Malnutrition screening and nutritional support in cancer care : dietetic challenges and the role of multidisciplinary collaboration

Background: Nutrition plays a key role in helping cancer patients tolerate treatments and maintain their quality of life. This PhD aimed to explore the opportunities to improve dietetic support during cancer treatments. Methods: A scoping review was conducted to investigate what is currently known regarding the barriers to late and missed dietetic referrals of cancer patients. A multi-centre audit and a case report were then undertaken to explore current practices in the NHS regarding nutritional screening and support. Two qualitative studies were conducted to explore experiences and opinions of cancer patients and healthcare professionals working in oncology; the semi-structured interviews were analysed using a framework analysis. Results: The scoping review identified current barriers to nutrition support. The audit revealed incomplete anthropometric documentation and lack of systematic nutritional screening, whilst the case study highlighted the effectiveness of the involvement of dietitians in cancer care. The interviews with patients underlined both the current lack of nutritional information and the value of lifestyle advice for patients. Finally, interviews with healthcare professionals stressed their concerns about the limitations of current screening tools and the importance of integrating nutritional education into cancer care. Conclusion: Some critical gaps in the nutritional care of people with a cancer diagnosis were identified, which, if addressed, could likely enhance patients’ overall treatment journey. This thesis emphasised the need to integrate nutrition into standard cancer care. Contribution to knowledge: This thesis has developed a detailed understanding of the role of nutrition in cancer care, highlighting the gaps and barriers to early nutritional support for patients. Persistent and unresolved issues in the field of nutrition care in oncology settings were analysed in depth, demonstrating their ongoing relevance to both research and practice. The needs and wishes of both cancer patients and healthcare professionals regarding nutrition education were explored in depth. The findings highlighted aspects of care not discussed in the existing literature, such as the suitability of screening tools for overweight patients and the needs of patients living with genetic mutations. The central role of dietitians in oncology care was highlighted, while acknowledging the broader context of multidisciplinary dynamics. The findings combined a variety of methods to provide a uniquely holistic perspective. This new knowledge can inform clinical practice and provide actionable insights for improving care.

Grantor dc:publisher

Oxford Brookes University

Author dc:creator

• Tabacchi, Francesca

Contributors dc:contributor

• Francesca Tabacchi
• Coe, Shelly
• Iatridi, Vasiliki
• Tammam, Jonathan
• Watson, Eila

Statement dc:rights

• All rights reserved

Language dc:language

en

DOI dc:identifier

https://doi.org/10.24384/y1ne-zw43

OAI identifier oai:identifier

tle:f66a9847-d53f-468f-a3b6-6520c47d0a0f:d6bd9758-527a-46cd-bfe2-c433766e8fca:1