METHODS: This interpretive qualitative study included the use of semi-structured interviews with active participants in a randomized controlled trial aimed at understanding how a medically tailored meal plus nutrition counseling intervention worked for vulnerable individuals with lung cancer treated at four cancer centers across the USA. During the 8-month long study, participants in the intervention arm were asked to be interviewed, which were recorded, transcribed verbatim, and analyzed using conventional content analysis with principles of grounded theory.
RESULTS: Twenty individuals participated. Data analysis resulted in a theoretical explanation of the intervention\'s mechanism of action. The explanatory process includes three linked and propositional categories leading to patient resilience: engaging in treatment, adjusting to diagnosis, and active coping. The medically tailored meals plus nutrition counseling engaged participants throughout treatment, which helped participants adjust to their diagnosis, leading to active coping through intentional self-care, behavior change, and improved quality of life.
CONCLUSIONS: These findings provide evidence that a Food is Medicine intervention may buffer some of the adversity related to the diagnosis of lung cancer and create a pathway for participants to experience post-traumatic growth, develop resilience, and change behaviors to actively cope with lung cancer. Medically tailored meals plus intensive nutrition counseling informed by motivational interviewing supported individuals\' adjustment to their diagnosis and resulted in perceived positive behavior change.
方法:这项解释性定性研究包括在一项随机对照试验中对活跃参与者进行半结构化访谈,旨在了解医学上定制的膳食加营养咨询干预措施如何对美国四个癌症中心接受治疗的易感肺癌患者起作用。在为期8个月的研究中,干预组的参与者被要求接受采访,被记录下来,逐字转录,并利用扎根理论的常规内容分析进行了分析。
结果:20个人参加。数据分析得出了干预作用机制的理论解释。解释过程包括三个链接和命题类别,导致患者的弹性:参与治疗,适应诊断,积极应对。在整个治疗过程中,医学上量身定制的膳食加上营养咨询使参与者参与其中,帮助参与者适应他们的诊断,通过有意的自我保健导致积极应对,行为改变,提高了生活质量。
结论:这些发现提供了证据,表明“以食物为药物”的干预措施可以缓冲一些与肺癌诊断相关的逆境,并为参与者提供创伤后成长的途径。发展韧性,改变行为以积极应对肺癌。医学上定制的膳食加上由动机性访谈提供的强化营养咨询支持个人对其诊断的调整,并导致感知到的积极行为改变。