Abstract
Rationale. Many cancer patients and survivors do not meet nutritional and physical activity guidelines, thus healthier eating and greater levels of physical activity could have considerable benefits for these individuals. While research has investigated cancer survivors’ perspective on their challenges in meeting the nutrition and physical guidelines, little research has examined how health professionals may assist their patients meet these guidelines. Cancer nurses are ideally placed to promote healthy behaviours to their patients, especially if access to dieticians or dietary resources is limited. However, little is known about cancer nurses’ healthy eating promotion practices to their patients. The primary aim of this study was to examine current healthy eating promotion practices, beliefs and barriers of cancer nurses in Australia and New Zealand. A secondary aim was to gain insight into whether these practices, beliefs and barriers were influenced by the nurses’ hospital or years of work experience.Patients and Methods. An online questionnaire was used to obtain data. Sub-group cancer nurse comparisons were performed on hospital location (metropolitan vs regional and rural) and years of experience (<25 or ≥25 years) using ANOVA and chi square analysis for continuous and categorical data respectively.Results. A total of 123 Australasian cancer nurses responded to the survey. Cancer nurses believed they were often the major provider of nutritional advice to their cancer patients (32.5%), a value marginally less than dieticians (35.9%) but substantially higher than oncologists (3.3%). The majority promoted healthy eating prior (62.6%), during (74.8%) and post treatment (64.2%). Most cancer nurses felt that healthy eating had positive effects on the cancer patients’ quality of life (85.4%), weight management (82.9%), mental health (80.5%), activities of daily living (79.7%) and risk of other chronic diseases (79.7%), although only 75.5% agreed or strongly agreed that this is due to a strong evidence base. Lack of time (25.8%), adequate support structures (17.3%) nutrition expertise (12.2%) were cited by the cancer nurses as the most common barriers to promoting healthy eating to their patients. Comparisons based on their hospital location and years of experience, revealed very few significant differences, indicating that cancer nurses’ healthy eating promotion practices, beliefs and barriers were largely unaffected by hospital location or years of experience.Conclusion. Australasian cancer nurses have favourable attitudes towards promoting healthy eating to their cancer patients across multiple treatment stages and believe that healthy eating has many benefits for their patients. Unfortunately, several barriers to healthy eating promotion were reported. If these barriers can be overcome, nurses may be able to work more effectively with dieticians to improve the outcomes for cancer patients.
Highlights
Cancer rates are rising in many countries, with Australian 2010 data indicating that within an overall population of 22 million people, there were 116,580 new cases of cancer diagnosed that year (Australian Institute of Health and Welfare, 2014)
Australian cancer nurses were invited to participate via links posted on the Cancer Nurses Society of Australia (CNSA) website, while New Zealand cancer nurses were invited via an email from the Cancer Nurses Section of the New Zealand Nurses Organisation (NZNO)
As emerging research indicates the benefits of maintaining a healthy diet in cancer patients and survivors (Langius et al, 2013; Millar & Davison, 2012; Mokdad et al, 2003), this study sought to gain insight into current nutrition promotion practices, beliefs and perceived barriers of cancer nurses in Australia and New Zealand
Summary
While survival rates are high, cancer treatments result in many short- and long-term side-effects that seriously affect the quality of life (QoL) and overall health and wellbeing of these individuals (Mazzotti et al, 2012). Many of these treatments may contribute to cancer fatigue, with hormonal therapies predisposing these individuals to unhealthy changes in body composition such as cachexia or sarcopenic obesity (Galvao et al, 2008; Young et al, 2014).
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