Digital body image interventions for adult women: A meta-analytic review.

Although many women experience body dissatisfaction, treatment options that prevent the onset of more serious conditions are limited in accessibility. As such, digital interventions may be an appropriate alternative resource to address restricted treatment options. This study provides statistical syntheses of the evidence for digital body image interventions for non-clinical adult women. A systematic literature search identified 19 studies (N = 2424) that tested the effect of a digital body image intervention compared to a control condition. Study results were synthesised using random effects models, and small to medium statistically significant effect sizes indicated that digital interventions were beneficial in increasing overall global satisfaction (g = 0.43) and reducing cognitive body dissatisfaction (g = 0.36). These meta-analytic findings provide evidence for the efficacy of digital body image interventions for non-clinical adult women. Intervention type was not found to be a statistically significant moderator, which may suggest that a range of intervention types can produce similar reductions in body dissatisfaction. Overall, digital body image interventions may be a feasible option to alleviate body dissatisfaction, particularly for women who may be unable to access conventional treatment.

Pseudoephedrine for ejaculatory dysfunction after retroperitoneal lymph node dissection in testicular cancer.

OBJECTIVE: To assess the impact of ejaculatory dysfunction (EjD; failure of emission or retrograde ejaculation) on health-related quality of life (HRQoL) after retroperitoneal lymph node dissection (RPLND) for testicular cancer and explore the efficacy of pseudoephedrine hydrochloride as treatment. PATIENTS AND METHODS: In a single arm, phase II trial, patients at ≥6 months after RPLND were invited to complete patient-reported outcome measures (European Organisation for Research and Treatment of Cancer [EORTC] quality of life questionnaire [QLQ]-30-item core, EORTC QLQ-testicular cancer-26, and Brief Male Sexual Function Inventory) evaluating HRQoL and sexual function in follow-up (ACTRN12622000537752/12622000542796). If EjD was reported, post-ejaculatory urine ± semen analysis was undertaken. In eligible patients, pseudoephedrine hydrochloride 60 mg was administered orally every 6 h for six doses. The primary endpoint was sperm count >39 million sperm/ejaculate (>5th centile) following treatment. The trial was powered to detect a clinically relevant 36% achieving sperm count of >39 million sperm/ejaculate. Secondary endpoints included semen volume >1.5 mL, total motile sperm count, safety, and HRQoL impacts. RESULTS: Of the 58 patients enrolled, the median (interquartile range [IQR]) age was 35 (29-41) years, with a median (IQR) of 37 (18-60) months from RPLND. EjD was reported in 33 (57%), including 27/52 (52%) receiving follow-up at our centre. There were no differences in global HRQoL; however, role functioning (P = 0.045), sexual problems (P < 0.005), and sexual enjoyment (P = 0.005) was poorer if EjD was present. In all, 24/33 (73%) patients with EjD consented to pseudoephedrine treatment. Of 22 evaluable patients, four (18%) achieved a sperm count of >39 million/ejaculate (P = 0.20), and four (18%) had a semen volume of >1.5 mL (P = 0.20). There was a mean increase of 105 million sperm/ejaculate (P = 0.051) and 1.47 mL increase in semen volume (P = 0.01). No safety concerns arose. CONCLUSION: Ejaculatory dysfunction is common after RPLND but did not impact global HRQoL in our cohort. Pseudoephedrine improved EjD for some; however, its efficacy was lower than expected. Pseudoephedrine may be considered on an individualised basis.

Personalised virtual reality in palliative care: clinically meaningful symptom improvement for some.

OBJECTIVES: This study examined the effects of virtual reality (VR) among palliative care patients at an acute ward. Objectives included evaluating VR therapy benefits across three sessions, assessing its differential impact on emotional versus physical symptoms and determining the proportion of patients experiencing clinically meaningful improvements after each session. METHODS: A mixed-methods design was employed. Sixteen palliative inpatients completed three personalised 20 min VR sessions. Symptom burden was assessed using the Edmonton Symptom Assessment Scale-Revised and quality of life with the Functional Assessment of Chronic Illness Therapy (FACIT-Pal-14). Standardised criteria assessed clinically meaningful changes. Quantitative data were analysed using linear mixed models. RESULTS: Quality of life improved significantly pre-VR to post-VR with a large effect size (Cohen's d: 0.98). Total symptom burden decreased after 20 min VR sessions (Cohen's d: 0.75), with similar effect sizes for emotional (Cohen's d: 0.67) and physical symptoms (Cohen's d: 0.63). Over 50% of patients experienced clinically meaningful improvements per session, though substantial individual variability occurred. CONCLUSIONS: This study reveals the nuanced efficacy of personalised VR therapy in palliative care, with over half of the patients experiencing meaningful benefits in emotional and physical symptoms. The marked variability in responses underscores the need for realistic expectations when implementing VR therapy.

