Transformations and (re)meanings of food: qualitative study in patients with chronic liver disease

Purpose This study aims to understand the experiences and perceptions related to eating practices and nutritional management in patients awaiting liver transplantation. Design/methodology/approach This was an empirical, qualitative, cross-sectional study. Patients on the waiting list for liver transplantation, over 18 years of age and with BMI < 30 kg/m2, participated in the study. The data saturation criterion defines the sample size. The instrument used was semi-structured interviews. Data analysis was based on Bardin’s thematic analysis. Findings In total, 14 patients were interviewed (54.5 ± 13.5 years; 71.4% male). Alcoholic cirrhosis was the leading indication for liver transplantation (50.0%). The data analysis generated three main themes: family and social aspects and their interfaces with nutritional care; implications of the disease in the diet; and dietary restrictions in the context of chronic liver disease. The participants reported changes in their diet associated with physiological and psycho-emotional changes caused by liver disease. They also externalized the difficulties related to adherence to dietary guidelines and the importance of family support. Patients on the liver transplant waiting list experience significant transformations and the need for (re)signification about food, which is strongly influenced by a lack of appetite and dietary restrictions. However, even in the face of difficulties, patients strive to follow dietary recommendations to manage their disease and its associated complications. It is essential to highlight the importance of family support in disease management. Originality/value Addressing a gap in understanding patient perspectives on nutritional therapy, this study provides original qualitative insights into barriers and facilitators for dietary adherence among liver transplant candidates, informing the development of more patient-centered interventions.