A process and mechanism of action evaluation of the effect of early and intensive nutrition care, delivered via telephone or mobile application, on quality of life in people with upper gastrointestinal cancer: a study protocol

BACKGROUND Adults diagnosed with cancers of the stomach, oesophagus and pancreas are at high risk of malnutrition. In many hospital-based health care settings there is a lack of systems in place to provide the early and intensive nutrition support that is required by these high-risk cancer patients. Our research team undertook a 3-arm parallel randomised controlled trial to test the provision of an early and intensive nutrition intervention to patients with UGI cancers using a synchronous telephone based delivery approach versus an asynchronous mobile application-based delivered using an iPad compared to a control group to address this issue. The novel coronavirus-19 (COVID-19) has resulted in the rapid adoption of telehealth services to enable remote delivery of healthcare to comply with physical distancing laws and to keep vulnerable patient’s safe. Thus, the impetus to understand the best way to deliver these services to enhance acceptability, engagement and improve patients’ health care outcomes has become even more urgent. OBJECTIVE To explore the acceptability of an early, intensive e-health nutrition intervention delivered either via a synchronous telephone based approach or an asynchronous mobile application based approach. METHODS Participants were recruited who were newly diagnosed with upper gastrointestinal cancer and who had consented to take part in a nutrition intervention. In depth, semi-structured qualitative interviews were conducted by telephone and transcribed verbatim. Data was analysed using deductive thematic analysis using the Theoretical Framework of Acceptability in NVivo Pro 12 Plus. RESULTS A total of 20 participants were interviewed, 10 from each intervention group (synchronous or asynchronous delivery). Four major themes emerged from the qualitative synthesis: 1) participant self-efficacy, low levels of burden and intervention comprehension were required for intervention effectiveness and positive affect 2) participants sought a sense of support and security through relationship building and rapport with their dietitian 3) knowledge acquisition and learning enabled empowerment through self-management 4) convenience, flexibility and bridging the gap to hard to reach individuals. CONCLUSIONS Features of eHealth models of nutrition care delivered via telephone and mobile application can be acceptable to those undergoing treatment for upper gastrointestinal cancer. Convenience, knowledge acquisition, improved self-management and support were key benefits for participants. Future interventions should focus on a home-based intervention delivered with simple, easy to use technology. Ideally enabling participants, the choice of and allow individual choice of intervention delivery mode (synchronous or asynchronous) that aligns to their individual values and capabilities may support improved outcomes. CLINICALTRIAL Trial Registration: Australian and New Zealand Clinical Trial Registry, 27th January 2017 (ACTRN12617000152325).

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Exploring the Attitudes of Health Professionals Providing Care to Patients Undergoing Treatment for Upper Gastrointestinal Cancers to Different Models of Nutrition Care Delivery: A Qualitative Investigation

Nutrients ◽

10.3390/nu13031020 ◽

2021 ◽

Vol 13 (3) ◽

pp. 1020

Author(s):

Kate Furness ◽

Catherine Huggins ◽

Daniel Croagh ◽

Terry Haines

Keyword(s):

Health Care ◽

Health Professionals ◽

Gastrointestinal Cancer ◽

Care Delivery ◽

Digital Health ◽

Ideal Model ◽

Nutrition Care ◽

Upper Gastrointestinal Cancer ◽

Upper Gastrointestinal ◽

The Ideal

Background: People with upper gastrointestinal cancer are at high risk for malnutrition without universal access to early nutrition interventions. Very little data exist on the attitudes and views of health professionals on providing nutrition care to this patient cohort delivered by electronic health methods. COVID-19 has fast-tracked the adoption of digital health care provision, so it is more important than ever to understand the needs of health professionals in providing health care via these modes. This study aimed to explore the perspectives of health professionals on providing nutrition care to upper gastrointestinal cancer patients by electronic methods to allow the future scaling-up of acceptable delivery methods. Methods: Semi-structured qualitative interviews were conducted face-to-face or by telephone and recorded, de-identified and transcribed. Thematic analysis was facilitated by NVivo Pro 12. Results: Interviews were conducted on 13 health professionals from a range of disciplines across several public and private health institutions. Thematic analysis revealed three main themes: (1) the ideal model, (2) barriers to the ideal model and (3) how to implement and translate the ideal model. Health professionals viewed the provision of nutrition interventions as an essential part of an upper gastrointestinal cancer patient’s treatment with synchronous, telephone-based internal health service models of nutrition care overwhelmingly seen as the most acceptable model of delivery. Mobile application-based delivery methods were deemed too challenging for the current population serviced by these clinicians. Conclusion: The use of novel technology for delivering nutrition care to people receiving treatment for upper gastrointestinal cancers was not widely accepted as the preferred method of delivery by health professionals. There is an opportunity, given the rapid uptake of digital health care delivery, to ensure that the views and attitudes of health professionals are understood and applied to develop acceptable, efficacious and sustainable technologies in our health care systems.

