title: Fighting a losing battle: eating-related distress of men with advanced cancer and their female partners. A mixed-methods study.
abstract: BACKGROUND
  Anorexia/cachexia is a frequent complication of advanced cancer with poorly understood psychosocial impact or eating-related distress (ERD) on both patients and family members. To assist palliative care practitioners manage this important psychosocial aspect of care, we aimed to discover and describe elements of ERD, focusing on male patients with advanced cancer and their female partners.
  
  
  METHODS
  Nineteen male patients and their partners were systematically investigated by (1) focus group interviews and data analysis inspired by Grounded Theory, and (2) a comparative survey with categorical questions.
  
  
  RESULTS
  For patients, eating-related distress was characterised by obstruction to eating, poor and capricious appetite, a disconnection of oral intake and ability to gain weight, and continuous efforts to eat. Partners expressed feelings of deep concern, frustration, and insufficiency in their loving and innovative efforts to prepare appealing food. Partners were more concerned about patients' weight loss than patients themselves (P =0.002). Patients felt more pressure to eat from partners than they estimated (P =0.007).
  
  
  CONCLUSIONS
  Anorexia/cachexia of male cancer patients affects the cooking at home, a couple's daily eating routines, and their spousal relationship. Identification of ERD may trigger targeted psychosocial interventions.
authors.affiliation: Department of Internal Medicine, Cantonal Hospital, St. Gallen, Switzerland. florian.strasser@kssg.ch
authors.forename: F
authors.initials: F
authors.lastname: Strasser
authors.forename: J
authors.initials: J
authors.lastname: Binswanger
authors.forename: T
authors.initials: T
authors.lastname: Cerny
authors.forename: A
authors.initials: A
authors.lastname: Kesselring
mesh_terms: D000328:Adult; D000368:Aged; D000855:Anorexia / Q000209:etiology*; D002100:Cachexia / Q000209:etiology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*; D015431:Weight Loss