Gewichtszunahme nach Brustkrebsdiagnose – ein noch unterschätztes Phänomen?

Zusammenfassung

Ziel Die Gewichtszunahme bei Brustkrebspatientinnen ist ein bekannter Nebeneffekt von Chemo- und endokriner Therapie, welche das Risiko für die Gesamt- und brustkrebsspezifische Mortalität von Brustkrebspatientinnen (BKP) erhöht, die psychosoziale Gesundheit gefährdet und deshalb möglichst vermieden/ behandelt werden sollte. Hierzu können Ernährungsinterventionen einen wirksamen Beitrag leisten. Diese Arbeit untersucht, wie sensibilisiert Onkologinnen und Onkologen (ONKO) für das Phänomen sind, wie sie bei Gewichtszunahme von BKP vorgehen und welche Rolle die Zusammenarbeit mit Ernährungsfachpersonen dabei spielt.

Methode Sieben auf gynäkologische Krebserkrankungen spezialisierte ONKO wurden anhand eines halbstrukturierten Interviewleitfadens interviewt. Die Datenanalyse erfolgte anhand einer qualitativ strukturierenden Inhaltsanalyse.

Ergebnisse Vier Hauptkategorien konnten identifiziert werden, welche die unterschiedlichen Sicht- und Handlungsweisen der ONKO bezüglich der Gewichtszunahme bei BKP nach Diagnosestellung strukturieren: 1. Das Phänomen: Beobachtung und Folgen einer Gewichtszunahme; 2. Patientinnenbezogene Perspektivenübernahme bezüglich der Gewichtszunahme; 3. Maßnahmen gegen eine Gewichtszunahme bei BKP; 4. Maßnahmenleitende/-hemmende Gedanken bei einer Gewichtszunahme.

Diskussion Die Handlungsweisen der ONKO (ungenügende Maßnahmen zur Prävention und Behandlung einer Gewichtszunahme bei BKP, seltene interprofessionelle Zusammenarbeit mit Ernährungsfachpersonen) lassen sich durch ihre Sichtweisen erklären: ONKO unterschätzen tendenziell: 1) die gesundheitliche Relevanz der Gewichtszunahme, 2) die für BKP subjektive Relevanz der Gewichtszunahme, 3) die fachliche Kompetenz von Ernährungsfachpersonen sowie 4) die Wirksamkeit von Ernährungsinterventionen.

Schlussfolgerung Zur Förderung der Intention von ONKO, Maßnahmen gegen eine Gewichtszunahme zu treffen, sollten ihre Risikowahrnehmung (bezüglich gesundheitlicher Folgen einer Gewichtszunahme) sowie ihre Handlungsergebniserwartung (bezüglich Zusammenarbeit mit Ernährungsfachpersonen) erhöht werden.

Abstract

Objective Weight gain in breast cancer patients is a known side effect of chemo- and endocrine therapy, which increases the risk of all-cause and breast cancer-specific mortality in breast cancer patients (BCP), endangers psychosocial health and should therefore be avoided/treated if possible. In this context, nutritional interventions can make an effective contribution. This study examines the level of awareness among oncologists regarding the phenomenon of weight gain in BCPs, how they manage it, and the extent to which they collaborate with nutrition professionals (registered dietitians) in addressing this issue.

Method Seven oncologists specialized in gynecological cancers were interviewed using a semi-structured interview questionnaire. Data analysis was done using a qualitative structuring content analysis.

Results Four main categories could be identified, which structure the different views and actions of the oncologists regarding weight gain in BCP after diagnosis: 1. the phenomenon: observation and consequences of weight gain; 2. oncologists’ assumption of the importance of the phenomenon for BCP; 3. measures against weight gain in BCP; 4. thoughts guiding/inhibiting measures in the case of weight gain.

Discussion The behavior of oncologists (insufficient measures for the prevention and treatment of weight gain in BCP, rare interprofessional cooperation with nutrition professionals) can be explained by their views: oncologists tend to underestimate: 1) the health relevance of weight gain, 2) the subjective relevance of weight gain for BCP, 3) the professional competence of registered dietitians and 4) the effectiveness of nutrition interventions.

Conclusion To promote oncologists’ intention to act against weight gain in BCP, their risk perception (regarding health consequences of weight gain) as well as their outcome expectancies (regarding cooperation with nutrition professionals) should be increased.

Schlüsselwörter

Brustkrebs - Gewichtszunahme - Onkologie - Einstellungen - Maßnahmen

Key words

breast cancer - weight gain - oncologists - attitudes - behaviors

Publication History

Article published online:
21 June 2023

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