Cancer cachexia care: the contribution of qualitative research to evidence-based practice.
BACKGROUND
Despite its prevalence and prognostic impact, primary cachexia is not well understood. Its potential to cause considerable psychological stress indicates the need for qualitative research to help understand the perspectives of those affected.


OBJECTIVE
The aims of this study were to describe the perspectives of patients with primary cachexia, of their relatives, and of the healthcare professionals involved in their care and to demonstrate how this evidence can be applied in practice at 4 different levels of application ranging from empathy to coaching.


METHODS
A review of the qualitative literature and empirical qualitative investigation was used to understand the experiences of patients and relatives and the perspectives of professionals.


RESULTS
The main worries expressed by patients and relatives concerned appetite loss, changing appearance, prognosis, and social interaction. We also describe their coping responses and their views of professionals' responses. The main concerns of professionals related to poor communication, lack of clinical guidance, and lack of professional education.


CONCLUSIONS
Understanding patients', families', and professionals' perspectives, and mapping that understanding onto what we know about the trajectory and prognosis of the condition, provides the evidence base for good practice. Qualitative research has a central role to play in providing the knowledge base for the nursing care of patients with cachexia.


CONCLUSIONS
The evidence provided can improve nurses' insight and assist them in assessment of status, the provision of guidance, and coaching. There is a need for the development of a holistic, information-based integrated care pathway for those with cancer cachexia and their families.
School of Nursing and Midwifery, Queen's University Belfast, United Kingdom. s.porter@qub.ac.uk
Sam
S
Porter
Claire
C
Millar
Joanne
J
Reid
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001066:Appetite; D002100:Cachexia / Q000209:etiology* / Q000451:nursing* / Q000503:physiopathology; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D009723:Nurse-Patient Relations; D009859:Oncology Nursing / Q000379:methods*; D011379:Prognosis; D036301:Qualitative Research; D012307:Risk Factors; D012720:Severity of Illness Index; D015431:Weight Loss