Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Discussing diet, nutrition, and body weight after treatment for gynaecological cancer: a conversation analytic study of outpatient consultations (#343)

Lizzy Johnston 1 2 3 , Stuart Ekberg 4 , Bronwyn Jennings 5 , Nisha Jagasia 5 , Jolieke van der Pols 2
  1. Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
  2. School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia
  3. Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
  4. School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, Queensland, Australia
  5. Department of Gynaecological Oncology, Mater Hospital Brisbane, South Brisbane, Queensland, Australia

Aims: To generate direct observational evidence for understanding how diet, nutrition, and weight-related topics are discussed during follow-up after treatment for gynaecological cancer, as recommended by survivorship care guidelines.

Methods: Women who had completed treatment for endometrial or ovarian cancer within the previous 12 months and were attending outpatient follow-up at the participating institution during the data collection period were invited to participate. Of 46 women who attended, 34 (74%) consented to participate. Of these participants, 30 consultations were able to be audio-recorded, creating a data corpus involving four gynae-oncologists, 30 outpatients (19 endometrial and 11 ovarian cancer survivors), and 11 family members/friends. Audio-recorded consultations were transcribed and analysed using conversation analysis, a qualitative methodology that uses direct observation rather than self-report methods to understand how people perform social actions, such as the delivery and receipt of healthcare, through their talk in conversation. Participants were not aware of the specific analytic focus until data collection had been completed.

Results: From 21 instances in 18 consultations, diet, nutrition, or weight-related talk continued beyond initiation if the issue raised by the patient (either as a stand-alone topic or in response to a clinician query) was ostensibly relevant to the clinical activity being undertaken at the time. These instances led to care-related outcomes (i.e., general dietary recommendations, referral to support, behaviour change counselling) only when the patient identified needing further support. Diet, nutrition, or weight-related talk was not continued by the clinician if it was not immediately relevant to the current clinical activity.

Conclusions: The contingent nature of these discussions means there can be missed opportunities for the provision of dietary information and support post-treatment. Additional avenues for dietary needs assessment and referral should be considered to optimize the consistent delivery of diet, nutrition, and weight-related information and support post-treatment for gynaecological cancer.