Eating Difficulties, Psychological Distress, and Self-Management in Colorectal Cancer Patients Undergoing Chemotherapy: A Qualitative Study.

Wei Peng, Xiaoyu Wang, Mengxue Chen, Xinxin Fan, Liang Fan, Wei Zou, Yujie Xu, Guo Cheng

Journal: Psycho-oncology 2026;35(6):e70497

PMID: 42272110

Abstract

OBJECTIVE

To explore eating difficulties, psychological distress and self-management strategies among colorectal cancer (CRC) patients receiving chemotherapy, and to examine how diet-related symptom burden shapes emotional responses, perceived control and coping, guided by Symptom Management Theory (SMT).

METHODS

A qualitative study was conducted with 22 CRC patients receiving chemotherapy at two tertiary hospitals in Chengdu. Purposive sampling ensured variation in demographic and clinical characteristics. Semi-structured interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis informed by SMT. The study was reported in line with the Consolidated criteria for reporting qualitative research (COREQ).

RESULTS

Three main themes were identified: (1) Diet-related symptom distress and disrupted eating: patients described complex, fluctuating multisystem symptom clusters that reduced appetite, altered taste, and eroded a sense of control over eating. (2) Dietary self-management as coping and regaining control: patients engaged in flexible dietary adjustments, trial-and-error experimentation, timing and portion modifications, and emotional regulation to alleviate discomfort, preserve daily functioning, and maintain social roles. (3) Uncertainty and unmet psychosocial-nutritional support needs: patients reported confusion about "right" foods and quantities, fear that diet might compromise treatment, exposure to conflicting information, and a desire for structured, accessible, and personalised guidance that addresses both nutritional and emotional concerns.

CONCLUSIONS

Eating during chemotherapy is both psychosocial and nutritional, intertwining symptom burden, emotional responses, perceived control, and coping efforts. Integrating patient-centered nutritional care with psycho-oncological support, through multidisciplinary collaboration, may improve symptom control, treatment adherence, and quality of life in CRC patients.

Address: West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.; Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.; Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan, China.; Ministry of Education, Maternal & Child Nutrition Center, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.; Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan, China.; Ministry of Education, Maternal & Child Nutrition Center, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.; Children's Medicine Key Laboratory of Sichuan Province, Sichuan University, Chengdu, Sichuan, China.

DOI: 10.1002/pon.70497

MeSH Terms: Humans, Female, Colorectal Neoplasms, Qualitative Research, Middle Aged, Male, Aged, Adaptation, Psychological, Self-Management, Psychological Distress, Coping Skills, Adult, Symptom Burden, Quality of Life, Feeding Behavior, Stress, Psychological