Effectiveness of Operation K9 Assistance Dogs on Suicidality in Australian Veterans with PTSD: A 12-Month Mixed-Methods Follow-Up Study.

Post-traumatic stress disorder (PTSD) is a pervasive disorder among both current and ex-serving Australian Defence Force (ADF) members. Studies have shown current psychological and pharmacological treatments for PTSD are suboptimal in veterans, with high dropout rates and poor adherence to treatment protocols. Therefore, evaluating complementary interventions, such as assistance dogs, is needed for veterans who may not receive the ultimate benefit from traditional therapies. The present longitudinal mixed-method study examined the effectiveness of Operation K9 assistance dogs among sixteen veterans with PTSD, specifically, their effects on suicidality, PTSD, depression, and anxiety from baseline to 12 months post-matching. Self-reported measures were completed prior to receiving their dog (baseline) and at three time points (3, 6, and 12 months) following matching. The Clinician-Administered PTSD Scale for DSM-5 was used to assess the severity of every PTSD case. Veterans participated in a semi-structured interview 3 months post-matching. Whilst there was a reduction in the proportion of veterans reporting any suicidality, there was no significant change in the probability of veterans reporting suicidality between time points. There was a significant effect of time on PTSD, depression, and anxiety symptoms. Three major themes emerged from qualitative data analysis: life changer, constant companion, and social engagement. Qualitative data suggest assistance dogs can have a positive impact on important areas of daily life and support veterans in achieving some of the prerequisites for health, including access to services, transport, education, employment, and development of new and diverse social and community connections. Connections were key in improving health and wellbeing. This study exemplifies the power of human-animal relationships and adds emphasis to the need to take these seriously and create supportive healthy environments for veterans with PTSD. Our findings could be used to inform public health policy and service delivery, in line with the Ottawa Charter action areas and indicate that for veterans with PTSD, assistance dogs may be a feasible adjunct intervention.

Virtual Reality in Palliative Care: A Systematic Review.

BACKGROUND: Virtual reality (VR) using head-mounted displays (HMDs) has demonstrated to be an effective tool for treating various somatic and psychological symptoms. Technological advances and increased affordability of VR technology provide an interesting option for delivering psychological interventions to patients in palliative care. The primary aim of this systematic review was to synthesise the available research on the use of VR for enhancing psychological and somatic outcomes for palliative care patients. Secondary aims included assessing general satisfaction and overall usability. METHOD: A pre-registered systematic literature search was conducted according to PRISMA guidelines using OVID Emcare, Cochrane Library, Embase, Medline, PsycINFO, and PubMed Care Search: Palliative Care Knowledge Network. Peer-reviewed experimental, quasi-experimental, observational, case, and feasibility studies consisting of single or multiple VR sessions using HMDs that reported psychological and/or somatic outcomes were included. RESULTS: Eight studies published between 2019 and 2021 were included, representing 138 patients. While the reported quantitative psychological and somatic outcomes were ambiguous, the qualitative outcomes were largely positive. Participants were generally satisfied with VR, and most studies reported the VR interventions as usable, feasible, and acceptable. CONCLUSIONS: VR shows promise in palliative care and generally addresses a range of symptoms with few adverse effects. Future research should consist of adequately powered RCTs evaluating dosage and focusing on providing meaningful activities to enhance outcomes further.

Dietary Drivers and Challenges of Australian Breast Cancer Survivors: A Qualitative Study.

