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Taste and Smell Changes in Patients Receiving Cancer Chemotherapy: Distress, Impact on Daily Life, and Self-care Strategies

Bernhardson, Britt-Marie RN; Tishelman, Carol PhD, RN; Rutqvist, Lars Erik MD, PhD

doi: 10.1097/01.NCC.0000343368.06247.74

Few studies have described how patients receiving chemotherapy experience taste/smell changes (TSCs). Food and meal situations have important meaning beyond nutrition, so these common symptoms may affect daily lives. This study aims to investigate distress and impact on daily life from TSCs in patients receiving cancer chemotherapy, analyze reported levels of distress and impact on daily life from TSCs with regard to sociodemographic and clinical factors, and explore patients' reports of self-care strategies and communication with staff. The 340 patients reporting TSCs on a multicenter survey (n = 518) were grouped into subsets by level of TSC-related distress and impact on daily life, which served as the basis for statistical comparison. Written comments were analyzed inductively using content analysis. Nearly one-third of participating patients reported both high levels of distress and impact on daily life (high distress and high impact on daily life [HDHI]) from TSCs. The HDHI subset reported other symptoms more often than others did (P = .01) and also more often responded to open questions about distress, impact, and self-care strategies (P = .01). Taste/smell changes were not always reported to staff, even in the HDHI subset. The specific aspects of TSCs resulting in distress and impact on daily life varied greatly, affecting both psychological and somatic aspects, with little consensus and great individual differences described in self-care strategies. The variety of distress, impact, and strategies used to alleviate TSCs clarifies the importance of situational meaning.

Authors' Affiliations: Department of Neurobiology, Care Sciences and Society (NVS), Division of Nursing, Karolinska Institutet, Stockholm, Sweden (Ms Bernhardson); R&D Unit Stockholms Sjukhem Foundation, Stockholm, Sweden (Ms Bernhardson and Dr Tishelman); Department LIME, Medical Management Centre (Dr Tishelman), and Department of Oncology and Pathology (Dr Rutqvist), Karolinska Institutet, Stockholm, Sweden; School of Nursing, Midwifery and Social Work, University of Manchester, United Kingdom (Dr Tishelman).

Corresponding author: Britt-Marie Bernhardson, RN, R&D Unit, Stockholms Sjukhem Foundation, Mariebergsgatan 22, 11235 Stockholm, Sweden (

Accepted for publication July 4, 2008.

© 2009 Lippincott Williams & Wilkins, Inc.