The patient experience of having a feeding tube during treatment for head and neck cancer: A systematic literature review.


Journal

Clinical nutrition ESPEN
ISSN: 2405-4577
Titre abrégé: Clin Nutr ESPEN
Pays: England
ID NLM: 101654592

Informations de publication

Date de publication:
10 2019
Historique:
received: 25 04 2019
revised: 30 06 2019
accepted: 09 07 2019
entrez: 28 8 2019
pubmed: 28 8 2019
medline: 25 8 2020
Statut: ppublish

Résumé

Patients undergoing treatment for head and neck cancer (HNC) can experience severe weight loss, malnutrition and dehydration which can cause treatment delays. Enteral feeding can reduce the risk of these. However, the use of feeding tubes (FT), including FT type and placement timing is debated. This paper aimed to describe the patient experience of having a FT during treatment for HNC. A systematic literature review of qualitative studies was undertaken in the databases Web of Science, CINAHL, Scopus and Science Direct using Prospero and Joanna Brigg's Institute guidelines. Nine studies were included providing the perspectives of 159 patients who had a FT during treatment for HNC. 150 findings and 183 illustrations which were primarily patient quotes were extracted. Analysis resulted in 42 categories from which nine synthesized findings were produced. These are summarized as: initial reluctance and fear; different understandings and expectations; individual preferences around choice; physical discomfort; restrictions to social life and daily living; new challenges and responsibilities; gradual acceptance; a challenging but rewarding transition process; and overall a worthwhile decision. These findings highlight the nutrition-related burden patients with HNC experience and support the need for interdisciplinary healthcare teams that integrate dietetics and speech pathology. This review supports individualized approaches to FT placement decisions. Further well-designed studies are needed to better understand patient and cancer-service structural factors that may influence the experience of having a FT, to ensure that decisions are evidence-based and patient-centered for best outcomes.

Sections du résumé

BACKGROUND AND AIMS
Patients undergoing treatment for head and neck cancer (HNC) can experience severe weight loss, malnutrition and dehydration which can cause treatment delays. Enteral feeding can reduce the risk of these. However, the use of feeding tubes (FT), including FT type and placement timing is debated. This paper aimed to describe the patient experience of having a FT during treatment for HNC.
METHODS
A systematic literature review of qualitative studies was undertaken in the databases Web of Science, CINAHL, Scopus and Science Direct using Prospero and Joanna Brigg's Institute guidelines.
RESULTS
Nine studies were included providing the perspectives of 159 patients who had a FT during treatment for HNC. 150 findings and 183 illustrations which were primarily patient quotes were extracted. Analysis resulted in 42 categories from which nine synthesized findings were produced. These are summarized as: initial reluctance and fear; different understandings and expectations; individual preferences around choice; physical discomfort; restrictions to social life and daily living; new challenges and responsibilities; gradual acceptance; a challenging but rewarding transition process; and overall a worthwhile decision.
CONCLUSION
These findings highlight the nutrition-related burden patients with HNC experience and support the need for interdisciplinary healthcare teams that integrate dietetics and speech pathology. This review supports individualized approaches to FT placement decisions. Further well-designed studies are needed to better understand patient and cancer-service structural factors that may influence the experience of having a FT, to ensure that decisions are evidence-based and patient-centered for best outcomes.

Identifiants

pubmed: 31451279
pii: S2405-4577(19)30296-7
doi: 10.1016/j.clnesp.2019.07.005
pii:
doi:

Types de publication

Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

66-85

Informations de copyright

Copyright © 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Auteurs

Emily Hazzard (E)

The Wollongong Hospital, Illawarra Shoalhaven Local Health District, NSW, Australia, 2500; School of Medicine, University of Wollongong, NSW, Australia, 2522. Electronic address: eeh989@uowmail.edu.au.

Sarah Gulliver (S)

School of Medicine, University of Wollongong, NSW, Australia, 2522.

Karen Walton (K)

School of Medicine, University of Wollongong, NSW, Australia, 2522.

Anne-Therese McMahon (AT)

School of Medicine, University of Wollongong, NSW, Australia, 2522.

Marianna Milosavljevic (M)

The Wollongong Hospital, Illawarra Shoalhaven Local Health District, NSW, Australia, 2500.

Linda Tapsell (L)

School of Medicine, University of Wollongong, NSW, Australia, 2522.

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Classifications MeSH