Purpose: Cancer survivors often make long-term dietary changes, and nutrition is important for survivorship outcomes. Many survivors experience persisting cognitive difficulties, which can impact health behaviors. This study aimed to identify perceived drivers of eating habit changes, and the barriers to making intentional dietary changes, among breast cancer survivors with persisting self-reported cancer-related cognitive impairment. Materials and Methods: A qualitative framework explored survivors' perceptions of dietary habit changes. Thirteen Australian breast cancer survivors (M.time since diagnosis: 23.6 months, standard deviation [SD] 15.3; M.time since completing primary treatment: 14.7 months, SD 15.3) completed semistructured interviews. Questions related to dietary changes since diagnosis and treatment. Major themes were identified from interview transcripts using thematic analysis. Results: While most individuals perceived their diet to be broadly similar to prediagnosis, several changes to diet and eating habits were identified, which were often meaningful to these survivors. Themes relating to survivors' eating habit changes included the following: (1) meal timing and frequency shifts, (2) more plant-based eating, and (3) less variety and more convenience. Changes in eating habits were attributed to the following: (1) persisting treatment-related changes, (2) help and support from others, (3) old treatment habits, (4) preventative health and self-care, and (5) changes to work schedule. Barriers to making intentional dietary changes included the following: (1) too much time and effort, (2) food cravings and enjoyment, and (3) lacking dietary ideas and resources. Conclusions: Many survivors reported long-term changes in dietary habits, some of which align with current recommendations. Causes of dietary habit changes, and barriers to engaging in healthier dietary habits, involved multiple biopsychosocial elements. Additional resources or strategies that assist navigating survivorship challenges and their effects on dietary habits are needed. Future studies should explore whether post-treatment nutritional review with a qualified dietary health professional is helpful for survivors who experience long-term cancer-related cognitive impairment.

Is primary appraisal a mechanism of daily mindfulness at work?

In two studies, we examined primary appraisal as a potential mechanism of workplace mindfulness, grounded in the Transactional Model of Stress and Coping. In Study 1, multilevel structural equation modeling utilizing diary data from 58 employees across 5 working days showed that daily challenge appraisal mediated the positive relationship between mindfulness and high-activation positive affect, and daily threat appraisal mediated the negative relationship between mindfulness and high-activation negative affect. In Study 2, 69 employees participated in a randomized control trial comparing self-directed mindfulness training with a wait-list control. Latent growth curve modeling demonstrated that the intervention produced a greater increase in daily mindfulness relative to the control condition. In turn, the rate of change in daily mindfulness influenced the change rate of appraisal, and daily appraisal influenced affect, as expected. Together, these studies indicate one way in which mindfulness may help employees to thrive at work is by adaptively shaping the stressor appraisal process, and that connecting mindfulness training to primary appraisal may bolster the potential beneficial effects in the work context. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Challenges and opportunities for using population health data to investigate cancer survivors' quality of life in Australia.

There is a recognised need for reported national data that inform health policy, health professions, and consumers about the wellbeing of Australians with cancer and other chronic conditions. International initiatives have demonstrated the viability and benefits of utilising population-based cancer registries to monitor the prevalence and trajectory of health-related quality of life (HRQOL) outcomes among people with cancer. Establishing a similar level of monitoring in Australia would require timely access to health data collected by publicly funded, population-based cancer registries, and the capacity to link this information across jurisdictions. Combining information from different sources via data linkage is an efficient and cost-effective way to maximise how data are used to inform population health and policy development. However, linking health datasets has historically been highly restricted, resource-intensive, and costly in Australia due to complex and outdated legislative requirements, duplicative approval processes, and differing policy frameworks in each state and territory. This has resulted in significant research waste due to underutilisation of existing data, duplication of research efforts and resources, and data not being translated into decision-making. Recognising these challenges, from 2015 to 2017 the Productivity Commission investigated options for improving data availability and use in Australia, considering factors such as privacy, security, and intellectual property. The inquiry report recommended significant reforms for Australian legislation, including the creation of a data sharing and release structure to improve access to data for research and policy development purposes. This paper discusses (1) opportunities in HRQOL research enabled by data linkage, (2) barriers to data access and use in Australia and the implications for waste in HRQOL research, and (3) proposed legislative reforms for improving data availability and use in Australia.

Choosing and Managing Aged Care Services from Afar: What Matters to Australian Long-Distance Care Givers.

This research aims to identify the factors that influence caregivers' decisions about the aged care providers they select for their elder relatives when caring from a distance and what they value once they have engaged a service. Adult long-distance carers for older relatives living within Australia were purposively sampled and they participated in audio-recorded interviews. A thematic analysis was employed to investigate the data. A sample of 13 participants enabled data saturation with no new major themes identified in the final three interviews. Participants were 50 to 65 years (Mean = 59.8) and mostly (77%) female. Four themes emerged relating to selection of care providers: (1) availability of care, (2) financial arrangements, (3) proximity and location, and (4) reputation of care provider. Five themes detailed valued qualities of care: (1) vigilant monitoring and responsivity, (2) communication with family, (3) flexibility and proactiveness of care, (4) staffing, and (5) access to appropriate and holistic care to maintain wellbeing. Long-distance caregivers face barriers in selecting and managing aged care services from afar within a complex Australian aged care system. They strongly value regular, proactive communication about the wellbeing of their relatives and may be particular beneficiaries of communication and assistive monitoring technologies.

