Characteristics of taste and smell alterations in patients treated for lung cancer : translation of and results using a symptom specific questionnaire
Sammanfattning: Background : Taste and smell alterations (TSAs) have been foun d to be common and distressing symptoms for patients with cancer. TSAs may also relate to other symptoms affecting food consumption and contribute to poor n utritional intake. Evidence-based knowledge to guide healthcare staff in identificati on and management of TSAs is lacking. Patients with lung cancer have been reported to per ceive TSAs but these alterations are poorly understood. Aim: This thesis explores the characteristics of TSAs in a lung cancer population from data obtained using a questionnaire translated and cultu rally adapted for the purpose. Methods : Two studies are included in this thesis. The firs t study uses a 5-step method for translation and cultural adaptation of the Taste an d Smell Survey (TSS) for use in a Swedish population. The second study uses the translated TS S to explore the characteristics of TSAs reported by patients after starting treatment for l ung cancer and to elucidate how patients describe their TSAs. This study also explores how T SAs relate to demographics, nutritional intake, six-month weight change and other symptoms. Results: The process for translation and cultural adaptatio n of the TSS produced a robust instrument in Swedish. Each of the 5-steps contribu ted information enhancing the quality of the translation, emphasising the value of using a m ulti-step process. Using the translated TSS, 61 out of a sample of 89 patients with primary lung cancer were found to report TSAs at some stage during the study period. Patients rep orting TSAs were younger and more often smokers. Gender differences were seen in char acteristics of TSAs reported with more women reporting stronger sensations of sour, bitter and smell and more men reporting weaker sensations of all tastes and smell. Patients reporting TSAs commonly reported other symptoms, notably loss of appetite, nausea and earl y satiety. A mean six-month weight loss of 6% was seen in patients reporting both TSAs and loss of appetite. Reduced enjoyment of eating was a key feature of patients’ descriptions of TSAs. Energy intakes were seen to decline with increasing number of reported TSAs. Conclusions : The translation and cultural adaptation of the TS S allows comparisons between English and Swedish speaking populations. G ender differences are seen in characteristics of reported TSAs and how TSAs are d escribed. This highlights a need for further investigation of this phenomenon and may in dicate that different approaches for identification and management of TSAs in men and wo men should be considered. Patients described TSAs in terms of both sensory changes enc ompassing taste and/or flavour, and hedonic changes indicating that TSAs are multi-dime nsional. A consistent vocabulary might therefore facilitate more clear communication about TSAs among patients, healthcare staff and researchers.
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