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Mårtensson U, Jenholt Nolbris M, Mellgren K, Wijk H, Nilsson S. Meals are more than nutrition for children with a malignant or non-malignant disorder with a gastrostomy tube: A qualitative study. Eur J Oncol Nurs 2024; 72:102663. [PMID: 39068866 DOI: 10.1016/j.ejon.2024.102663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE To elucidate mealtime experiences of children hospitalized with a malignant or severe non-malignant disorder -and their parents-after a gastrostomy tube insertion. METHODS A qualitative design involving a child-centred care approach was used. Parents of children aged 1-18 years old who had received a gastrostomy tube during treatment for a malignant or non-malignant disorder were included, as were the children themselves when aged 5-18 years old. Semi-structured interviews with 21 families were carried out and a thematic analysis performed. RESULTS The findings were presented in four themes: changed meal conditions, a troublesome sensory dimension, aggravating obstacles and solving the unmanageable. Hospitalization involves challenges regarding environmental aspects, hospital food and side effects, contributing to impaired nutritional intake and aggravated mealtime situations. CONCLUSIONS Hospital environment and hospital food have a profound impact on children's nutritional intake and mealtime situations. In addition, sensory aspects and side effects aggravate the child's motivation to eat, resulting in demanding meals. The families described a gastrostomy tube as a valuable strategy for improving mealtime situations.
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Affiliation(s)
- Ulrika Mårtensson
- Faculty of Care Science, Work Life and Social Welfare, University of Borås, SE - 501 90, Borås, Sweden.
| | - Margaretha Jenholt Nolbris
- The Queen Silvia Children's Hospital, SE- 416 50, Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30, Gothenburg, Sweden.
| | - Karin Mellgren
- The Queen Silvia Children's Hospital, SE- 416 50, Gothenburg, Sweden; Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 416 85 Gothenburg, Sweden.
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30, Gothenburg, Sweden; Chalmers Technology University/Centre for Health Care Architecture, SE- 412 96, Gothenburg, Sweden.
| | - Stefan Nilsson
- The Queen Silvia Children's Hospital, SE- 416 50, Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30, Gothenburg, Sweden; Centre for Person-Centred Care, University of Gothenburg, SE- 405 30, Gothenburg, Sweden.
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2
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Fistikçi Y, Bilsin Kocamaz E. Eating Behavior, Nutritional Status, and Taste Perception Alteration in Children with Cancer. J Pediatr Hematol Oncol 2024; 46:88-95. [PMID: 38237000 DOI: 10.1097/mph.0000000000002814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/27/2023] [Indexed: 02/28/2024]
Abstract
The aim of this study was to investigate eating behavior, nutritional status, and taste alterations in children with cancer. The population of the study consisted of children 8 to 18 years of age and their parents who were followed up and received chemotherapy in the pediatric hematology and oncology clinic and outpatient clinic of a University Faculty of Medicine Oncology Hospital. Data were collected using the Child Identification Form, the Children's Eating Behavior Questionnaire (CEBQ), the Taste Alteration Scale for Children Receiving Chemotherapy (TAC-TAS), and the Subjective Total Taste Acuity Scale (STTA). Body Mass Index (BMI) Z score was between -2 and +2 (normal) in 92.5% of the children and below ≤-2 (malnutrition) in 7.5%. The mean CEBQ subdimensions scores were food craving 12.48±5.36, emotional overeating 5.28±1.45, enjoyment of food 16.83±5.41, passion for drinking 9.72±5.13, satiety enthusiasm 22.93±6.65, slow eating 9.81±4.95, emotional undereating 16.38±4.41, and food selectivity 10.72±2.86, and the mean total TAC-TAS score was 8.66±10.22. A negative, moderate correlation was determined between food craving and enjoyment of food and taste alteration, with food craving and enjoyment decreasing as food alteration increased. A positive moderate correlation was observed between slow eating and taste alteration, with eating slowing down as taste alteration increased.
