Abstract

Objective: This study aimed to determine patients’ perspectives regarding the role of dietitians in nutrition management.

Methods: This study was conducted at our hospital’s oncology outpatient clinics. It used a questionnaire previously reported in the literature. One hundred sixty-two adult volunteers were included in this study. Patients’ knowledge of nutritional information, preferences for nutrition care, and perspectives on the dietitian’s role were measured. Descriptive statistics were used to describe the continuous variables. The degree of agreement was assessed using a 5-point Likert scale.

Results: Nutritional care was a high priority for most volunteers (74.7%). Almost half of the patients expressed a need for dietitians to address their dietary challenges proactively. Most patients (64.2%) first met with a dietitian during ongoing treatment. They emphasized the need for frequent meetings and were willing to be referred to a dietitian earlier in their treatment.

Conclusions: Most patients are referred to a dietitian after malnutrition, indicating the need for earlier intervention. Patients strongly desire improved communication among the healthcare team members regarding their nutritional concerns. Proactive nutritional management can reduce the incidence of malnutrition and enhance patient outcomes.

Keywords: Cancer treatment, dietitian counseling, nutrition management, patient perspective

Copyright and license

Copyright © 2024 The author(s). This is an open-access article under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Ece MN, Demirel B, Bayoğlu V, Uluköylü Mengüç M, Atasoy BM. Patient perspectives on dietitians’ role in nutrition management among cancer patients: Implications for proactive care and communication . Clin Sci Nutr. 2024;6(3):160-167. doi:10.62210/ClinSciNutr.2024.99

