Aims: Dietitians are nutrition professionals equipped with specialised skills required to manage malnutrition in cancer. Optimisation of dietary intake is recommended as the primary nutrition strategy for the treatment of cancer-related malnutrition. However, it is unclear whether dietary patterns (DPs), described as the quality, variety, and frequency of food consumption, are considered. This study examined dietitians’ food-based management of malnutrition; explored dietitians’ awareness of DPs and assessed barriers and enablers to the use of DPs in clinical practice.
Methods: A qualitative study was conducted using semi-structured interviews with oncology dietitians. Recruitment occurred through national nutrition societies, social media, and professional networks. Data collection and analysis were conducted concurrently; recruitment ceased once data saturation was achieved. Inductive thematic analysis was used to identify key concepts. Qualitative description was used to interpret participants’ understanding of DPs and current dietetic practice.
Results: Fourteen oncology dietitians from four Australian states and territories participated. Three themes were identified: (i) principles to guide nutritional care, (ii) DPs as a gap in knowledge and practice, and (iii) opportunities for better care with systems as both a barrier and enabler. Dietetic practice was food-focussed, encouraging energy- and protein-rich foods consistent with evidence-based guidelines. Dietitians encouraged one of two nutrition-related approaches: (i) intake of ‘any tolerated food’ or (ii) ‘foods supportive of longer-term health’. Dietitians were generally unaware of DPs and questioned their relevance in certain clinical situations. A multidisciplinary team approach, adequate food service and dissemination of DPs research and education were identified as opportunities for better patient care.
Conclusions: Recommendations for the treatment of malnutrition vary between oncology dietitians and uncertainty exists regarding DPs and their relevance in clinical practice. Further exploration into the role of DPs to treat cancer-related malnutrition and education for dietitians are required prior to implementation of a DPs approach into clinical practice.