"Completely and utterly flummoxed and out of my depth": patient and caregiver experiences during and after treatment for head and neck cancer-a qualitative evaluation of barriers and facilitators to best-practice nutrition care.

摘要: Malnutrition is prevalent in patients with head and neck cancer (HNC), impacting on outcomes. Despite publication of best-practice nutrition care clinical guidelines, evidence-practice gaps persist. This project aimed to understand the perspectives their caregivers about nutritional how unmet supportive needs can be better addressed designing a new model (MOC). The results will contribute documenting barriers enablers implementing best practice for HNC. Qualitative interviews were conducted who had completed radiotherapy or without (+/−) other treatment modality (surgery and/or systematic therapy) curative intent Patients purposively sampled from major tertiary referral centre Sydney, Australia. Patients’ primary also invited participate if both parties consented. A semi-structured interview schedule was developed elicit information facilitators change inform development MOC. Interviews transcribed verbatim then analysed using an inductive thematic approach. study one component mixed methods design explore oncology unit. Eleven participants (seven patients, four caregivers) took part interviews. Four key themes identified branching within each: (1) being ill-prepared impact treatment, even when advised; (2) navigating complex systems meet significant needs; (3) depleted by overwhelming prolonged suffering; (4) lost translation. highlights unique people HNC those caring them. To successfully deliver patient-centred MOC, specific strategies required address: early ongoing access expert clinicians; integrated coordinated care; individual information, education support and; MDT staff accurate consistent messaging, ensuring collective responsibility. Nutrition did not appear viewed separately overall patient perspective as importance ultimately became vital treatment.