title: Food connections: A qualitative exploratory study of weight- and eating-related distress in families affected by advanced cancer.
abstract: OBJECTIVE
  Weight loss and eating problems are common in cancer and have a profound effect on quality of life. They are symptoms of cancer cachexia syndrome. This paper examines interdependency between advanced cancer patient and family carer experience of weight- and eating-related problems, leading to proposition of how weight- and eating-related distress might be alleviated in both patients and their family members.
  
  
  METHODS
  The study was of cross-sectional design. Interpretive phenomenology informed the analytic process. Patient participants had advanced cancer and concern about weight and/or eating. Semi-structured interviews were conducted with 31 patient-spouse/partner dyads (62 interviews), which focused on weight loss and eating problems in the patient and how these had been managed.
  
  
  RESULTS
  This study found change in weight and eating habits in advanced cancer to disrupt food connections. Food connects us with others physically by fuelling the body and sustaining physical activity and life, emotionally by communicating feelings about self and others, and socially by providing a reason for sharing time with others. The study found three dyadic responses to disruption in food connections; dual acceptance, dual resistance and mismatched resistance. They are of interest, because they can help discriminate between those patient-family carer dyads who might benefit from psychosocial interventions and those who will cope without such help.
  
  
  CONCLUSIONS
  The findings challenge clinicians and researchers to seek ways of aiding not only with concerns of the individual patients and carers, but also with interactions between distressed family members affected by symptoms of cancer cachexia syndrome.
authors.affiliation: School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, UK. Electronic address: HopkinsonJB@Cardiff.ac.uk.
authors.forename: J B
authors.initials: JB
authors.lastname: Hopkinson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002100:Cachexia / Q000209:etiology* / Q000523:psychology*; D017028:Caregivers / Q000523:psychology; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000209:etiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological; D015431:Weight Loss
keywords: Cachexia; Cancer; Carer; Distress; End of life; Family; Qualitative; Research; Supportive care; Weight loss