BACKGROUND Head and neck cancer (HNC) survivors may face an array of nutrition impact symptoms (NIS), including dysphagia, xerostomia, taste alterations, and difficulty chewing, which occur as a result of tumor location and treatment with radiation. Few qualitative studies have assessed the chronic impact of NIS on everyday life. OBJECTIVE The aim of this study was to obtain a comprehensive understanding of the lived experience of chronic NIS burden on HNC survivors. DESIGN AND PARTICIPANTS Semi-structured, face-to-face interviews were conducted with 31 HNC survivors to address the research aims and objectives. An interview guide was utilized to consider themes that had been generated through the review of literature and through the researchers' clinical experience within the field. There were probes within the interview for participants to raise unanticipated issues and flexibility to follow such leads. Interviews were conducted between March 2018 and May 2019. ANALYSIS A single researcher conducted the interviews to maintain consistency in data collection. Interviews lasted approximately 1 hour and were audio-recorded. All interview transcripts were professionally transcribed verbatim and checked for accuracy to ensure a complete account of participants' responses. Two researchers applied qualitative thematic content analysis to identify major themes. RESULTS The following 4 major thematic categories emerged from the interview data: symptom presence, dietary preferences, eating adjustments, and addressing symptoms. The most common symptoms were dysphagia, xerostomia, taste alterations, and bothered chewing. As a result of dietary preferences, survivors avoided citrus fruits, dry foods, raw vegetables, sweets, and meats. Survivors preferred soft and moist foods, spices or seasonings, and sauces or gravies. Eating adjustments were described as increased time to consume meals, cutting food into smaller pieces, consuming less food, and consuming more fluid. As a result of food preference changes and eating adjustments, survivors reported dietary pattern changes from pre to post treatment. All survivors experienced 1 or more chronic NIS, yet nearly 40% were unaware before treatment that NIS had the potential to persist chronically. CONCLUSIONS The results of this study provide unique qualitative insight into the lived experience of chronic NIS burden on HNC survivors. By recognizing the daily challenges, health care team members can better support HNC survivors in the transition from active treatment to follow-up care.

中文翻译：

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头颈癌幸存者在放射后慢性营养影响症状负担方面的经历：一项定性研究

背景头颈癌 (HNC) 幸存者可能面临一系列营养影响症状 (NIS)，包括吞咽困难、口腔干燥症、味觉改变和咀嚼困难，这些症状是肿瘤定位和放射治疗的结果。很少有定性研究评估 NIS 对日常生活的长期影响。目的 本研究的目的是全面了解 HNC 幸存者慢性 NIS 负担的生活经历。设计和参与者 对 31 名 HNC 幸存者进行了半结构化的面对面访谈，以解决研究目的和目标。访谈指南被用来考虑通过文献回顾和研究人员在该领域的临床经验产生的主题。采访中对参与者进行了调查，以提出意料之外的问题，并灵活地遵循这些线索。访谈于 2018 年 3 月至 2019 年 5 月期间进行。 分析 一位研究人员进行了访谈以保持数据收集的一致性。采访持续了大约 1 小时，并进行了录音。所有采访记录都经过专业的逐字转录并检查准确性，以确保完整记录参与者的反应。两名研究人员应用定性主题内容分析来确定主要主题。结果 访谈数据中出现了以下 4 个主要主题类别：症状存在、饮食偏好、饮食调整和解决症状。最常见的症状是吞咽困难、口干、味觉改变和咀嚼困难。由于饮食偏好，幸存者避免食用柑橘类水果、干粮、生蔬菜、糖果和肉类。幸存者更喜欢柔软湿润的食物、香料或调味料，以及酱汁或肉汁。饮食调整被描述为增加进餐时间、将食物切成小块、减少食物消耗和消耗更多液体。由于食物偏好的变化和饮食调整，幸存者报告了从治疗前到治疗后的饮食模式变化。所有幸存者都经历了 1 次或多次慢性 NIS，但近 40% 的人在治疗前不知道 NIS 有可能长期持续存在。结论 本研究的结果为 HNC 幸存者慢性 NIS 负担的生活经历提供了独特的定性见解。通过认识到日常挑战，