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Affiliation(s)
- Yasemin Fistikçi
- Blood Collection Department, Nizip Public Hospital, Gaziantep, Turkey
| | - Elif Bilsin Kocamaz
- Department of Child Health and Diseases Nursing, Dicle University Atatürk Health Science Faculty, Sur, Diyarbakir, Turkey
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3
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Lovell AL, Gardiner B, Henry L, Bate JM, Brougham MFH, Iniesta RR. The evolution of nutritional care in children and young people with acute lymphoblastic leukaemia: a narrative review. J Hum Nutr Diet 2024. [PMID: 38185902 DOI: 10.1111/jhn.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Acute lymphoblastic leukaemia (ALL) is the most common paediatric malignancy in the world. Advances in treatment protocols have resulted in survival rates of >80% in most high-income countries (HIC); however, children and young people (CYP) with ALL continue to face significant nutrition-related challenges during treatment. METHODS This narrative review outlines the changing landscape of treatment and survivorship for CYP with ALL and the advances in nutrition knowledge that call for changes to clinical nutrition practice. RESULTS The incidence of ALL has remained stable in HIC; however, there have been significant advances in survival over the past 30 years. Overweight and obesity are increasingly prevalent in CYP with ALL at diagnosis, during treatment and in survivorship. Coupled with poor diet quality, high-energy and saturated fat intakes, altered eating behaviours and inactivity, this necessitates the need for a shift in nutrition intervention. Undernutrition remains a concern for CYP with high-risk treatment protocols where oral or enteral nutrition support remains a cornerstone of maintaining nutrition status. CONCLUSIONS With improved treatment protocols and high survival rates, a shift to focusing on diet quality, prevention of excessive weight gain and obesity during treatment and survivorship is necessary.
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Affiliation(s)
- Amy L Lovell
- Department of Nutrition and Dietetics, The University of Auckland, Faculty of Medical and Health Sciences, Auckland, New Zealand
- Starship Blood and Cancer Centre, Starship Child Health, Auckland, New Zealand
| | - Breeana Gardiner
- Department of Nutrition and Dietetics, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Louise Henry
- Department of Nutrition and Dietetics, Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Jessica M Bate
- Department of Paediatric Oncology, Southampton Children's Hospital, Southampton, UK
| | - Mark F H Brougham
- Department of Haematology and Oncology, Royal Hospital for Sick Children, Edinburgh, UK
| | - Raquel Revuelta Iniesta
- Children's Health and Exercise Research Centre (CHERC), Faculty of Health and Life Sciences, Public Health and Sport Sciences, Medical School, St Luke's Campus, University of Exeter, Exeter, UK
- Child Life and Health, University of Edinburgh, Edinburgh, UK
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4
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Kamkhoad D, Santacroce SJ, Patoomwan A. Clinician perspectives on nutritional impairment in children undergoing cancer chemotherapy in Thailand: A qualitative descriptive study. Asia Pac J Oncol Nurs 2024; 11:100348. [PMID: 38222967 PMCID: PMC10784142 DOI: 10.1016/j.apjon.2023.100348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/16/2023] [Indexed: 01/16/2024] Open
Abstract
Objective This study aimed to explore the perspectives of pediatric oncology clinicians in Thailand on children's gastrointestinal symptoms, eating habits, and nutrition during cancer chemotherapy. Additionally, it sought to identify factors influencing children's nutritional status, including the characteristics of the children, clinician-related factors, and hospital-level factors. Methods The study involved pediatric oncology clinicians working at a tertiary hospital in Bangkok. Data were collected through interviews, focusing on three key areas: (1) children's gastrointestinal symptoms, eating behaviors, and nutrition, (2) clinicians' cognitions and behaviors that impact children's nutrition, and (3) environmental factors. Each participating clinician also identified a colleague who could offer additional perspectives. Interviews were conducted in the Thai language and analyzed using directed content analysis. Results A total of 22 participants were enrolled in the study, comprising sixteen nurses, four physicians, one child life specialist, and one Hospital Nutrition Service staff member. The majority of participants were female (95.4%), with an average age of 37.77 years and an average of 15.55 years of experience in caring for children with cancer. Factors influencing children's nutritional status included the children's cancer diagnosis, treatment exposures, and symptoms. Clinicians attributed changes in children's weight and eating patterns to these symptoms. Influential clinician-related factors included current practices that impacted children's symptoms and food intake. Hospital-level factors included both direct influences on children and those arising from clinical practices. Conclusions To optimize the nutritional status of Thai children undergoing chemotherapy, multi-level interventions are needed. These interventions should target children's symptoms, clinician knowledge, role norms, and address issues related to the hospital environment, specifically those elements that contribute to unpleasant experiences.
