Clinician perspectives on nutritional impairment in children undergoing cancer chemotherapy in Thailand: A
Donruedee Kamkhoad1, Sheila Judge Santacroce2, Autchareeya Patoomwan1
1Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
Pediatric oncology clinicians in Thailand identified factors affecting children's nutrition during chemotherapy. Interventions targeting symptoms, clinician practices, and hospital environment are crucial for improving nutritional status in pediatric cancer patients.
Area of Science:
- Pediatric Oncology
- Clinical Nutrition
- Healthcare Delivery
Background:
- Children undergoing cancer chemotherapy often experience gastrointestinal symptoms and eating difficulties, impacting their nutritional status.
- Understanding clinician perspectives is vital for developing effective nutritional support strategies in pediatric oncology.
Purpose of the Study:
- To explore Thai pediatric oncology clinicians' views on children's gastrointestinal symptoms, eating habits, and nutrition during chemotherapy.
- To identify child, clinician, and hospital-level factors influencing nutritional status in pediatric cancer patients.
Main Methods:
- Qualitative study involving interviews with 22 pediatric oncology clinicians (nurses, physicians, child life specialist, nutrition service staff) at a Bangkok tertiary hospital.
- Interviews focused on gastrointestinal symptoms, eating behaviors, nutrition, clinician cognitions/behaviors, and environmental factors.
- Data analyzed using directed content analysis in the Thai language.
Main Results:
- Children's cancer diagnosis, treatment, and symptoms significantly influenced their nutritional status, weight, and eating patterns.
- Clinician practices and hospital environmental factors also played a role in children's nutritional outcomes.
- Participants had extensive experience, with an average of 15.55 years caring for children with cancer.
Conclusions:
- Multi-level interventions are necessary to optimize nutritional status in Thai children undergoing chemotherapy.
- Interventions should address children's symptoms, clinician knowledge and practices, and hospital environmental factors contributing to negative experiences.
Objective:
This study aimed to explore the perspectives of pediatric oncology clinicians in Thailand on children's gastrointestinal symptoms, eating habits, and nutrition during cancer chemotherapy. Additionally, it sought to identify factors influencing children's nutritional status, including the characteristics of the children, clinician-related factors, and hospital-level factors.
Methods:
The study involved pediatric oncology clinicians working at a tertiary hospital in Bangkok. Data were collected through interviews, focusing on three key areas: (1) children's gastrointestinal symptoms, eating behaviors, and nutrition, (2) clinicians' cognitions and behaviors that impact children's nutrition, and (3) environmental factors. Each participating clinician also identified a colleague who could offer additional perspectives. Interviews were conducted in the Thai language and analyzed using directed content analysis.
Results:
A total of 22 participants were enrolled in the study, comprising sixteen nurses, four physicians, one child life specialist, and one Hospital Nutrition Service staff member. The majority of participants were female (95.4%), with an average age of 37.77 years and an average of 15.55 years of experience in caring for children with cancer. Factors influencing children's nutritional status included the children's cancer diagnosis, treatment exposures, and symptoms. Clinicians attributed changes in children's weight and eating patterns to these symptoms. Influential clinician-related factors included current practices that impacted children's symptoms and food intake. Hospital-level factors included both direct influences on children and those arising from clinical practices.
Conclusions:
To optimize the nutritional status of Thai children undergoing chemotherapy, multi-level interventions are needed. These interventions should target children's symptoms, clinician knowledge, role norms, and address issues related to the hospital environment, specifically those elements that contribute to unpleasant experiences.
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