Need and demand for nutritional counselling and their association with quality of life, nutritional status and eating-related distress among patients with cancer receiving outpatient chemotherapy: a cross-sectional study

  • Saori KoshimotoEmail author
  • Masako Arimoto
  • Keiko Saitou
  • Mayumi Uchibori
  • Akiko Hashizume
  • Akiko Honda
  • Koji Amano
  • Yasuaki Nakajima
  • Hiroyuki Uetake
  • Eisuke Matsushima
Original Article



Patients with cancer often experience general nutritional problems as the disease progresses. We aimed to examine if there is a need and demand for nutritional counselling among cancer outpatients, and explore relevant psychological factors pertaining to eating and nutrition.


A survey was conducted among adult patients receiving outpatient chemotherapy at the Tokyo Medical and Dental University Hospital. The participants completed self-report questionnaires, which included questions on their nutritional state (Patient-Generated Subjective Global Assessment Short Form), experience of eating-related distress and quality of life (QOL) (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30).


Of the 151 (median age, 66.5 years) participants, 42 had a demand for nutritional counselling. Patients’ experience of eating-related distress and demand for nutritional counselling were significantly associated, particularly in regard to ‘conflicts over food between patients and the people surrounding them’ (p = 0.005), ‘concerns about food’ (p = 0.007) and ‘self-motivated effect related to nutrition’ (p = 0.018). A significant association was also observed between the demand for nutritional counselling and global health status (p = 0.028), emotional functioning (p = 0.022), cognitive functioning (p = 0.028) and social functioning (p = 0.040) in terms of QOL. Patients with a low QOL tended to demand nutritional counselling.


The demand for nutritional counselling was associated with QOL and eating-related distress. Therefore, medical staff caring for patients with cancer, such as attending physicians, dietitians, nurses, clinical psycho-oncologists, social workers and psychiatric oncologists, should collaborate and share information to provide nutritional counselling.


Cancer Outpatient Nutritional counselling Quality of life Team medical care 



We are deeply grateful to all the patients who kindly participated in this study despite the fact that they were undergoing cancer treatment. We are also very grateful to the nurses who have kindly supported this study and the doctors who provided valuable advice.


This study was supported by scientific grants in-aid from the Nestle Nutritional Council, Japan, to the Tokyo Medical and Dental University (No. 2566) and the Sasakawa Memorial Health Foundation (No. 2679, 2017A-017).

Compliance with ethical standards

Informed consent

Informed consent was obtained from all individual participants included in the study.

Transparency declaration

The lead author affirms that this manuscript is an honest, accurate and transparent account of the study being reported. The reporting of this work is compliant with STROBE guidelines.

Conflict of interest

The authors report grants from Nestle Nutritional Council, Japan, and grants from Sasakawa Memorial Health Foundation, Japan, during the conduct of the study. There are no other conflict of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Medical School Ethics Committee, and was conducted after written informed consent was obtained from the participants (Ethical Review No. M2015-578). Clinical trial registration (UMIN registration number UMIN000021540) was carried out prior to the start of the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Saori Koshimoto
    • 1
    Email author
  • Masako Arimoto
    • 2
  • Keiko Saitou
    • 2
  • Mayumi Uchibori
    • 3
  • Akiko Hashizume
    • 4
  • Akiko Honda
    • 3
  • Koji Amano
    • 5
  • Yasuaki Nakajima
    • 6
  • Hiroyuki Uetake
    • 7
  • Eisuke Matsushima
    • 1
  1. 1.Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
  2. 2.Department of Clinical NutritionTokyo Medical and Dental University HospitalTokyoJapan
  3. 3.Section of Home Care Nursing, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
  4. 4.Department of NursingTokyo Medical and Dental University HospitalTokyoJapan
  5. 5.Department of Palliative MedicineOsaka City General HospitalOsakaJapan
  6. 6.Department of Esophageal SurgeryTokyo Medical and Dental University HospitalTokyoJapan
  7. 7.Department of Chemotherapy and OncosurgeryTokyo Medical and Dental University HospitalTokyoJapan

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