Post-diagnostic dietary changes in prostate cancer: associations with patients’ wellbeing and the perceptions of GPs

Abstract

This paper aims to investigate associations between perceived control and Health-Related Quality of Life (HRQOL) with dietary changes after prostate cancer diagnosis and to explore General Practitioners' (GPs) perceptions on the role of diet in prostate cancer post-diagnosis. Ninety-five prostate cancer patients completed measures of dietary change, one for after diagnosis and another for after therapy. They also scored their HRQOL and perceived control. There were discrepancies in dietary changes reported between a general question (28.4% no dietary changes) and a specific (42.1-51.5% range of no change for various food items). Most patients initiated healthy changes. Patients who changed their diet after diagnosis had lower cognitive functioning and external locus of control (doctors). Patients who changed their diet after therapy had lower cognitive and emotional functioning, quality of life and external locus of control (doctors). Then, fourty-four GPs responded to an online survey. Their open-ended responses were analyzed using Content Analysis. They reported interest in the role of diet in cancer but also lack of relevant knowledge. They were skeptical on providing information. Clinical interventions should consider patients' cognitive ability, their relationship with their health professional and their wellbeing.Also, GPs' confidence to provide dietary advice needs to be addressed. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 IntroductionThe evidence related to the association between dietary changes and cancer patients' wellbeing is scarce. A patients' perceived control (Hagger and Orbell, 2003), HealthRelated Quality of Life (HRQOL) (Alfano et al., 2009;Larsson et al., 2005), fatigue (Pakiz et al., 2005), neuroticism, introversion and increased social support and stress (Choi et al., 2013) were found to affect post-diagnostic changes in diet, exercise and smoking. However, these associations are less clear for patients' post-diagnostic dietary behaviors (Di Noia and Prochaska, 2010;Kristal et al., 2000;Ory et al., 2002).To this end, the American Cancer Society called for studies investigating associations between dietary changes and HRQOL (Brown et al., 2003). A recent systematic review (Kassianos et al., 2014) suggests that this association is inconclusive and unclear. Greater perceived control may mediate this association. Control is related with a greater likelihood of making difficult behavioural changes (Thompson and Schlehofer, 2008; Thompson and Spacapan, 1991) like adhering to a healthier diet (Parelkar et al., 2013). Also, patients who perceive health as a matter of chance are less likely to adhere to healthy behaviours (Grotz et al., 2011).The benefits of adhering to a post-diagnostic healthier diet can be observed in patients' psychological outcomes. For example, women with breast cancer who change t...

Combined Use of Web-Based and In-Person Education on Ill Health Self-management Skills in Adults With Bipolar Disorder: Protocol for a Mixed Methods Study

“…Thus, interventions, mainly psychotherapeutic, toward addressing these issues need to be further explored [ 28 ]; the combination of in-person and web-based interventions is highly recommended for effective management of symptoms [ 29 ]. Other studies support that performance of ill health self-management skills is associated with one’s self-perception about the health-related locus of control and related health literacy level [ 30 , 31 ]. Overall, educational interventions targeted to people with chronic disorders, including BD, should constitute a basic service offered by health care systems and mental health service structures at the international level [ 11 ].…”

Psychosocial Determinants of Lifestyle Change after a Cancer Diagnosis: A Systematic Review of the Literature

“…The majority of the 71 quantitative studies were conducted in the USA (n = 38, 53.5%) . The other studies were conducted in Canada [64][65][66][67][68][69][70][71], Australia [72][73][74][75][76][77][78][79], Germany [80][81][82], the Netherlands [83,84], the UK [85,86], Portugal [87], New Zealand [88], Sweden [89], Spain [90], Norway [91], the UK [85,92], Denmark [93], Taiwan [94,95], South Korea [96], Puerto Rico [38], and China [44]. The number of participants in these studies ranged from 23 [40] to 3000 [61].…”

“…Median sample size in these 71 quantitative studies was 224.5 (Interquartile Range 354). Most of the studies were conducted in breast cancer survivors (n = 25, 35.2%) [26,28,29,32,[35][36][37][38]40,[42][43][44]50,51,61,[64][65][66]68,70,80,87,90,93,94], five studies were conducted in prostate cancer survivors [73,74,85,89,92], six in colorectal cancer survivors [33,34,49,63,72,96], two in lung cancer survivors [52,95], two in head and neck cancer survivors [55,71], one in in thyroid cancer survivors [79], one in laryngology cancer survivors [54], one in endometrial cancer survivors [27], and one in hematologic cancer survivors [69]. 27 studies (38%) were conducted in survivors of mixed cancer types [30,31,…”

“…27 studies (38%) were conducted in survivors of mixed cancer types [30,31,39,41,[45][46][47][48]53,[56][57][58][59][60]62,67,73,[75][76][77][78][81][82][83][84]86,88]. 15 out of 71 studies (i.e., 21.1%) had a cross-sectional study design and assessed changes in lifestyle behaviors following diagnosis and/or treatment retrospectively [26,31,32,62,67,73,76,78,79,83,[89][90][91][92]96]. 38 out of 71 studies (i.e., 53.5%) were intervention studies [27,28,[33][34][35][36][37]…”

“…Nine studies assessed socio-demographic determinants of dietary changes in cancer survivors [61,70,76,78,80,87,[90][91][92]. Seven out of those nine studies assessed age as a determinant of lifestyle changes [61,70,78,80,87,90,91].…”