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Affiliation(s)
- Donruedee Kamkhoad
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Autchareeya Patoomwan
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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5
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Clarke E, Pugh G, van den Heuvel E, Winstanley M, Wood AC, Laughton SJ, Lovell AL. Understanding the patient and family experience of nutrition and dietetic support during childhood cancer treatment. Support Care Cancer 2023; 31:326. [PMID: 37154869 PMCID: PMC10167176 DOI: 10.1007/s00520-023-07787-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/27/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE This study aimed to understand the experience of families caring for a child with cancer in New Zealand (NZ) who received nutrition and dietetic support during cancer treatment and their preferences for the delivery, format, and timing of nutrition information. METHODS Childhood cancer patients and their families (N = 21) participated in a mixed-methods study at a specialist paediatric oncology centre in Auckland, NZ. Before the semi-structured interview, participants completed a questionnaire capturing demographic, disease, and treatment characteristics of their child, their nutrition concerns, and their information needs. Quantitative data were described, and qualitative thematic analysis of the semi-structured interviews was performed using NVivo data analysis software. RESULTS Eighty-six percent of participants indicated they had concerns about their child's nutrition during treatment. The most common concerns were anorexia, vomiting, and weight loss. While many were happy with the quality of the nutrition support received, one-third of the patients wanted more support. Four key themes emerged from the interviews: (1) patients experience significant and distressing nutrition challenges; (2) patients and families have mixed perceptions of EN; (3) there are gaps in the current nutrition support system for inpatients; and (4) a desire for more accessible nutrition support. CONCLUSION Childhood cancer patients and families experience significant and distressing nutrition challenges during treatment. Standardising information given to patients and their families may optimise nutrition support for paediatric oncology patients and reduce the discordance between families and health professionals. Future implementation of a nutrition decision aid in this population is warranted.
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Affiliation(s)
- Emma Clarke
- The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Gemma Pugh
- National Child Cancer Network, Te Aho O Te Kahu Cancer Control Agency, Wellington, New Zealand
| | | | - Mark Winstanley
- Starship Blood and Cancer Centre, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand
| | - Andrew C Wood
- Starship Blood and Cancer Centre, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand
| | - Stephen J Laughton
- Starship Blood and Cancer Centre, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand
| | - Amy L Lovell
- The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
- Starship Blood and Cancer Centre, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand.
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6
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Tonorezos ES, Marcil V. Childhood cancer survivors: healthy behaviours and late mortality. Lancet 2023; 401:1403-1405. [PMID: 37030313 DOI: 10.1016/s0140-6736(22)02632-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/15/2022] [Indexed: 04/10/2023]
Affiliation(s)
- Emily S Tonorezos
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD 20954, USA.
