Effects of a self-monitoring intervention in breast cancer patients suffering from taste alterations induced by chemotherapy: A randomized, parallel-group controlled trial

Abstract

This study evaluates the effect of a self-monitoring intervention on taste alterations in breast cancer patients undergoing outpatient chemotherapy. Methods: The study was a randomized controlled trial. Thirty-four participants were divided into two groups: a self-monitoring (SMG) group (n = 17) and a control group (CG) (n = 17). A conceptual framework was developed with reference to the components of self-management, cognitive behavioral therapy, and the concepts of self-monitoring. Interventions were based on this framework. SMGs recorded their taste symptoms as homework and worked with the researcher to set goals and provide feedback four times every three weeks. In the feedback, the researcher actively listened to the SMG about their feelings and coping strategies during the taste changes, and gave approval and praise for these. The implementation period was 9 weeks for each participant; the CG was provided with conventional nursing support. The intervention was evaluated by comparing the items of symptom improvement, quality of life (QOL), and self-efficacy between the groups before and after the start of the intervention using a scale score. Scale scores were also compared for recognition of taste changes, concerns during treatment, distress, and impacts on each treatment day. Results: SMG had significantly lower scores than CG for perceived change in taste (p = 0.009), and there was an interaction with CG (p = 0.008). SMG had also significantly lower scores than CG in concern during treatment (p = 0.015). Conclusion:This study showed that a self-monitoring intervention reduced negative cognition of taste alterations and reduced discomfort. The results suggest that the self-monitoring intervention is effective nursing support for chemotherapy-induced taste alterations.

Dysgeusia in Patients with Breast Cancer Treated with Chemotherapy—A Narrative Review

“…It has been demonstrated that the enhanced expression of cytokines in taste buds can cause taste-related disorders and increase programmed cell death of taste cells when interferon (IFN)-α and IFN-γ are activated [ 32 ]. Among the mechanisms of post-CT taste alterations, the following have been proposed: olfactory receptor cells and taste bud damage, peripheral and central neuropathy, such as neuronal cell deterioration and neurotransmission blockage (involving the VII, IX, and X cranial nerves), mucosal injury, xerostomia, concomitant infections/inflammations requiring specific therapies, and psychological effects [ 10 , 20 ]. Establishing the precise mechanisms through which each drug or therapeutic scheme impairs neurosensorial cells is difficult [ 7 ].…”

“…Furthermore, the physical disability of BC patients by worsening body image and future perspective can have a profound negative psychological impact [ 22 , 53 ], often forcing changes in their social and relational habits both at home and outside home [ 23 , 55 ]. Indeed, BC patients are generally women, who may have to prepare meals for their families while coping with their taste alterations [ 10 ]. It has been reported that women with dysgeusia chose not to eat as much, impaired their eating time, and/or lost interest in preparing meals for themselves and/or their family [ 23 ].…”

“…However, spontaneous strategies may not always be wholesome, leading, for example, to an increased use of salty foods, energy-dense condiments, sweets, or sugary drinks [ 23 ]. On the other hand, a small 9-weeks randomized controlled trial showed that self-monitoring (i.e., the observation and recording of the recognition, moods, and behaviors toward taste changes together with set goals for coping in collaboration with the researcher) determined a significant lower level of recognition of unpleasant taste in BC patients experiencing CT-induced taste alterations with respect to controls (i.e., education about taste alterations and oral care, and conventional nursing support for taste change management) [ 10 ]. Finally, patients with cancer frequently suffer from anxiety, depression, and sleep disturbances related to their diagnosis and the side effects of chemotherapy.…”

“…Several mechanisms contribute to taste alterations in cancer patients, such as cancer-related inflammation, adverse effects of chemotherapy and of other drugs used to treat complications, nutritional status, and the lifestyle habits of the patients [ 9 ]. CT is associated with dysgeusia through multiple mechanisms, such as damage to taste buds and olfactory receptors, impairment to neurotransmission, and other physical (i.e., xerostomia) or psychological effects [ 10 ]. Dysgeusia in cancer subjects undergoing CT is usually underestimated or even ignored by clinicians, as this condition does not represent a life-threatening event nor determine drug dose modifications [ 9 , 11 , 12 ].…”

Randomized clinical trial quantifying the effectiveness of a self-monitoring intervention in cancer patients with peripheral neuropathy: A quantitative study

“…In our previous study [29,30], we reported that an approach combining self-monitoring with goal-setting and feedback techniques is effective in improving symptoms. This study examines whether self-monitoring interventions that incorporate symptom management recording and observation into daily life are effective in improving self-management skills, mental stability, and quality of life in CIPN patients with low adjuvants.…”