What do young Australian adults know about modifiable risk factors for dementia?

BACKGROUND: There are well established modifiable risk factors for late-life dementia. These risk factors account for over 30% of population attributable dementia risk and accrue over the lifespan. Young adults have the greatest potential to reduce their own risk for dementia. This study aimed to investigate what young Australian adults know about dementia and its risk factors, and further, how they estimated these risks. METHODS: An online survey promoted through various social media platforms was completed by 604 young Australian adults aged 18-44 years of age. RESULTS: Seventy percent of participants had a limited understanding of dementia (identifying cognitive or functional impairment), 25% had a good understanding, with 5% having no understanding. Twenty percent of respondents thought there were no modifiable risk factors for dementia. Less the half of participants agreed with two of the nine established dementia risk factors (hearing loss in midlife and education in early life), with over half of participants agreeing to the remaining seven risk factors. Females consistently judged the risks conferred by the nine established dementia risk factors to be higher than males. Those who were lonely judged the dementia risk conferred by loneliness to be higher than those who were not lonely; and smokers judged the dementia risk conferred by smoking to be less than non-smokers. CONCLUSION: Young adults have the greatest potential to change their dementia risk, and these findings show that there are important gaps in knowledge of dementia and its risk factors in this group.

How coming out and community involvement affects body image: An in-depth examination of lesbian women's personal experiences.

Research on body image commonly focuses on the negative aspects of the construct, and the majority of findings related to body image in general arise from quantitative methods of investigation. Furthermore, little is known about the experiences lesbian women go through as they come out, and what consequence this has on their body image. In this study we examined the experiences of 12 lesbian women and explored how coming out affected their body image. Data were collected via face-to-face interviews and analyzed using thematic analysis. Participants' ages ranged from 20 to 33 (M = 25). The analysis revealed that all participants reported experiencing improved body image after coming out. Other changes related to the presentation of sexual identity in terms of how they dressed, i.e., presenting as either more masculine or feminine. Most participants reported feeling that the sexual and gender minority community was more accepting of different body shapes and sizes compared to the heteronormative society in which they resided. Negative feelings and experiences related to family situations, and occasionally from within themselves. The results are important in understanding how gender and sexual orientation are intertwined to create a distinct experience of body image in lesbian women, and also to illustrate the heterogeneity of body image within subgroups of women.

Cognitive late effects following allogeneic stem cell transplantation in haematological cancer patients.

OBJECTIVE: The objective of this exploratory study was to determine the presence and correlates of self-reported cognition in a sample of haematological cancer patients who had undergone allogeneic stem cell transplantation (SCT). METHODS: Haematological cancer patients (n = 30) who had undergone allogeneic SCT between one and five years previously and age-matched control participants (n = 30) completed questionnaires assessing cognition, affect, sleep quality and fatigue and an assessment of premorbid IQ. RESULTS: Patients reported significantly poorer perceived cognitive ability (d = 1.12) and greater perceived cognitive impairment (d = 0.96) than controls. Lower fatigue was significantly associated with greater perceived cognitive ability (r = 0.75 patients and controls) and less perceived cognitive impairment (r = 0.80 patients; r = 0.57 controls). Interestingly, depression was significantly correlated with perceived cognitive ability in the control group only (r = 0.80). Hierarchical multiple regressions showed that fatigue was a significant predictor of perceived cognitive ability in patients, accounting for 56% of the variance. CONCLUSIONS: This study established that self-reported cognitive ability and cognitive impairment was significantly poorer in haematological cancer patients than controls. Furthermore, fatigue was significantly associated with perceived cognitive ability in patients. Future research should focus on identifying interventions that target fatigue in allogeneic SCT recipients in order to improve quality of life throughout survivorship.

'Food for Thought'-The Relationship between Diet and Cognition in Breast and Colorectal Cancer Survivors: A Feasibility Study.

Survivors of cancer frequently experience persistent and troublesome cognitive changes. Little is known about the role diet and nutrition plays in survivors' cognition. We explored the feasibility of collecting cross-sectional online data from Australian survivors of breast and colorectal cancer to enable preliminary investigations of the relationships between cognition with fruit and vegetable intake, and the Omega-3 Index (a biomarker of long chain omega 3 fatty acid intake). A total of 76 participants completed online (and postal Omega-3 Index biomarker) data collection (62 breast and 14 colorectal cancer survivors): mean age 57.5 (±10.2) years, mean time since diagnosis 32.6 (±15.6) months. Almost all of the feasibility outcomes were met; however, technical difficulties were reported for online cognitive testing. In hierarchical linear regression models, none of the dietary variables of interest were significant predictors of self-reported or objective cognition. Age, BMI, and length of treatment predicted some of the cognitive outcomes. We demonstrated a viable online/postal data collection method, with participants reporting positive levels of engagement and satisfaction. Fruit, vegetable, and omega-3 intake were not significant predictors of cognition in this sample, however the role of BMI in survivors' cognitive functioning should be further investigated. Future research could adapt this protocol to longitudinally monitor diet and cognition to assess the impact of diet on subsequent cognitive function, and whether cognitive changes impact dietary habits in survivors of cancer.

