Designing symptom specific dietary leaflets for head and neck cancer patients undergoing radiotherapy : a delphi study

Abstract

Purpose: To develop dietary leaflets that have reached consensus among healthcare professionals, that patients suffering from common Head and Neck (HN) Radiotherapy (RT) induced side effects can refer to for nutritional advice. These leaflets can be used in clinical practice for patients to maintain good nutritional status and cope better with the treatment. Objectives: To have a multi-disciplinary panel of participants working in an oncology centre in Malta reach consensus while developing dietary leaflets for use by patients undergoing head and neck radiotherapy. Methodology: A Delphi approach was used. A panel of experts reviewed a series of dietary leaflets developed based on literature review. The panel was asked for feedback on these leaflets, amendments were made, and the leaflets were re-circulated over three rounds. After each round, participants would vote on major changes and vote on the likelihood of them using the leaflets in a clinical setting. Consensus was achieved when all participants identified that they would use the leaflets in clinical practice. Results: Participants reached consensus regarding the overall quality of the leaflets, with all participants voting “high likelihood” to use in their own clinical practice. Although individual items had opposite opinions (use of sugary gum vs. non-sugary gum), overall consensus was reached. Four final leaflets addressing: oral mucositis, xerostomia, taste loss, and radiation-induced nausea and vomiting were achieved. Conclusion: The participants reached consensus and developed leaflets that were based on literature recommendations for use for patients that, in their opinion, were acceptable for clinical use. The Delphi method was a good method to achieve the objective of this study.