References

  1. Bossi P, Delrio P, Mascheroni A, Zanetti M. The Spectrum of Malnutrition/Cachexia/Sarcopenia in Oncology According to Different Cancer Types and Settings: A Narrative Review. Nutrients. 2021;13:1980. https://doi.org/10.3390/nu13061980
  2. van der Meij BS, Teleni L, McCarthy AL, Isenring EA. Cancer cachexia: an overview of diagnostic criteria and therapeutic approaches for the accredited practicing dietitian. J Hum Nutr Diet. 2021;34:243-254. https://doi.org/10.1111/jhn.12811
  3. Ravasco P, Monteiro-Grillo I, Camilo ME. Does nutrition influence quality of life in cancer patients undergoing radiotherapy? Radiother Oncol. 2003;67:213-220. https://doi.org/10.1016/s0167-8140(03)00040-9
  4. Isenring E, Zabel R, Bannister M, et al. Updated evidence-based practice guidelines for the nutritional management of patients receiving radiation therapy and/or chemotherapy. Nutrition & Dietetics. 2013;70:312-324. https://doi.org/10.1111/1747-0080.12013
  5. Arends J, Baracos V, Bertz H, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017;36:1187-1196. https://doi.org/10.1016/j.clnu.2017.06.017
  6. Muscaritoli M, Arends J, Bachmann P, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr. 2021;40:2898-2913. https://doi.org/10.1016/j.clnu.2021.02.005
  7. Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36:11-48. https://doi.org/10.1016/j.clnu.2016.07.015
  8. Atasoy BM, Özgen Z, Yüksek Kantaş Ö, et al. Interdisciplinary Collaboration in Management of Nutrition during Chemoradiotherapy in Cancer Patients: A Pilot Study. Marmara Medical Journal. 2012;25:32-36. https://doi.org/10.5472/MMJ.2011.02072.1
  9. Taberna M, Gil Moncayo F, Jané-Salas E, et al. The Multidisciplinary Team (MDT) Approach and Quality of Care. Front Oncol. 2020;10:85. https://doi.org/10.3389/fonc.2020.00085
  10. Ravasco P, Monteiro-Grillo I, Camilo M. Individualized nutrition intervention is of major benefit to colorectal cancer patients: long-term follow-up of a randomized controlled trial of nutritional therapy. Am J Clin Nutr. 2012;96:1346-1353. https://doi.org/10.3945/ajcn.111.018838
  11. Isenring EA, Capra S, Bauer JD. Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area. Br J Cancer. 2004;91:447-452. https://doi.org/10.1038/sj.bjc.6601962
  12. Cong MH, Li SL, Cheng GW, et al. An Interdisciplinary Nutrition Support Team Improves Clinical and Hospitalized Outcomes of Esophageal Cancer Patients with Concurrent Chemoradiotherapy. Chin Med J (Engl). 2015;128:3003-3007. https://doi.org/10.4103/0366-6999.168963
  13. Vashi P, Popiel B, Lammersfeld C, Gupta D. Outcomes of systematic nutritional assessment and medical nutrition therapy in pancreatic cancer. Pancreas. 2015;44:750-755. https://doi.org/10.1097/MPA.0000000000000336
  14. Kenny E, Touger-Decker R, August DA. Structured Review of the Value Added by the Registered Dietitian to the Care of Gastrointestinal Cancer Patients. Nutr Clin Pract. 2021;36:606-628. https://doi.org/10.1002/ncp.10568
  15. McCarter K, Baker AL, Britton B, et al. Head and neck cancer patient experience of a new dietitian-delivered health behaviour intervention: 'you know you have to eat to survive'. Support Care Cancer. 2018;26:2167-2175. https://doi.org/10.1007/s00520-017-4029-5
  16. Cook F, Rodriguez JM, McCaul LK. Malnutrition, nutrition support and dietary intervention: the role of the dietitian supporting patients with head and neck cancer. Br Dent J. 2022;233:757-764. https://doi.org/10.1038/s41415-022-5107-8
  17. Kiss NK, Krishnasamy M, Loeliger J, Granados A, Dutu G, Corry J. A dietitian-led clinic for patients receiving (chemo)radiotherapy for head and neck cancer. Support Care Cancer. 2012;20:2111-2120. https://doi.org/10.1007/s00520-011-1321-7
  18. Fuji S, Cheng J, Yakushijin K, Wanitpongpun C. Nutritional support in allogeneic hematopoietic stem cell transplantation Asian perspective. Blood Cell Ther. 2022;5:54-60. https://doi.org/10.31547/bct-2021-024
  19. Cuerda C, Muscaritoli M, Chourdakis M, et al. Nutrition education in medical schools (NEMS) project: Promoting clinical nutrition in medical schools - Perspectives from different actors. Clin Nutr. 2023;42:54-59. https://doi.org/10.1016/j.clnu.2022.11.003
  20. Caccialanza R, Cereda E, Pinto C, et al. Awareness and consideration of malnutrition among oncologists: Insights from an exploratory survey. Nutrition. 2016;32:1028-1032. https://doi.org/10.1016/j.nut.2016.02.005
  21. Almasaudi AS. An investigation of the clinical nutritional practices of oncologists and the management of cancer-related malnutrition in inpatient care. Eur Rev Med Pharmacol Sci. 2023;27:9928-9936. https://doi.org/10.26355/eurrev_202310_34171
  22. Cotogni P, Stragliotto S, Ossola M, Collo A, Riso S; On Behalf Of The Intersociety Italian Working Group For Nutritional Support In Cancer. The Role of Nutritional Support for Cancer Patients in Palliative Care. Nutrients. 2021;13:306. https://doi.org/10.3390/nu13020306
