title: The eating experience in long-term survivors of head and neck cancer: a mixed-methods study.
abstract: OBJECTIVE
  This study explored the eating experience in long-term survivors of head and neck cancer (HNC) ≥3 years post concurrent chemoradiation. Quality of life (QOL) and the meanings and perceptions survivors had as it related to the eating experience were explored.
  
  
  METHODS
  Purposive sampling was utilized; 10 long-term survivors of HNC participated in the study. A mixed-methods approach was used; exploratory qualitative research using content analysis and summary statistics was used to describe demographic and clinical characteristics and the Vanderbilt Head and Neck Symptom Survey version 2.0 scores (VHNSS 2.0).
  
  
  RESULTS
  Four categories (psychological, social impact, functional status, and the current eating experience) containing 15 subthemes and 1 overarching theme (adaptation) emerged. Current health status, QOL, and QOL related to eating were viewed favorably despite the impact of treatment late effects on participants' daily lives. Adaptation and maladaptation in regard to food choice and downplaying of symptoms were recognized. Interviews as well as the VHNSS 2.0 scores indicated that xerostomia, mucosal sensitivity, swallowing difficulty, length of time required to eat, and dysgeusia remained problematic.
  
  
  CONCLUSIONS
  Psychological, functional, and social losses associated with eating were identified. Participants modify or avoid foods that are challenging yet report enjoyment with eating. Challenges with eating were downplayed. Due to the potential negative nutritional and social implications of avoiding specific food/food groups, standard of care in long-term survivors of HNC should include assessment of the eating experience and functional challenges. Nutrition professional can help patients optimize dietary intake and the eating experience.
authors: Department of Nutritional Sciences, Rutgers, The State University of New Jersey, School of Health Related Professions, 65 Bergen Street, Room 157, Newark, NJ, 07107-3001, USA. ganzerhl@shrp.rutgers.edu.
authors: Heidi
authors: H
authors: Ganzer
authors: Coordinated Program in Nutrition and Dietetics, Rutgers, The State University of New Jersey, School of Health Related Professions, 65 Bergen Street, Room 156, Newark, NJ, 07107-3001, USA.
authors: Pamela
authors: P
authors: Rothpletz-Puglia
authors: Department of Nutritional Sciences, Rutgers, The State University of New Jersey, School of Health Related Professions, 40 E. Laurel Road, Room 2018, Stratford, NJ, 08084, USA.
authors: Laura
authors: L
authors: Byham-Gray
authors: Division of Hematology and Oncology, Vanderbilt-Ingram Cancer Center, 777 Preston Research Building, Nashville, TN, 37215, USA.
authors: Barbara A
authors: BA
authors: Murphy
authors: Department of Nutritional Sciences, Rutgers, The State University of New Jersey, School of Health Related Professions, 65 Bergen Street, Room 157, Newark, NJ, 07107-3001, USA.
authors: Riva
authors: R
authors: Touger-Decker
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy; D003679:Deglutition / Q000502:physiology; D004408:Dysgeusia / Q000150:complications / Q000453:epidemiology*; D004435:Eating / Q000502:physiology* / Q000523:psychology; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000628:therapy; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D014987:Xerostomia / Q000150:complications / Q000453:epidemiology*
keywords: Eating experience; Head and neck cancer survivors; Mixed methods; Qualitative; Quality of life; Vanderbilt Head and Neck Symptom Survey 2.0