2007 Volume 21 Issue 2 Pages 14-22
Abstract
We wanted to identify the particular difficulties in resuming meals experienced by patients who had undergone esophagectomy and reconstruction with 3―field lymph node dissection for esophageal cancer, from the early postoperative period, until shortly after discharge from hospital, and to examine the nursing care required to support the process. The subjects were 9 patients who had undergone right―thoracotomy thoraco―abdominal esophagectomy and thoracic wall anterior gastric reconstruction for cancer of the thoracic esophagus, and in whom oral feeding had been started. Data were collected by interview and observations, and were evaluated by qualitative induction analysis. We identified 9 categories of difficulty, including “It takes a great effort just to get ready to eat”, “Swallowing, digestion, and absorption are all hard”, “It is impossible to predict, prevent, or cope with unpleasant symptoms”, “Unpleasant symptoms affect activities of daily living”, and “Unable to eat even though wanting to”. The 4 components of difficulty in resuming meals were :（1）attitude towards meals,（2）development of unpleasant symptoms and difficulty predicting them,（3）interference with quality of life, and（4）loss of the pleasure associated with meals. These findings suggested that nursing care to encourage resumption of meals needs to be based on symptom assessments, individual meal design, and helping patients find new pleasures and a creative life.
