value <0.001). There were significant differences in QoL at multiple time points during CRT (p-Value <0.001), and each parameter differed significantly at various time points (p <0.05). The QoL of all areas at the end of CRT were significantly higher than those before CRT, or two or four weeks after CRT (p-Value <0.001).

Conclusions

In patients with NPC undergoing CRT, taste alterations increasingly worsen as treatment progresses, with poor QoL outcomes.

Psychiatric nurses' perception of dignity in patients who attempted suicide

BACKGROUND

Maintaining the dignity of patients who attempted suicide is one of the caregivers' main ethical duties. Yet, in many cases, these patients are not treated with dignity. The concept of dignity is abstract, and there is no research on the dignity of suicidal patients. So, the present study is done to investigate psychiatric nurses' perception of dignity in patients who attempted suicide.

OBJECTIVE

The present study explores the concept of dignity in patients who attempted suicide from the perspective of psychiatric nurses.

RESEARCH DESIGN

The present study is a qualitative, descriptive work of research.

PARTICIPANTS AND RESEARCH CONTEXT

A total of 20 psychiatric nurses from 2 hospitals affiliated with a university of medical sciences in the southeast of Iran were selected via purposeful sampling.

ETHICAL CONSIDERATIONS

The Research Ethics Committee of the Hamadan University of Medical Sciences approved the study's protocol, and ethical principles were followed in general.

FINDINGS

From the findings of the study, three main themes, namely " respect for personal; identity," "management of psychological tension," and "compassion-focused therapy," with 12 sub-themes were extracted.

DISCUSSION AND CONCLUSION

In the perspective of caregivers, patients who attempted suicide need to be cared for in supportive environments with compassionate and respectful behaviors to control their psychological tensions. These conditions would maintain such patients' dignity and result in appropriate behavioral outcomes. Policy-makers and administrators can use the present study's findings to create an appropriate clinical environment in which the dignity of patients who attempted suicide is properly maintained.

Factors that affect quality of life for older people with head and neck cancer: A systematic review

PURPOSE

Quality of life is a critical aspect in the management of older head and neck cancer patients. It needs to be considered alongside survival benefit, treatment burden, and longer-term outcomes. The purpose was to undertake a systematic review of empirical peer-reviewed studies with a primary focus on factors impacting quality of life for older head and neck cancer patients.

METHODS

A systematic review, searching 5 electronic databases (PsychoINFO, MEDLINE, CINHAL, Embase, and Scopus) using PRISMA methodology was conducted. Data was appraised using the Newcastle-Ottawa scale and a narrative synthesis performed.

RESULTS

Only 10 papers fulfilled the inclusion criteria. Two main themes emerged: 1) Impact of head and neck cancer on quality of life domains and 2) quality of life in treatment decision-making.

CONCLUSIONS

In an era of progressive personalised care, there is an evident need for more qualitative and quantitative studies focusing on quality of life for older head and neck cancer patients. However, older head and neck cancer patients experience notable differences, especially with poorer physical functioning and greater eating and drinking challenges. Quality of life impacts older patients decision-making, treatment planning and intensifies post-treatment support.

"It's part of our life now": a qualitative exploration of the social eating experiences of family members of patients living with head and neck cancer

Purpose

Family members (FMs) of patients with head and neck cancer (HNC) report a change in their social eating experience. They miss out on the opportunities and benefits that eating with others provides. However, few studies investigate FM’s social eating experiences, with existing research primarily focusing on the patient experience. Therefore, the aim of this study was to explore the social eating experiences of FMs of patients who have had treatment for HNC.

Methods

A qualitative research design using semi-structured interviews was used to understand FM’s social eating experiences. Key themes were inductively developed from the data using reflexive thematic analysis.

Results

Twelve interviews were conducted with FMs, and three key themes were identified: (1) changes and challenges experienced by FMs due to HNC patients’ social eating difficulties, (2) living with social eating changes is a balancing act, and (3) FMs’ efforts to promote social eating for a patient with HNC. FMs expressed significant changes to their social eating habits within and outside the home, indicating the need for support to meet their own emotional, psychological and social needs.

Conclusion

FMs experience many demands and tensions, having to balance the psychological impact they experience, which are often minimised, whilst attempting to find the best ways to support, protect and encourage their loved ones to adjust and adapt to social eating changes. Therefore, interventions need to support FMs’ challenges and equip them to know how to best support patients living with HNC and themselves.

Implant-based dental rehabilitation in head and neck cancer patients after maxillofacial reconstruction with a free vascularized fibula flap: the effect on health-related quality of life

PURPOSE

To evaluate the effect of implant-based dental rehabilitation (IDR) on health-related quality of life (HRQoL) in head and neck cancer (HNC) patients after reconstruction with a free vascularized fibula flap (FFF).

METHODS

Eligible patients were identified by retrospectively reviewing the medical records of patients treated in Amsterdam UMC-VUmc. HRQoL data were used from OncoQuest, a hospital-based system to collect patient-reported outcome measures in routine care. Data were used of the EORTC QLQ-C30 and QLQ-H&N 35 before FFF reconstruction (T₀) and after completing IDR (T₁). Data were statistically analysed with the chi-square test, independent samples t test and linear mixed models.

RESULTS

Out of 96 patients with maxillofacial FFF reconstruction between January 2006 and October 2017, 57 patients (19 with and 38 without IDR) had HRQoL data at T₀ and T₁. In the cross-sectional analysis, patients with IDR scored significantly better at T₀ and T₁ on several EORTC domains compared to the patients without IDR. Weight loss was significantly different in the within-subject analysis between T₀ and T₁ for patients with IDR (p = 0.011). However, there were no significant differences in the mean changes of all the EORTC QLQ-C30 and EORTC QLQ-H&N35 scores between the defined timepoints for patients with IDR compared to those without.

CONCLUSIONS

In this study, no differences were found in the course of HRQoL in HNC patients who had undergone IDR after maxillofacial FFF reconstruction, compared to those who had not. Patients should be preoperatively informed to have realistic expectations regarding the outcome of IDR.