Regular collaborative problem-solving to encourage empowerment
nausea, taste changes, cancer, fatigue, anxiety
CANCER, CANCER PROGRESSION, LOSS OF APPETITE
Patients experienced nutrition impact symptoms such as nausea, taste changes, obstructions, fatigue, and loss of appetite that impacted on eating. Symptoms experienced varied from patient-to-patient, and week-to-week, depending on factors such as cancer type, treatment modality, and cancer progression. These symptoms and the consequent loss of weight were a source of anxiety for patients. Patients were uncertain of how to manage eating and drinking with these symptoms and required the dietitian’s support.…I have also lost my appetite and find it difficult to find a meal that I can eat and enjoy without feeling nauseous… I don’t know what to do. I have lost about 3 kilograms in weight since I last wrote. I will see the [usual care] dietitian at the trial centre on Monday and hope she will have an answer for me…. (Participant 2, myPace, week 10)Dietary advice provided by the dietitian (verbally and in written education material) to achieve goals of weight stability in cancer was sometimes in conflict with dietary advice received prior to cancer diagnosis for other health issues. Having regular contact with the dietitian helped patients prioritise dietary instructions and removed the angst that came with trying to decipher conflicting advice leading to greater confidence to self-manage nutrition needs.On many occasions, the patient was unnecessarily worried about their weight status, eating and drinking strategies, or food safety practices, and reassurance from the dietitian alleviated this concern. The prompt and regular delivery of reassurance by the dietitian was empowering for the patient. The dietitian also played an active role in encouraging self-confidence. This included illustrating to the patient when they were managing an issue appropriately and recognising patient achievements. Other forms of empowerment included encouraging social connection and patient participation in self-care. At study cessation, there was a sense that patients felt empowered in their own self-management capabilities.I’ve learnt so much from interacting with [the dietitian] … and I think that’s the best part of it, that a patient has a chance to interact with a professional like that, and be able to help themselves. (Participant 2, myPace and email, post-study interview)