Oncology · Medical Literature
A nurse-led self-management nutritional support intervention for chemotherapy-induced diarrhea and constipation in patients with cancer: A pilot study.
Abstract
Chemotherapy-induced diarrhea (CID) and constipation (CIC) are prevalent, distressing symptoms that can adversely affect nutritional status and treatment tolerance. Evidence for non-pharmacological management remains limited, particularly in low-resource settings. This pilot randomized study assessed feasibility, acceptability, and preliminary effectiveness of a co-designed, nurse-led nutritional support program for managing CID and CIC in patients with cancer in Vietnam. Adult patients experiencing CID and/or CIC participated in a 12-week pilot trial. The intervention included face-to-face education, a culturally tailored booklet, personalized dietary support, promotion of self-management strategies, and weekly telephone follow-up. Feasibility (recruitment and completion), acceptability (intervention engagement), and preliminary effectiveness (CID/CIC incidence, stool consistency, and dietary intake) were assessed at Week 3-4 and Week 12. Feasibility was strong, with a 94.1% recruitment rate and 98.8% completion. Acceptability was high: all participants attended education sessions, 95% completed telephone support, and over 80% adopted recommended self-management strategies. Acceptability scores remained high at Week 3-4 (88.51 ± 3.35) and Week 12 (88.33 ± 1.23) on the Intervention Rating Profile-15. At Week 3-4, the intervention group showed significantly higher proportions of patients free from both CID and CIC (53.8% vs. 27.5%, p = 0.01) and CIC alone (74.4% vs. 45%, p = 0.01). Improvements were sustained at Week 12 within a sub-sample of intervention participants. The co-designed, nurse-led nutritional support program was feasible, acceptable, and showed preliminary effectiveness in managing CID and CIC. Its culturally tailored, low-cost and scalable design supports implementation in resource-limited oncology settings. A fully powered randomized controlled trial is warranted.
Clinical relevance
In adult cancer patients in Vietnam experiencing chemotherapy-induced diarrhea (CID) and/or constipation (CIC), is a co-designed, nurse-led nutritional self-management program feasible, acceptable, and associated with preliminary improvements in bowel symptom incidence, stool consistency, and dietary intake over 12 weeks? __SNAPSHOT__ {"studyDesign":"Pilot randomized study (design described as 'pilot randomized'; allocation method, blinding, and comparator arm structure not fully reported in abstract)","setting":"Vietnam; specific institution type (tertiary hospital, outpatient oncology clinic, etc.) not reported in abstract","sampleSize":"Not fully reported in abstract; recruitment rate of 94.1% and completion rate of 98.8% are stated, but absolute enrollment numbers are not provided","population":"Adult patients with cancer currently experiencing chemotherapy-induced diarrhea (CID) and/or chemotherapy-induced constipation (CIC); additional inclusion criteria (cancer type, chemotherapy regimen, performance status, prior treatment) not reported in abstract","intervention":"Co-designed, nurse-led nutritional support program comprising: face-to-face education, a culturally tailored printed booklet, personalized dietary support, promotion of self-management strategies, and weekly telephone follow-up over 12 weeks","comparator":"Not clearly specified in the abstract; comparator arm identity (standard care, usual care, or active control) not reported","primaryOutcome":"Feasibility (recruitment and completion rates), acceptability (intervention engagement metrics), and preliminary effectiveness (incidence of CID/CIC, stool consistency, and dietary intake) — assessed at Week 3–4 and Week 12; no single pre-specified primary efficacy endpoint is defined in the abstract","followUp":"12 weeks, with interim assessment at Week 3–4","fundingSource":"Not reported"}
Key findings
The abstract reports the following results: Feasibility was characterized as strong, with a recruitment rate of 94.1% and a study completion rate of 98.8%. Acceptability was described as high: all participants (100%) attended face-to-face education sessions, 95% completed weekly telephone support, and more than 80% adopted the recommended self-management strategies. Preliminary effectiveness data pertaining to CID/CIC incidence, stool consistency, and dietary intake are referenced as assessed at Week 3–4 and Week 12, but specific numerical outcomes (e.g., absolute event rates, between-group differences, effect sizes, confidence intervals, or p-values) are NOT reported in the available abstract text, as the abstract appears to be truncated. No adverse events are described in the available abstract. NNT and NNH cannot be calculated from the reported data.
Practice implications
IMPORTANT CAVEAT: This summary is based solely on the published abstract, which is truncated — the effectiveness results section is not available. As a consequence, no conclusions about clinical efficacy (symptom reduction, dietary benefit, or stool normalization) can be drawn from the available text. What the study does establish, within the constraints of a pilot design, is that a nurse-led, culturally tailored nutritional self-management program for CID and CIC appears operationally feasible (very high recruitment and retention) and highly acceptable to patients in a Vietnamese low-resource oncology setting. What it does NOT establish: whether the intervention produces clinically meaningful or statistically significant improvements in CID, CIC, stool consistency, or nutritional status compared to a control condition; what the control condition was; whether any observed improvements are causally attributable to the intervention rather than natural symptom trajectory, attention effects, or regression to the mean. Generalizability is limited by the single-country, culturally specific context, uncertain cancer-type distribution, and unknown chemotherapy regimens. The findings are most applicable to low-to-middle income country oncology settings with nurse-led outpatient infrastructure. __LIMITATIONS__ Abstract is truncated — effectiveness data are not available for review, preventing any assessment of efficacy outcomes.,Pilot study design: underpowered for definitive efficacy conclusions by design; preliminary effectiveness data should be considered hypothesis-generating only.,Comparator arm not described in the abstract — it is unclear whether a true concurrent control group was included, making between-group inference impossible to evaluate.,Randomization method, allocation concealment, and blinding procedures are not described in the abstract.,Sample size (absolute N) not reported in the abstract, precluding independent assessment of statistical power.,Outcomes rely heavily on self-report (dietary intake, stool consistency, self-management strategy adoption), which are susceptible to social desirability and recall bias — particularly relevant when participants receive intensive nurse contact.,Single-country, culturally specific setting (Vietnam) with a culturally tailored booklet limits direct generalizability to other healthcare systems or patient populations.,Cancer type heterogeneity and chemotherapy regimen diversity (if present) are not described, making it unclear whether findings apply equally across gastrointestinal, hematologic, or other malignancies.,12-week follow-up does not capture long-term durability of behavioral change or symptom benefit beyond the active intervention period.,Funding source not reported — potential for unrecognized conflicts of interest cannot be excluded.,High completion rate (98.8%), while encouraging, may reflect selection of a particularly motivated or well-supported patient cohort rather than broad real-world feasibility. __BOTTOM_LINE_CATEGORY__ promising_but_preliminary __BOTTOM_LINE__ This pilot study demonstrates that a nurse-led, culturally adapted nutritional self-management program for chemotherapy-induced bowel symptoms is highly feasible and acceptable in a Vietnamese oncology setting, with excellent recruitment and retention metrics. However, because the abstract is truncated and no efficacy data with effect sizes, confidence intervals, or p-values are available, it is not possible to draw conclusions about clinical benefit. The findings support proceeding to a fully powered randomized controlled trial with a clearly defined control arm, before any practice change is considered.