TY - JOUR

T1 - Re-embodying eating after surgery for oesophageal cancer

T2 - Patients' lived experiences of participating in an education and counselling nutritional intervention

AU - Missel, Malene

AU - Hansen, Mette

AU - Jackson, Rie

AU - Siemsen, Mette

AU - Schønau, Mai Nanna

N1 - © 2018 John Wiley & Sons Ltd.

PY - 2018/4

Y1 - 2018/4

N2 - AIMS AND OBJECTIVES: To provide in-depth insight into patients' lived experiences of participating in an education and counselling nutritional intervention after curative surgery for oesophageal cancer.BACKGROUND: Surgery for oesophageal cancer carries a risk of malnutrition. The consequences of nutritional problems may lead to increased morbidity and mortality postoperatively and have consequences for convalescence, rehabilitation and quality of life.DESIGN: Qualitative study based on a phenomenological approach. The theoretical framework was grounded in the philosophy of Merleau-Ponty.METHODS: Qualitative interviews were conducted with 10 patients who participated in an education and counselling nutritional intervention after surgery for oesophageal squamous-cell carcinoma. Data were analysed according to the principles of Kvale and Brinkmann, and their three levels of interpretation were applied.FINDINGS: The essence of experiencing the education and counselling nutritional intervention can be divided into three themes: embodied disorientation, living with increased attention to bodily functions and re-embodying eating.CONCLUSIONS: Patients were living with increased attention to bodily functions and tried to find a balance between the task of eating and nutritional needs. Despite the embodied perceptions of alterations after oesophageal cancer surgery, the patients developed high levels of bodily awareness and skills in self-management. This process was characterised by reconnecting to the body and re-embodying eating. The intervention empowered the patients to regain some control of their own bodies in an effort to regain agency in their own lives.RELEVANCE TO CLINICAL PRACTICE: There is a need for systematic long-term follow-up after surgery for oesophageal cancer regarding nutrition. The findings of this study can inform future supportive nutrition care service development aimed at supporting patients to learn to eat sufficiently after oesophageal resection.

AB - AIMS AND OBJECTIVES: To provide in-depth insight into patients' lived experiences of participating in an education and counselling nutritional intervention after curative surgery for oesophageal cancer.BACKGROUND: Surgery for oesophageal cancer carries a risk of malnutrition. The consequences of nutritional problems may lead to increased morbidity and mortality postoperatively and have consequences for convalescence, rehabilitation and quality of life.DESIGN: Qualitative study based on a phenomenological approach. The theoretical framework was grounded in the philosophy of Merleau-Ponty.METHODS: Qualitative interviews were conducted with 10 patients who participated in an education and counselling nutritional intervention after surgery for oesophageal squamous-cell carcinoma. Data were analysed according to the principles of Kvale and Brinkmann, and their three levels of interpretation were applied.FINDINGS: The essence of experiencing the education and counselling nutritional intervention can be divided into three themes: embodied disorientation, living with increased attention to bodily functions and re-embodying eating.CONCLUSIONS: Patients were living with increased attention to bodily functions and tried to find a balance between the task of eating and nutritional needs. Despite the embodied perceptions of alterations after oesophageal cancer surgery, the patients developed high levels of bodily awareness and skills in self-management. This process was characterised by reconnecting to the body and re-embodying eating. The intervention empowered the patients to regain some control of their own bodies in an effort to regain agency in their own lives.RELEVANCE TO CLINICAL PRACTICE: There is a need for systematic long-term follow-up after surgery for oesophageal cancer regarding nutrition. The findings of this study can inform future supportive nutrition care service development aimed at supporting patients to learn to eat sufficiently after oesophageal resection.

KW - Aged

KW - Attitude to Health

KW - Carcinoma, Squamous Cell/complications

KW - Counseling/methods

KW - Eating

KW - Esophageal Neoplasms/complications

KW - Esophageal Squamous Cell Carcinoma

KW - Female

KW - Health Education/methods

KW - Humans

KW - Male

KW - Malnutrition/prevention & control

KW - Middle Aged

KW - Qualitative Research

KW - Quality of Life

U2 - 10.1111/jocn.14297

DO - 10.1111/jocn.14297

M3 - Journal article

VL - 27

SP - 1420

EP - 1430

JO - Journal of Clinical Nursing

JF - Journal of Clinical Nursing

SN - 0962-1067

IS - 7-8

ER -