| | - Valérie Marcil
- Research Center of the Centre Hospitalier Universitaire Sainte-Justine and Department of Nutrition, Faculty of Medicine, University de Montréal, QC, Canada
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7
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Napartuk M, Bélanger V, Bouchard I, Meloche C, Curnier D, Sultan S, Laverdière C, Sinnett D, Marcil V. Improvement of Diet after an Early Nutritional Intervention in Pediatric Oncology. CHILDREN 2023; 10:children10040667. [PMID: 37189915 DOI: 10.3390/children10040667] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023]
Abstract
Pediatric cancer survivors may experience cardiometabolic sequelae over the course of their lives as a result of the treatments they have received. While nutrition consists of an actionable target for cardiometabolic health, few nutritional interventions have been documented in this population. This study assessed the changes in diet during a one-year nutritional intervention for children and adolescents undergoing cancer treatments and the participants’ anthropometric and cardiometabolic profiles. A total of 36 children and adolescents (mean age: 7.9 years, 52.8% male) newly diagnosed with cancer (50% leukemia) and their parents underwent a one-year individualized nutrition intervention. The mean number of follow-up visits with the dietitian during the intervention was 4.72 ± 1.06. Between the initial and one-year assessments, there was an improvement in diet quality reflected by the Diet Quality Index (5.22 ± 9.95, p = 0.003). Similarly, the proportion of participants with moderate and good adherence (vs. low adherence) to the Healthy Diet Index score almost tripled after one year of intervention (14% vs. 39%, p = 0.012). In parallel, there was an increase in the mean z-scores for weight (0.29 ± 0.70, p = 0.019) and BMI (0.50 ± 0.88, p = 0.002), and in the mean levels of HDL-C (0.27 ± 0.37 mmol/L, p = 0.002) and 25-hydroxy vitamin D (14.5 ± 28.1 mmol/L, p = 0.03). Overall, this study supports that a one-year nutritional intervention deployed early after a pediatric cancer diagnosis is associated with an improvement in the diets of children and adolescents.
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Affiliation(s)
- Mélanie Napartuk
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1A8, Canada
| | - Véronique Bélanger
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1A8, Canada
| | - Isabelle Bouchard
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Caroline Meloche
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Daniel Curnier
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montreal, QC H3G 1Y5, Canada
| | - Serge Sultan
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Caroline Laverdière
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Daniel Sinnett
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Valérie Marcil
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1A8, Canada
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8
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Kerba J, Demers C, Bélanger V, Napartuk M, Bouchard I, Meloche C, Morel S, Prud’homme N, Gélinas I, Higgins J, Curnier D, Sultan S, Laverdière C, Sinnett D, Marcil V. Needs, Barriers and Facilitators of Adolescents Participating in a Lifestyle Promotion Program in Oncology: Stakeholders, Adolescents and Parents’ Perspective. CHILDREN 2022; 9:children9091340. [PMID: 36138649 PMCID: PMC9497682 DOI: 10.3390/children9091340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/17/2022] [Accepted: 08/30/2022] [Indexed: 11/28/2022]
Abstract
Treatments for adolescent cancer can cause debilitating side effects in the short- and long-term such as nausea and malnutrition but also cardiometabolic disturbances. Although the risk for cardiometabolic complications is greater for adolescents with cancer than younger ones, adolescents typically respond poorly to family-oriented health promotion programs. This study aims to assess the needs, barriers and facilitators to healthy lifestyle promotion interventions for adolescents with cancer and how to best adapt these interventions for them. Interviews were held with adolescents treated for cancer (n = 9) and parents (n = 6), focus groups were conducted with stakeholders working in oncology (n = 12) and self-report questionnaires were sent to stakeholders involved in a health promotion intervention (n = 6). At the time of interview, mean age of adolescent participants (40% female) was 17.0 ± 1.9 years (mean age at diagnosis: 14.6 ± 1.6 years). Verbatim and responses to questionnaires were coded and analyzed using qualitative methods. Stakeholder stated that adolescents with cancer need to access activities adapted to their age, to communicate with peers going through a similar experience, and to preserve their schooling and friendships. Barriers to intervention reported by adolescents, parents and stakeholders include lack of motivation, schedule conflicts, fatigue and treatment side effects. Some of the barriers mentioned by adolescents and parents include pain, post-surgery problems, school, physical deconditioning, and lack of time. Facilitators mentioned by adolescents and parents comprise trust in stakeholders’ expertise, personalized approaches, scheduling flexibility. Stakeholders recommended to build trust in the relationship, favoring non-moralizing teachings, adapt interventions to adolescents’ limited attention span and avoiding the use of long-term health benefits as a motivator.
