Effectiveness of the CANCER-AIMS intervention on nutritional status and symptom management in patients with gastric cancer following gastrectomy: A randomized controlled trial

Background: Dietary education and modification interventions are valuable and feasible strategies for enhancing nutritional status and managing symptoms in patients with gastric cancer following gastrectomy. In alignment with administrative policies prioritizing shorter hospital stays and enhanced postoperative self-management, the provision of a simplified nutritional management approach following gastrectomy holds promise for preventing weight loss and expanding resources for monitoring both the nutritional and symptomatic aspects of these patients. Objective: This study evaluated the effectiveness of an integrative approach involving the five sequential steps of Conversation, Assessment, Nutrition plan, Complications, Evaluation, and Reassurance or Removal (CANCER) into Altering Intake and Managing Symptoms (AIMS), with specific focus on enhancing nutritional status and symptom management. Design: A single-blind, two-arm, randomized controlled trial. Setting: This study was conducted at a tertiary hospital in Shandong province, China. Participants: Patients with total or subtotal gastrectomy for gastric cancer. Methods: The participants were randomly assigned to either the intervention or control group in a 1:1 ratio. The intervention group received a 16-week CANCER-AIMS intervention program. The control group received usual routine care dietary guidance. Questionnaires and electronic medical records of each patient were used to assess dietary intake, dietary symptoms, and subjective and objective nutritional status. Outcomes were assessed at four specific time points: the day before discharge and at 4-, 8-, and 16-weeks following hospital discharge. Results: Thirty-eight participants completed the study. The findings revealed significant interaction effects between group and time for dietary intake, dietary symptoms, and nutritional status between intervention and control groups (P < 0.001). The intervention group had significantly higher dietary intake, fewer dietary symptoms, and better nutritional status post-intervention than the control group (P < 0.001). Moreover, there were significant differences in dietary intake, dietary symptoms, and nutritional status according to time in both the intervention and control groups. Conclusion: The CANCER-AIMS intervention for patients with gastric cancer following gastrectomy may be efficient at enhancing nutritional intake, reducing negative dietary symptoms, and thus improving both their subjective and objective nutritional status.