title: Health care professionals' experience, understanding and perception of need of advanced cancer patients with cachexia and their families: The benefits of a dedicated clinic.
abstract: BACKGROUND
  Cachexia is defined as the on-going loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support. It is found in up to 80% of patients with advanced cancer and has profound psycho-social consequences for patients and their families. Previous studies demonstrate that many healthcare professionals receive little formal education in cachexia management leading them to feel that they have limited understanding of the syndrome and cannot intervene effectively. This study aims to examine the value of a dedicated cachexia clinic and its influence on staff understanding and practice.
  
  
  METHODS
  An exploratory qualitative study was conducted. The study employed semi-structured interviews with a range of healthcare professionals responsible for designing and delivering cancer care in a large teaching hospital in Australia. This hospital had a dedicated cachexia clinic.
  
  
  RESULTS
  In-depth interviews were conducted with 8 healthcare professionals and senior managers. Four themes were identified: formal and informal education; knowledge and understanding; truth telling in cachexia and palliative care; and, a multi-disciplinary approach. Findings show that improved knowledge and understanding across a staff body can lead to enhanced staff confidence and a willingness to address cancer cachexia and its consequences with patients and their families.
  
  
  CONCLUSIONS
  Comparisons with similar previous research demonstrate the advantages of providing a structure for staff to gain knowledge about cachexia and how this can contribute to feelings of improved understanding and confidence necessary to respond to the challenge of cachexia.
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK. David.scott@qub.ac.uk.
authors.forename: David
authors.identifier: http://orcid.org/0000-0002-8978-5486
authors.initials: D
authors.lastname: Scott
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Reid
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Hudson
authors.affiliation: Barwon Health, Geelong, VIC, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Martin
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
authors.forename: Sam
authors.initials: S
authors.lastname: Porter
mesh_terms: D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D002100:Cachexia / Q000523:psychology / Q000628:therapy*; D002983:Clinical Competence / Q000592:standards; D004501:Education, Medical / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care / Q000592:standards; D010348:Patient Care Team / Q000592:standards; D010465:Perception; D014342:Truth Disclosure; D014739:Victoria