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Affiliation(s)
- Johanne Kerba
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
| | - Catherine Demers
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
| | - Véronique Bélanger
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
| | - Mélanie Napartuk
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
| | - Isabelle Bouchard
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Caroline Meloche
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Sophia Morel
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
| | - Nicolas Prud’homme
- Division of Hematology-Oncology, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Isabelle Gélinas
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montreal, QC H3N 1X7, Canada
| | - Daniel Curnier
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Serge Sultan
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Caroline Laverdière
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Daniel Sinnett
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Valérie Marcil
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +1-514-345-4931-(3272)
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9
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Bélanger V, Delorme J, Napartuk M, Bouchard I, Meloche C, Curnier D, Sultan S, Laverdière C, Sinnett D, Marcil V. Early Nutritional Intervention to Promote Healthy Eating Habits in Pediatric Oncology: A Feasibility Study. Nutrients 2022; 14:nu14051024. [PMID: 35267999 PMCID: PMC8912879 DOI: 10.3390/nu14051024] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 12/21/2022] Open
Abstract
This study aims to describe the feasibility of a nutritional intervention that promotes healthy eating habits early after cancer pediatric diagnosis in patients and their parents. Participants were recruited 4 to 12 weeks after cancer diagnosis as part of the VIE study. The one-year nutritional intervention included an initial evaluation and 6 follow-up visits every 2 months with a registered dietician. The feasibility assessment included rates of retention, participation, attendance, completion of study measures, and participants' engagement. A preliminary evaluation of the intervention's impact on the participants' dietary intakes was conducted. A total of 62 participants were included in the study (51.6% male, mean age = 8.5 years, mean time since diagnosis = 13.2 weeks). The retention and attendance rates were 72.6% and 71.3%, respectively. Attendance to follow-up visits declined over time, from 83.9% to 48.9%. A majority of participants had high participation (50.8%) and high engagement (56.4%). Measures of body-mass-index or weight-for-length ratio and dietary 24-h recalls were the procedures with the highest completion rates. Participants with refractory disease or relapse were less likely to complete the intervention. Post-intervention, participants (n = 21) had a lower sodium intake compared to the initial evaluation. These results suggest that a nutritional intervention that involves patients and parents early after a pediatric cancer diagnosis is feasible.
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Affiliation(s)
- Véronique Bélanger
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada; (V.B.); (J.D.); (M.N.)
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
| | - Josianne Delorme
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada; (V.B.); (J.D.); (M.N.)
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
| | - Mélanie Napartuk
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada; (V.B.); (J.D.); (M.N.)
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
| | - Isabelle Bouchard
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
| | - Caroline Meloche
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
| | - Daniel Curnier
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Serge Sultan
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
- Division of Hematology-Oncology, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada;
| | - Caroline Laverdière
- Division of Hematology-Oncology, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada;
- Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Daniel Sinnett
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
- Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Valérie Marcil
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada; (V.B.); (J.D.); (M.N.)
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
- Correspondence: ; Tel.: +1-514-345-4931 (ext. 3272)
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10
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Cohen J, Goddard E, Brierley ME, Bramley L, Beck E. Poor Diet Quality in Children with Cancer During Treatment. J Pediatr Oncol Nurs 2021; 38:313-321. [PMID: 33960867 DOI: 10.1177/10434542211011050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: With improved long-term health outcomes and survivorship, the long-term nutritional management of childhood cancer survivors, from diagnosis to long-term follow-up, has become a priority. The aim of this study was to examine the diet quality of children receiving treatment for cancer. Methods: Participants were parents of children with cancer who were receiving active treatment and not receiving supplementary nutrition. A 24-h dietary recall assessed food and nutrient intake. Serves of food group intakes and classification of core and discretionary items were made according to the Australian Dietary Guidelines and compared with age and sex recommendations. Results: Sixty-four parents participated (75% female). Most children were not consuming adequate intake of vegetables (94% of patients), fruit (77%), and milk/alternatives (75%). Of the vegetables that were consumed, half were classified as discretionary foods (e.g., chips/fries). Nearly half (49%) of children exceeded recommendations for total sugar intake and 65% of patients had an excessive sodium intake. Discussion: Children receiving cancer treatment are consuming diets of reasonable quantity, but poor quality. Information provided during treatment should focus on educating parents on a healthy diet for their child, the importance of establishing healthy eating habits for life, and strategies to overcome barriers to intake during treatment.
