Healthcare professionals' response to cachexia in advanced cancer: a qualitative study

Oncol Nurs Forum. 2013 Nov;40(6):E393-402. doi: 10.1188/13.ONF.E393-E402.

Abstract

Purpose/objectives: To explore healthcare professionals' experience, understanding, and perception of the needs of patients with cachexia in advanced cancer.

Research approach: A qualitative approach based on symbolic interactionism.

Setting: A regional cancer center in a large teaching hospital in the United Kingdom.

Participants: 34 healthcare professionals who had experience providing care to patients with cachexia in advanced cancer.

Methodologic approach: Data collection consisted of two phases: focus group and semistructured interviews. Interviews were digitally recorded and transcribed verbatim for analysis. This article reports on findings from the second phase of data collection.

Findings: Analysis revealed that professional approaches to cachexia were influenced by three overarching and interthinking themes: knowledge, culture, and resources. Healthcare professionals commonly recognized the impact of the syndrome; however, for nonpalliative healthcare professionals, a culture of avoidance and an overreliance on the biomedical model of care had considerable influence on the management of cachexia in patients with advanced cancer.

Conclusions: Cachexia management in patients with advanced cancer can be difficult and is directed by a variable combination of the influence of knowledge, culture of the clinical area, and available resources. Distinct differences exist in the management of cachexia among palliative and nonpalliative care professionals.

Interpretation: This study presented a multiprofessional perspective on the management of cachexia in patients with advanced cancer and revealed that cachexia is a complex and challenging syndrome that needs to be addressed from a holistic model of care.

Knowledge translation: Cachexia management in patients with advanced cancer is complex and challenging and is directed by a combination of variables. An overreliance on the biomedical model of health and illness occurs in the management of cachexia in patients with advanced cancer. Cachexia needs to be addressed from a holistic model of care to reflect the multidimensional needs of patients and their families.

MeSH terms

  • Attitude of Health Personnel*
  • Cachexia / diagnosis
  • Cachexia / etiology*
  • Cachexia / nursing
  • Cachexia / psychology
  • Cancer Care Facilities
  • Culture
  • Focus Groups
  • Hospitals, Teaching
  • Humans
  • Interviews as Topic
  • Neoplasms / complications*
  • Neoplasms / nursing
  • Neoplasms / psychology
  • Neoplasms / therapy
  • Nurse Clinicians / psychology
  • Nurses / psychology
  • Nutritionists / psychology
  • Palliative Care / psychology
  • Personnel, Hospital / education
  • Personnel, Hospital / psychology*
  • Personnel, Hospital / supply & distribution
  • Physicians / psychology
  • Professional-Patient Relations
  • Qualitative Research
  • Time Management
  • United Kingdom
  • Weight Loss