Role limitations lead to unmet nutrition needs
diarrhoea, nausea, throat, dry retching, anorexia
SAID, ANOREXIA
The case analysis revealed a myriad of unmet needs described by participants throughout the 18-week intervention period. To explore this further, an analysis of the post-intervention interviews (Not being able to eat. Physically, not mentally. I mean, I used to force food down my throat to the point where I was, you know, dry retching and I couldn’t eat because I was losing so much weight. But eating, that was the most challenging. (Participant 7, post-study interview)The centralised nature of the dietetic intervention meant that many of the physical symptoms of anorexia, dry retching, nausea, and diarrhoea were unable to be managed effectively without the collaboration of a multidisciplinary team where the dietitian could advocate for medications to be reviewed. Often, where medication was prescribed to manage these symptoms, its dosing and mechanism for action were not explained or understood by the patients.“I’m on four Creon [PERT]. Is that right?” She [the dietitian] said, “No, no, back to two.” Instantly the bowels stopped feeling bloated and gassy and all that jazz, it was much better for me. (Participant 8, post-study interview)The dietitian provided recommendations for participants to contact their general practitioner, oncologist, or surgeon to prescribe medications; however, this required patient advocacy which was often delayed. Delays were caused by appointment time delays, a competing schedule of chemotherapy and/or other appointments, and physical access such as transport.