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Affiliation(s)
- Jennifer Cohen
- School of Women's and Children's Health, 7800UNSW Sydney, Sydney, NSW, Australia.,Kids Cancer Centre, 63623Sydney Children's Hospital, Sydney, Australia
| | - Emma Goddard
- School of Medicine, 8691University of Wollongong & Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Mary-Ellen Brierley
- School of Women's and Children's Health, 7800UNSW Sydney, Sydney, NSW, Australia
| | - Lynsey Bramley
- Kids Cancer Centre, 63623Sydney Children's Hospital, Sydney, Australia
| | - Eleanor Beck
- School of Medicine, 8691University of Wollongong & Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
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Mårtensson U, Jenholt Nolbris M, Mellgren K, Wijk H, Nilsson S. The five aspect meal model as a conceptual framework for children with a gastrostomy tube in paediatric care. Scand J Caring Sci 2021; 35:1352-1361. [PMID: 33512004 DOI: 10.1111/scs.12957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/23/2020] [Accepted: 01/04/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cancer treatments may induce side effects and cause eating problems. A gastrostomy tube may be required in order to maintain and optimise the child's nutritional needs. Despite the use of a gastrostomy tube, it is important to maintain a natural and attractive mealtime for the child. The Five Aspect Meal Model is age neutral and originally designed to improve restaurant visits. Its five aspects conceptualise what is necessary to ensure a complete meal experience. To date, there is lack of knowledge to guided model development about mealtimes adapted to children and limited knowledge regarding mealtime experiences for children with a gastrostomy tube. AIM The aim was to investigate whether the Five Aspect Meal Model could be appropriate to be used for children with a gastrostomy tube in caring science and paediatric care. METHODS The design followed steps retrieved from Renjith and colleagues. Seven interviews were performed with the Five Aspect Meal Model as a base in the interview guide. The transcripts were analysed by using a qualitative directed content analysis with a deductive approach, which finally passed into a more inductive one. FINDINGS All aspects of the Five Aspect Meal Model were represented in the interviews. There were also experiences related to the gastrostomy tube and the mealtimes that did not fit into any of the five predetermined categories. As a result, the modified version was developed, an adapted prescribing practice model that includes seven aspects, whereof bodily discomfort and time for change and acceptance are specific to children with a gastrostomy tube. CONCLUSION Based on children and their parent's experiences, the Five Aspect Meal Model has been developed and adapted into a modified version, which includes seven aspects. The modified version seems to be appropriate to use within caring science and paediatric care.
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Affiliation(s)
- Ulrika Mårtensson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margaretha Jenholt Nolbris
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karin Mellgren
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Health Care Architecture, Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Cohen J, Collins L, Gregerson L, Chandra J, Cohn RJ. Nutritional concerns of survivors of childhood cancer: A "First World" perspective. Pediatr Blood Cancer 2020; 67 Suppl 3:e28193. [PMID: 31994836 DOI: 10.1002/pbc.28193] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 12/12/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022]
Abstract
Childhood cancer survivor (CCS) numbers are increasing as a result of advances in both treatment and supportive care. This positive outcome is tempered by the recognition of a high burden of chronic health conditions. Here, we review the nutritional concerns of CCS, including dietary habits after treatment and the factors during treatment that may contribute to chronic health conditions. Dietary interventions that have been conducted in CCS will be summarized along with focused goals of these interventions. We will also address the need to leverage these interventions to reduce the risk of chronic disease in CCS.
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Affiliation(s)
- Jennifer Cohen
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Randwick, New South Wales, Australia
| | - Laura Collins
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Laura Gregerson
- Department of Nutrition, Exercises and Sport, University of Copenhagen, Copenhagen, Denmark
| | - Joya Chandra
- Departments of Pediatrics Research, Epigenetics and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard J Cohn
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Randwick, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
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