Lived experience of dietary change among Chinese colorectal cancer survivors in Hong Kong: A qualitative study

Janet Yuen Ha Wong, Judy Wai Chu Ho, Antoinette Marie Lee, Daniel Yee Tak Fong, Natural Chu, Sharron Leung, Y Y Wynnie Chan, Sharon Hs Lam, Ivy P F Leung, Duncan Macfarlane, Ester Cerin, Aliki J Taylor, Kar Keung Cheng, Janet Yuen Ha Wong, Judy Wai Chu Ho, Antoinette Marie Lee, Daniel Yee Tak Fong, Natural Chu, Sharron Leung, Y Y Wynnie Chan, Sharon Hs Lam, Ivy P F Leung, Duncan Macfarlane, Ester Cerin, Aliki J Taylor, Kar Keung Cheng

Abstract

Objectives: This is a qualitative study which aims to understand the lived experience of dietary changes among Chinese survivors of colorectal cancer who participated in a dietary intervention.

Setting: The surgical and oncological departments of four public hospitals in Hong Kong.

Participants: Fifty-five Chinese colorectal cancer survivors who were aged 18 years or above and had received potentially curative treatment in the surgical and oncological departments in Hong Kong were examined. Participants' mean age was 64 years, with 29 (53%) males.

Intervention: A 12-month dietary intervention delivered via face-to-face motivational interviews, fortnightly motivational phone calls, monthly electronic pamphlets, quarterly newsletters and quarterly group meeting.

Outcome measure: We adopted the qualitative approach to capture participants' perspectives and to apply the understanding pragmatically in everyday life. Content analysis was conducted.

Results: We identified themes of motives to changes of dietary practices including (1) individual commitment to dietary change; (2) adaptive strategies in interpersonal contexts and (3) working with healthcare professionals during the journey.

Conclusions: The findings demonstrated how Chinese custom and culture posing unique challenges to colorectal cancer survivors and the need of having dietary advice from healthcare professionals. Participants were motivated to change their eating habits by support from family, friends and healthcare professionals. Our findings could help healthcare professionals provide specific dietary advice and guidance to Chinese colorectal cancer survivors.

Trial registration number: NCT01708824.

Keywords: gastrointestinal tumours; nutritional support; public health; qualitative research.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

References

    1. Hong Kong Cancer Registry . Overview of Hong Kong cancer statistics of 2015, 2017. Available:
    1. Kanwar SS, Poolla A, Majumdar AP. Regulation of colon cancer recurrence and development of therapeutic strategies. World J Gastrointest Pathophysiol 2012;3:1–9. 10.4291/wjgp.v3.i1.1
    1. World Cancer Research Fund International . Cancer prevention & survival: Summary of global evidence on diet, weight, physical activity & what increases or decreases your risk of cancer. World Cancer Research Fund International, 2016. Available:
    1. Cha R, Murray MJ, Thompson J, et al. . Dietary patterns and information needs of colorectal cancer patients post-surgery in Auckland. N Z Med J 2012;125:38–46
    1. Aune D, Chan DSM, Lau R, et al. . Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies. BMJ 2011;343:d6617. 10.1136/bmj.d6617
    1. Williams K, Steptoe A, Wardle J. Is a cancer diagnosis a trigger for health behaviour change? findings from a prospective, population-based study. Br J Cancer 2013;108:2407–12. 10.1038/bjc.2013.254
    1. Fisher A, Beeken RJ, Heinrich M, et al. . Health behaviours and fear of cancer recurrence in 10 969 colorectal cancer (CRC) patients. Psychooncology 2016;25:1434–40. 10.1002/pon.4076
    1. Ma G. Food, eating behavior, and culture in Chinese Society. J Ethn Foods 2015;2:195–9. 10.1016/j.jef.2015.11.004
    1. Mews C, Schuster S, Vajda C, et al. . Cultural Competence and Global Health: Perspectives for Medical Education - Position paper of the GMA Committee on Cultural Competence and Global Health. GMS J Med Educ 2018;35:1–17. 10.3205/zma001174
    1. Schwarzer R, Luszczynska A. How to overcome health-compromising behaviors - The health action process approach. Eur Psychol 2008;13:141–51.
    1. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process 1991;50:179–211. 10.1016/0749-5978(91)90020-T
    1. Ho JWC, Lee AM, Macfarlane DJ, et al. . Study protocol for "Moving Bright, Eating Smart"- A phase 2 clinical trial on the acceptability and feasibility of a diet and physical activity intervention to prevent recurrence in colorectal cancer survivors. BMC Public Health 2013;13:487. 10.1186/1471-2458-13-487
    1. Higginbottom GM, Pillary JJ, Boadu NY. Guidance on performing focused ethnographies with an emphasis on healthcare research. Qualitative Report 2013;18:1–16
    1. Roper JM, Shapira J. Ethnography in nursing research. Vol 1. Thousand Oaks, CA: SAGE, 2000.
    1. Bikker AP, Atherton H, Brant H, et al. . Conducting a team-based multi-sited focused ethnography in primary care. BMC Med Res Methodol 2017;17:139. 10.1186/s12874-017-0422-5
    1. Denzin NK. Collecting and interpreting qualitative materials. Vol 3. Thousand Oaks, CA: SAGE, 2008.
    1. Darawsheh W. Reflexivity in research: promoting rigour, reliability and validity in qualitative research. Int J Ther Rehabil 2014;21:12:560–8. 10.12968/ijtr.2014.21.12.560
    1. Silverman D. Qualitative research. thousand oaks. CA: SAGE, 2016.
    1. Meyerhardt JA, Niedzwiecki D, Hollis D. The content analysis guidebook. thousand oaks. CA: SAGE, 2016.
    1. Cregan C. Can organizing work? an inductive analysis of individual attitudes toward Union membership. ILR Review 2005;58:282–304. 10.1177/001979390505800207
    1. Piazza J, Ruby MB, Loughnan S, et al. . Rationalizing meat consumption. The 4Ns. Appetite 2015;91:114–28. 10.1016/j.appet.2015.04.011
    1. Leroy F, Degreef F. Convenient meat and meat products. societal and technological issues. Appetite 2015;94:40–6. 10.1016/j.appet.2015.01.022
    1. Rong X, Peng Y, Yu H-P, et al. . Cultural factors influencing dietary and fluid restriction behaviour: perceptions of older Chinese patients with heart failure. J Clin Nurs 2017;26:717–26. 10.1111/jocn.13515
    1. Bell K. Cancer survivorship, mor(t)ality and lifestyle discourses on cancer prevention. Sociol Health Illn 2010;32:349–64. 10.1111/j.1467-9566.2009.01198.x
    1. Wong-Kim E, Sun A, DeMattos MC. Assessing cancer beliefs in a Chinese immigrant community. Cancer Control 2003;10:22–8. 10.1177/107327480301005s04
    1. Shih FJ. Concepts related to Chinese patients' perceptions of health, illness and person: issues of conceptual clarity. Accid Emerg Nurs 1996;4:208–15. 10.1016/S0965-2302(96)90086-7
    1. Holm LE, Nordevang E, Ikkala E, et al. . Dietary intervention as adjuvant therapy in breast cancer patients--a feasibility study. Breast Cancer Res Treat 1990;16:103–9. 10.1007/BF01809294
    1. Schwarzer R, Luszczynska AJEP. How to overcome health-compromising behaviors: the health action process approach. Eur Psychol 2008;13:141–51. 10.1027/1016-9040.13.2.141

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir