# The distress of psychological adaptation in nutritional management among people after esophagectomy: an interpretative phenomenological study

## TL;DR

This study explores how nutritional challenges after esophagectomy affect mental health, revealing the need for integrated psychological and dietary support for cancer survivors.

## Contribution

The study introduces a novel interpretative phenomenological analysis of psychological adaptation to nutritional challenges post-esophagectomy.

## Key findings

- Persistent nutrition impact symptoms and unmet recovery expectations contribute to anxiety and helplessness.
- Family dietary contexts and role-identity conflicts hinder psychological recovery.
- Personalized nutritional and psychological support is essential for improving quality of life.

## Abstract

Patients who undergo esophagectomy frequently encounter long-term nutrition impact symptoms (NISs) and dietary challenges resulting from anatomical and functional alterations. Although these issues adversely affect mental health, the underlying psychological mechanisms remain poorly understood. This study aimed to explore the psychological experiences of post-esophagectomy people diagnosed with esophageal cancer regarding nutritional management to elucidate the impact of nutritional challenges on mental health.

A purposive sample of 16 who had undergone esophagectomy for esophageal cancer was recruited. Data were collected via semi-structured, in-depth interviews and analyzed using Interpretative Phenomenological Analysis (IPA). The analysis followed the hermeneutic circle principle through iterative coding, theme development, and the synthesis of cross-case patterns.

Three principal themes emerged: (1) cognitive and behavioral adaptation to gastrointestinal symptoms; (2) adaptive challenges and identity reconstruction in family dietary contexts; and (3) survival significance and social pressures in nutritional management. Collectively, these factors reinforced the “cancer patient” identity and impeded psychological recovery.

This study revealed that persistent NISs, unmet recovery expectations, and role-identity conflicts contribute to anxiety, helplessness, and confusion regarding health identity. These findings emphasized the necessity of patient-centered nutritional interventions that address symptom-related cognitive anxiety, facilitate familial support for dietary adaptation, and balance disease risk management with the enjoyment of food. These insights provide a theoretical foundation for developing personalized, integrated nutritional and psychological support programs to enhance the mental health and quality of life of esophageal cancer survivors.