  23. Tanaka N, Takeda K, Kawasaki Y, et al. Early Intensive Nutrition Intervention with Dietary Counseling and Oral Nutrition Supplement Prevents Weight Loss in Patients with Advanced Lung Cancer Receiving Chemotherapy: A Clinical Prospective Study. Yonago Acta Med. 2018;61:204-212. https://doi.org/10.33160/yam.2018.12.003
  24. Polisena CG, Wade VR. Cancer patients need referrals to dietitians. J Am Diet Assoc. 1993;93:975-976. https://doi.org/10.1016/0002-8223(93)92027-u
  25. Maschke J, Kruk U, Kastrati K, et al. Nutritional care of cancer patients: a survey on patients' needs and medical care in reality. Int J Clin Oncol. 2017;22:200-206. https://doi.org/10.1007/s10147-016-1025-6
  26. Isenring E, Capra S, Bauer J. Patient satisfaction is rated higher by radiation oncology outpatients receiving nutrition intervention compared with usual care. J Hum Nutr Diet. 2004;17:145-152. https://doi.org/10.1111/j.1365-277X.2004.00502.x
  27. Guest DD, Adler Jaffe S, Lelii LA, et al. Differing Experiences of Nutrition Care During Treatment Among Oncology Nurses, Providers, and Patients. Clin J Oncol Nurs. 2023;27:653-662. https://doi.org/10.1188/23.CJON.653-662
  28. Keaver L, Richmond J, Rafferty F, Douglas P. Sources of nutrition advice and desired nutrition guidance in oncology care: Patient's perspectives. J Hum Nutr Diet. 2023;36:434-442. https://doi.org/10.1111/jhn.13111
  29. Loeliger J, Dewar S, Kiss N, Drosdowsky A, Stewart J. Patient and carer experiences of nutrition in cancer care: a mixed-methods study. Support Care Cancer. 2021;29:5475-5485. https://doi.org/10.1007/s00520-021-06111-1
  30. Loeliger J, Dewar S, Kiss N, et al. Co-design of a cancer nutrition care pathway by patients, carers, and health professionals: the CanEAT pathway. Support Care Cancer. 2023;31:99. https://doi.org/10.1007/s00520-022-07558-6
  31. Jebb AT, Ng V, Tay L. A Review of Key Likert Scale Development Advances: 1995-2019. Front Psychol. 2021;12:637547. https://doi.org/10.3389/fpsyg.2021.637547
  32. Sullivan ES, Rice N, Kingston E, et al. A national survey of oncology survivors examining nutrition attitudes, problems and behaviours, and access to dietetic care throughout the cancer journey. Clin Nutr ESPEN. 2021;41:331-339. https://doi.org/10.1016/j.clnesp.2020.10.023
  33. Reinhart R, D'Alimonte L, Osmar K, et al. Educating our patients collaboratively: a novel interprofessional approach. J Cancer Educ. 2014;29:382-388. https://doi.org/10.1007/s13187-014-0623-0
  34. Stringer EJ, Sidhu S, Austin K, Cosby C. Nutrition Education Seminars for Prostate Cancer-Diet and Prostate Program: Evaluation and Recommendations (DAPPER Study). Can J Diet Pract Res. 2021;82:27-31. https://doi.org/10.3148/cjdpr-2020-028
  35. De Waele E, Demol J, Caccialanza R, et al. Unidentified cachexia patients in the oncologic setting: Cachexia UFOs do exist. Nutrition. 2019;63-64:200-204. https://doi.org/10.1016/j.nut.2019.02.015
  36. Yee-Ting Cheng T, Szumacher E, Di Prospero L. Breast and Prostate Cancer Patient Perspectives and Perceptions of Interprofessional Collaboration during Cancer Treatment: A Pilot Study. J Med Imaging Radiat Sci. 2014;45:373-381. https://doi.org/10.1016/j.jmir.2014.09.004
  37. Eglseer D, Bauer S. Predictors of Dietitian Referrals in Hospitals. Nutrients. 2020;12:2863. https://doi.org/10.3390/nu12092863
  38. Lorton CM, Griffin O, Higgins K, et al. Late referral of cancer patients with malnutrition to dietitians: a prospective study of clinical practice. Support Care Cancer. 2020;28:2351-2360. https://doi.org/10.1007/s00520-019-05042-2
  39. Lu Z, Fang Y, Liu C, et al. Early Interdisciplinary Supportive Care in Patients With Previously Untreated Metastatic Esophagogastric Cancer: A Phase III Randomized Controlled Trial. J Clin Oncol. 2021;39:748-756. https://doi.org/10.1200/JCO.20.01254
  40. Sanft T, Harrigan M, McGowan C, et al. Randomized Trial of Exercise and Nutrition on Chemotherapy Completion and Pathologic Complete Response in Women With Breast Cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis Study. J Clin Oncol. 2023;41:5285-5295. https://doi.org/10.1200/JCO.23.00871
  41. Arensberg MB, Besecker B, Weldishofer L, Drawert S. Commentary: Quality nutrition care is integral to the Oncology Care Model. Support Care Cancer. 2021;29:7139-7142. https://doi.org/10.1007/s00520-021-06436-x
  42. Soares CH, Beuren AG, Friedrich HJ, Gabrielli CP, Stefani GP, Steemburgo T. The Importance of Nutrition in Cancer Care: A Narrative Review. Curr Nutr Rep. 2024;13:950-965. https://doi.org/10.1007/s13668-024-00578-0
  43. Flores-Pérez JA, de la Rosa Oliva F, Argenes Y, Meneses-Garcia A. Nutrition, Cancer and Personalized Medicine. Adv Exp Med Biol. 2019;1168:157-168. https://doi.org/10.1007/978-3-030-24100-1_11