Work

Experiences of nutritional management in patients with breast cancer-related lymphedema: a qualitative study guided by Fitch's supportive care framework

Year: 2026

Type: article

Abstract: Purpose To explore patients' experiences, perceptions, self-management practices, and unmet supportive care needs regarding nutritional management in breast cancer-related lymphedema, and to inform future patient-centered interventions. Methods Guided by Fitch's Supportive Care Framework, we developed a semi-structured interview guide and conducted in-depth interviews with 13 patients with breast cancer-related lymphedema recruited via purposive sampling between January and October 2025. Interview data were analyzed using a framework-guided hybrid inductive–deductive thematic analysis. This approach integrated theory-driven coding informed by Fitch's framework with data-driven theme development. Results Three core themes emerged, encompassing nine sub-themes: (a) inadequate understanding and misconceptions regarding nutrition management, comprising lack of lymphedema-specific nutritional knowledge, poor recognition of diet-disease associations, and low self-efficacy in nutritional management; (b) practical challenges in nutrition management, comprising lack of nutritional management skills, fluctuations in dietary adherence, ambiguity in attributing symptoms to dietary causes, and absence of a self-monitoring system; and (c) gaps in support systems and unmet needs, comprising insufficient family collaboration and support and lack of continuous professional guidance. Conclusions Patients with breast cancer-related lymphedema described multifaceted difficulties in nutritional management across cognitive, behavioral, and support dimensions. These findings suggest that healthcare providers should recognize these real-world experiences when planning supportive care. Future interventions may consider combining cognitive support, skill-building, and systematic support; however, this qualitative study cannot determine whether such interventions affect lymphedema outcomes or self-management capabilities.

Source: Frontiers in Nutrition

DOI: 10.3389/fnut.2026.1961839