Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
and identification of priority activities have repeatedly been
identified as potentially helpful interventions to manage fatigue. In
this study, men referred to their fatigue in terms of loss of energy
and muscle weakness, so having programmes that concentrate on
physical interventions may be very useful for them. If we accept
that caring is attending to the ‘whole’ person, we must develop
skills to work with individuals in such a way that phenomena such
as fatigue cannot be reduced to specific component parts. McIntyre
(2005) and others have designed gentle exercise programmes to
help combat fatigue, which has catered for the needs of patients
with different levels of fitness and different types of cancer. These
programmes have been evaluated well and perhaps they should be
made available to all patients. However, like most interventions, to
develop these programmes would have financial implications that
would need to be addressed by health care commissioners. For
patients who suffer from this debilitating symptom, the potential
benefits that gentle exercise programmes may have for them could
outweigh the costs and may in fact reduce other health costs. It
could reduce the volume of referrals to other specialist clinics or the
need to have extra nutritional supplements prescribed and for some
patients the administration of erythropoietin which can be very
expensive.
Dietary and Sensory Issues
Food usually has an important role in any culture and most of us
generally associate food with an enjoyable use of time. While food
may be seen as a normal part of daily living, health care workers
concentrate sometimes on the physical impact of eating rather than
the broader social or cultural issues. Cachexia and weight loss can
be characteristic symptoms in a person with cancer. Nutrition is a
problem that affects all cancer patients to varying degrees during
their illness. As with other symptoms of cancer or side-effects of
chemotherapy, identifying the cause or causes is an important part
of devising an effective therapeutic strategy.
Cancer patients receiving chemotherapy frequently report changes
in their sense of taste (Berteretche et al 2004). Most patients who
participated in this study were affected by alterations in their sense
of taste and smell. This occurred immediately following their
chemotherapy for some, but with others it was an ongoing problem
throughout their treatment. This led to some patients avoiding
certain foods or indeed ‘going totally off their food’. However, it is
not clear whether these alterations result from changes in taste or
olfactory perception (Beidler and Smith 1991), since taste, smell,
and somatosensory stimuli are tightly integrated during eating
(Corneau et al 2001). Chemotherapy reduces appetite through
nausea and vomiting, but the development of conditioned food
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