title: The life experience of nutrition impact symptoms during treatment for head and neck cancer patients: a systematic review and meta-synthesis.
abstract: In the literature, there is limited research about the changed meaning of food, the eating and the eating experience during treatment in patients with head and neck cancer. This systematic review includes findings from a qualitative research synthesis to gain a deeper understanding of the influence and experiences of dysphagia, dysgeusia, oral mucositis and xerostomia in head and neck cancer patients (HNC) and suggests recommendations for care practice.
  
  
  
  A systematic review and meta-synthesis techniques were adopted to identify, appraise and synthesize the relevant literature regarding the experience of nutritional symptoms of HNC patients conducted according to the PRISMA guidelines. Several electronic databases such as PubMed, CINAHL, Scopus, PsycINFO and the Cochrane Library databases were searched.
  
  
  
  A systematic search yielded 121 papers, of which 12 met the inclusion criteria. A thematic account of shared nutritional symptom experiences reported across studies is highlighted and presented. Eight major themes covering three key supportive care domains were identified: impact of symptoms (symptoms during treatment, symptoms working together, affecting daily living activities and physical changes, symptoms and food changes), changing social networks and support (social life restrictions, support of peers), nutritional concerns and strategies (coping strategies, professional support).
  
  
  
  Dysphagia, dysgeusia, oral mucositis and xerostomia negatively affected the patients' quality of life throughout the period of treatment. The patients' nutritional symptom experiences do not occur in isolation. Therefore, acknowledging the patients' eating difficulties and challenges can guarantee appropriate management and support to best manage symptoms in a timely manner.
authors.affiliation: Department of Health Sciences, University of Genoa, Via Pastore 1, 16132, Genoa, Italy. breva05@gmail.com.
authors.forename: Valentina
authors.initials: V
authors.lastname: Bressan
authors.affiliation: Department of Health Sciences, University of Genoa, Via Pastore 1, 16132, Genoa, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Bagnasco
authors.affiliation: Department of Health Sciences, University of Genoa, Via Pastore 1, 16132, Genoa, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Aleo
authors.affiliation: Department of Health Sciences, University of Genoa, Via Pastore 1, 16132, Genoa, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Catania
authors.affiliation: Department of Health Sciences, University of Genoa, Via Pastore 1, 16132, Genoa, Italy.
authors.forename: Milko P
authors.initials: MP
authors.lastname: Zanini
authors.affiliation: School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland.
authors.forename: Fiona
authors.initials: F
authors.lastname: Timmins
authors.affiliation: Department of Health Sciences, University of Genoa, Via Pastore 1, 16132, Genoa, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Sasso
mesh_terms: D004435:Eating; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008016:Life Change Events; D009752:Nutritional Status; D011788:Quality of Life
keywords: Eating experience; Head and neck cancer; Qualitative research; Symptom; Systematic review