The Investigation of Nutritional Knowledge, Attitudes, Practices, Dietary Achievement, and Satisfaction among Patients with Colorectal Cancer Post-Using a Web Application: A Quasi-Experimental Study

Background: Colorectal cancer (CRC) is a major global health concern, with malnutrition being a leading cause of death among Thai cancer patients. Misinformation, lack of knowledge, and false beliefs contribute to nutrition-related issues. Online platforms offer an alternative for patient education. This study aimed to compare the impact of two nutritional education tools, the Nutrition Educational Prototype based on Smartphone Web Applications (NEPSA) and standard hospital leaflets with nutrition counselling, on nutrition knowledge, attitudes, and practices in malnourished patients with CRC undergoing chemotherapy. Method: This quasi-experimental study employed pretest and posttest designs with a nonequivalent control group. Twenty-eight patients with a body mass index under 20 were included in the study. NEPSA was given to 13 participants, while the standard hospital leaflet was given to 15 participants. Knowledge, attitudes, practices, calories intake, protein intake, and satisfaction with the two educational tools were assessed before and after the intervention. Results: All parameters significantly improved after the intervention, with the intervention group showing significantly higher knowledge levels. The intervention group also met nutrition goals for calorie and protein intake within three visits, following European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines. Satisfaction with NEPSA among the intervention group was high (98%) after three visits. Conclusions: Implementing NEPSA led to improved nutrition knowledge, attitudes, and practices, highlighting the potential of web-based nutritional guidance. Access to Thai nutrition information through NEPSA could have positive implications on a national scale. Keywords: Colorectal cancer, Malnutrition, Nutrition web application, Thailand