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Evaluating efficacy of screening for upper gastrointestinal cancer in China: a study protocol for a randomized controlled trial

Chinese Journal of Cancer Research ◽

10.21147/j.issn.1000-9604.2017.04.02 ◽

2017 ◽

Vol 29 (4) ◽

pp. 294-302 ◽

Cited By ~ 9

Author(s):

Wanqing Chen ◽

◽

Hongmei Zeng ◽

Ru Chen ◽

Ruyi Xia ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Study Protocol ◽

Gastrointestinal Cancer ◽

Controlled Trial ◽

Randomized Controlled ◽

Upper Gastrointestinal Cancer ◽

Upper Gastrointestinal

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Variations in perioperative nutrition care in upper gastrointestinal cancer: findings from the Australia wide nourish point prevalence study

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2021.09.581 ◽

2021 ◽

Vol 46 ◽

pp. S749

Author(s):

I. Deftereos ◽

J. Yeung ◽

E. Isenring ◽

V. Carter ◽

N. Kiss

Keyword(s):

Gastrointestinal Cancer ◽

Point Prevalence ◽

Prevalence Study ◽

Point Prevalence Study ◽

Nutrition Care ◽

Upper Gastrointestinal Cancer ◽

Perioperative Nutrition ◽

Upper Gastrointestinal

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In Reply: Centralization of Upper Gastrointestinal Cancer Care Should Be Dictated by Quality of Care

Annals of Surgical Oncology ◽

10.1245/s10434-017-6222-7 ◽

2017 ◽

Vol 24 (S3) ◽

pp. 621-622

Author(s):

Daniel Henneman ◽

Johan L. Dikken ◽

Hein Putter ◽

Valery E. P. P. Lemmens ◽

Lydia G. M. Van der Geest ◽

...

Keyword(s):

Quality Of Care ◽

Gastrointestinal Cancer ◽

Cancer Care ◽

Upper Gastrointestinal Cancer ◽

Upper Gastrointestinal

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Satisfaction in Population-Based Cancer Screening in a Chinese Rural High-Risk Population: The Yangzhong Early Diagnosis and Treatment of Upper Gastrointestinal Cancer

10.21203/rs.3.rs-858010/v1 ◽

2021 ◽

Author(s):

Xiang Feng ◽

Jinhua Zhu ◽

Zhaolai Hua ◽

Qin Zhou ◽

Aiwu Shi ◽

...

Keyword(s):

Early Diagnosis ◽

Service Quality ◽

Gastrointestinal Cancer ◽

Service Providers ◽

Diagnosis And Treatment ◽

Screening Service ◽

Upper Gastrointestinal Cancer ◽

Perceptions And Expectations ◽

Upper Gastrointestinal

Abstract Background Screening for upper gastrointestinal cancer (UGC) effectively reduces morbidity and mortality in gastric and oesophageal cancers. It is considered one of the effective measures for cancer control in China, but studies on its functional quality are lacking. Our study assessed the quality of screening service funded by Upper Gastrointestinal Cancer Early diagnosis and treatment (UGCEDAT) and its correlation in Yangzhong People’s hospital, China. Methods A cross-sectional study was conducted among 516 screening users at a screening centre in Yanghzong People’s hospital from April to July 2021. The service quality questionnaire (SERVQUAL) base on the service quality gap (SQG) model was adopted. We calculated the mean scores of perceptions and expectations and their gap. To determine the association between overall SQG and related features of participants, we used a multivariate logistic regression. Results The average scores of screening service users’ perceptions and expectations were 4.05 and 4.55, respectively. The SQG of five dimensions (tangibles, reliability, responsiveness, assurance and empathy) were negative, and the overall SQG was − 0.51. The responsiveness dimension had the largest gap, and tangibles had the smallest gap. Occupation status (AOR:0.575; CI:0.371–0.890), health self-assessment (AOR:4.965; CI:1.352–18.232), endoscopy experience (AOR:0.551; CI:0.377–0.806), distance from screening hospital (AOR:1.847; CI:1.249–2.733) and frequency of visit (AOR:1.646; CI:1.100-2.462) were associated with the overall SQG. Conclusions We observed a negative gap between perceptions and expectations of the function quality of screening service, implying a high dissatisfaction across different dimensions. Service providers should take adequate measures to bridge the dimension with the largest quality gap. Meanwhile, attention should be paid to identifying the influencing factors of the overall gap and the characteristics of dimensional expectations and perceived scores to improve the effectiveness of the intervention.

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