Dieet- en voedingsinligtingbehoeftes en -soekgedrag in 'n kankerkonteks

Abstract

Cancer is one of the most feared diseases. Cancer can be pro-actively treated through diet and nutrition and reactively during treatment and other phases. Information as well diet and nutrition advice and diet therapy is therefore important. Against this background and with the increased number in cancer patients, a study was done (mostly qualitative and empirically) in the Tshwane Metropolitan (South Africa) also known as Pretoria in 2011. Other core role players were involved: oncologists, general medical practitioners, dietitians and family members. The study was based on a literature review and eclectic use of the information behaviour models of Johnson (1997) (based on the cancer context), Leckie, Pettigrew and Sylvain (1996) (based on professional occupation), Wilson (1981, 1996) (general model), Dervin (2005a, 2005b) (sense making), Savolainen (2005) (everyday life experiences) and the cognitive assessment theory and stress coping theory of Lazarus (1992). The aim of this study was to determine the diet and nutrition information seeking behaviour and information needs for patients, family members and other core role players in stressful cancer contexts. The sub problems included: information needs and information seeking behaviour of oncologists, (oncology) dietitians, patients and family members regarding diet and nutrition as well as advice in this regard; findings from similar and related studies reported in the literature and the choice of an appropriate information behaviour model with eclectic use of models with recognition to coping in a cancer contexts. This was aimed to be exploratory study. Cancer is a sensitive situation and people do not easily talk about it to strangers. Participants were therefore invited according to a convenience and snowball sampling method. Dietitians were (with a few exceptions) approached through the Association of Dietetics of South Africa. Eleven patients, seven family members, five oncologists, two general medical practitioners and twelve dietitians participated. Data was gathered through semi structured questionnaires (completed through the participants) and where possible interviews were conducted using the questionnaires (completed by the researcher). Thematic analysis was used for data analysis. The environment and frame of reference of participants, experience of stress, need and importance of diet and nutrition information and advice, obtaining of information, sharing of information and the role of emotional circumstances and emotion were taken in consideration. Experience with cancer, the type of information needed, the problem situation and the emotional experience of the cancer patients determine information behaviour. Diet and nutrition advice can relieve stress through the keeping of the nutritional status. The eclectic choice of models is adapted to provide for coping and the acknowledgement therof through patients and other role players in cancer contexts. Recommendations include the testing of models on other role players like nurses and social workers.

Kanker is een van die mees gevreesde siektes. Kanker kan pro-aktief behandel word deur aandag te gee aan dieet en voeding en ook reaktief tydends behandeling en ander fases. Inligting asook raadgewing oor dieet, voeding en dieetterapie, is dus belangrik. Teen hierdie agtergrond en die toename in kankerpasi?nte is ? oorwegend kwalitatiewe empiriese studie in 2011 gedoen met kankerpasi?nte in die Tshwanemetropool (Suid-Afrika) ook bekend as Pretoria. Daar is ? baie klein kwantitatiewe komponent. Ander kernrolspelers is betrek: onkolo?, algemene geneeshere, dieetkundiges en gesinslede. Die studie is gebaseer op ? literatuuroorsig en eklektiese gebruik van die inligtinggedrag-modelle van Johnson (1997) (gerig op kankerkonteks), Leckie, Pettigrew en Sylvain (1996) (gerig op professionele beroepslui), Wilson (1981, 1996) (algemene model), Dervin (2005a, 2005b) (singewing), Savolainen (2005) (alledaagse lewe) en die kognitiewe beoordelingsteorie en streshanteringsteorie van Lazarus (1992). Die doel van die studie was om die dieet- en voedingsinligtingsoekgedrag en -behoeftes van pasi?nte, gesinslede en ander kernrolspelers in stresvolle kankerkontekste te bepaal. Sub-probleme het ingesluit: die inligtingbehoeftes en inligtingsoekgedrag van onkolo?, (onkologie-) dieetkundiges, kankerpasi?nte en gesinslede rakende dieet en voeding, asook raadgewing in die verband; bevindinge uit die literatuur oor soortgelyke en verwante studies; en die keuse van ? gepaste inligtinggedragmodel of eklektiese gebruik van modelle wat erkenning verleen aan streshantering in ? kankerkonteks. Hierdie studie is as ?n verkennende studie aangepak. Kanker is ? sensitiewe saak en mense praat nie graag daaroor met vreemdelinge nie. Deelnemers is dus volgens ? gerieflikheidsbenadering en sneeubalvorming genooi; dieetkundiges is met enkele uitsonderings genader deur die Vereniging vir Dieetkunde in Suid-Afrika. Elf pasi?nte, sewe gesinslede, vyf onkolo?, twee algemene geneeshere en 12 dieetkundiges het deelgeneem. Data is ingesamel deur semi-gestruktureerde vraelyste (voltooi deur deelnemers) en waar moontlik onderhoude aan die hand van die vraelyste (die navorser het dan die vraelys voltooi). Tematiese ontleding is gebruik vir data-ontleding. Die omgewing en verwysingsraamwerk van deelnemers, ervaring van stres, behoefte aan en belangrikheid van dieet- en voedingsinligting, verkryging van inligting, deel van inligting, en die rol van gemoedstoestande en emosies is onder andere inag geneem. ? Behoefte aan raadgewing is ook hiermee ge?ntegreer. Ervaring met kanker, die tipe inligting benodig, die probleemsituasie en die emosionele ervaring van die kankerpasi?nt bepaal inligtingsoekgedrag. Dieet- en voedingsinligting en -raadgewing kan stres verlig deurdat die voedingstatus van die kankerpasi?nt instand gehou word. Die eklektiese keuse van modelle is aangepas om ? inligtingsoekgedragmodel voor te stel wat voorsien vir streshantering en die erkenning daarvan deur pasi?nte en ander rolspelers in kankerkontekste. Aanbevelings sluit in die toets van die model met ander rolspelers soos verpleegkundiges en maatskaplike werkers.