Feeding, Fear, and Acceptance: Caregivers' Experiences of Nutritional Support During Childhood Cancer Treatment.
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PURPOSE: To explore caregivers' experiences and perceptions of the nutritional challenges faced by children and adolescents undergoing cancer treatment, including oral intake and the use of nutritional support. METHODS: This was a qualitative study based on focus groups with parents and caregivers at a Brazilian pediatric oncology hospital. Eight groups were conducted with 44 caregivers, and the seven available transcripts, corresponding to 38 caregivers, were analyzed with computer-assisted lexical analysis, interpreted as themes and illustrated with representative quotes, together with an exploratory affective analysis. RESULTS: The accounts spanned two domains, oral feeding and nutritional support, and six themes: altered oral feeding and food preferences, food hygiene and safety, gastrointestinal symptoms, oral nutritional supplements, nasoenteral tube feeding from fear to acceptance, and weight loss, fear, and coping. Caregivers described food selectivity and a shift toward ultra-processed foods, strict hygiene routines driven by fear of infection, and difficulty accepting supplements and the tube. Families who had used tube feeding described it as essential and reported learning to manage it. Negative emotions predominated in the exploratory affective profile, with sadness and fear the most frequent and trust also prominent. CONCLUSION: The nutritional experience of caregivers during pediatric cancer treatment was shaped by fear and by a gradual acceptance of nutritional support. Supportive care should address caregivers' fears early and help families move to acceptance of oral supplements and tube feeding.