Dealing with loss: Food and eating in women with ovarian cancer on parenteral nutrition

Anne Marie Sowerbutts, Simon Lal, Jana Sremanakova, Andrew Clamp, Gordon Jayson, Lisa Hardy, Eileen Sutton, Anne-Marie Raftery, Antje Teubner, Sorrel Burden

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Abstract

Background
Malignant bowel obstruction is a common complication of ovarian cancer, resulting in limited oral intake. Home parenteral nutrition (HPN) may be offered to patients in this condition to meet nutritional requirements. However, it is not known how they experience being unable to eat. This study reports how patients related to food whilst receiving HPN.

Methods
A qualitative study underpinned by phenomenology with women with advanced ovarian cancer in bowel obstruction receiving parenteral nutrition. Interview transcripts were analysed thematically guided by the techniques of Van Manen.

Results
We recruited 20 women to the study. Participants were interviewed a maximum of four times and a total of 39 in-depth longitudinal interviews were conducted.
Participants could tolerate minimal amounts of food, if they had a venting gastrostomy. Not being able to eat engendered a sense of sadness and loss, and most women found it challenging to be in the presence of others eating. They adopted strategies to cope, which included fantasying about food and watching cookery programmes. These approaches were not a long term solution either participants came to terms with their loss or the strategies became less effective in providing relief.

Conclusion
HPN meets the nutritional requirements of patients with malignant bowel obstruction, but cannot replace the non-nutritive functions of food. Healthcare professionals can offer a patient centred approach by acknowledging the difficulties patients may face and wherever possible encourage them to focus on the positive benefits of interacting with people rather than the loss of eating on social occasions.
Original languageEnglish
JournalJournal of Human Nutrition and Dietetics
Early online date6 Feb 2020
DOIs
Publication statusPublished - 2020

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