A core set of patient-reported outcomes for population-based cancer survivorship research: a consensus study.

PURPOSE: Core outcome sets aim to improve the consistency and quality of research by providing agreed-upon recommendations regarding what outcomes should be measured as a minimum for a population and setting. This study aimed to identify a core set of patient-reported outcomes (PROs) representing the most important issues impacting on cancer survivors' long-term health, functioning, and quality of life, to inform population-based research on cancer survivorship. METHODS: In phase I, a list of 46 outcomes was generated through focus groups (n = 5) with cancer survivors (n = 40) and a review of instruments for assessing quality of life in cancer survivorship. In phase II, 69 national experts in cancer survivorship practice, research, policy, and lived experience participated in a two-round Delphi survey to refine and prioritise the listed outcomes into a core outcome set. A consensus meeting was held with a sub-sample of participants to discuss and finalise the included outcomes. RESULTS: Twelve outcome domains were agreed upon for inclusion in the core outcome set: depression, anxiety, pain, fatigue, cognitive problems, fear of cancer recurrence or progression, functioning in everyday activities and roles, financial toxicity, coping with cancer, overall bother from side effects, overall quality of life, and overall health status. CONCLUSIONS: We established a core set of PROs to standardise assessment of cancer survivorship concerns at a population level. IMPLICATIONS FOR CANCER SURVIVORS: Adoption of the core outcome set will ensure that survivorship outcomes considered important by cancer survivors are assessed as a minimum in future studies. Furthermore, its routine use will optimise the comparability, quality, and usefulness of the data cancer survivors provide in population-based research.

Acceptability of online sun exposure awareness-raising interventions among young Australian women: an exploratory mixed-methods study.

Melanoma is the most common cancer among young Australians. Despite school-based programs such as 'Sun Smart' leading to increased knowledge among children of the harmful effects of sun exposure, many young adults continue to desire a darker skin tone because of a general perception among their peers that tanned skin is attractive. This 'tanned-ideal' may be challenged through exposure to material posted on social media. This study aimed to investigate the impact of two online interventions on knowledge of skin cancer and intentions to engage in sun tanning and protective behaviours, as assessed by survey. In addition, the likelihood that the intervention would be 'shared' on social media was explored by interview during an intervention session. Eighteen women aged 18-24 years participated in this pilot, mixed-methods intervention study. Participants completed surveys 2 weeks before and 2 weeks after attending an intervention session in which they viewed a video and completed a face-aging activity, with the order of completion balanced within the sample. Two weeks after the intervention, there was a significant increase in knowledge and intended sun protection behaviours and a significant decrease in intended future tanning hours. There was no effect of intervention order. Interview data indicated that younger participants would share the ageing application with peers because it was fun; older participants reported that they would share the video because it was educational. Factors that encourage sharing on social media include being realistic, instructive or personally meaningful, and short in duration.

Depression and its Treatment in Late Life.

Depression in late life is associated with poorer quality of life and higher mortality. Pain, chronic illness, loneliness, loss of physical abilities, grief, cognitive impairment, and socioeconomic disadvantage all increase the risk of depression in this age group. Treatment for depression in late life includes antidepressant medications, cognitive behavior therapy, interpersonal therapy, and electroconvulsive therapy. The use of virtual reality is also proposed as a potential new treatment for depression that could be made available in aged care settings, and early evidence holds promise. Differentiating between depression, dementia, and delirium plays an important role in diagnosis and treatment, and often relies on a comprehensive neuropsychological assessment. The prevention and treatment of depression in late life requires collaboration and cooperation between families, carers, health professionals, and aged care providers.

Body image disturbance and sexual orientation: An updated systematic review and meta-analysis.

Negative body image, or body image disturbance (BID) has been associated with depression, low self-esteem, and the development of eating disorders. Furthermore, BID may affect an individual regardless of gender or sexual orientation. To synthesise the current literature, we conducted a meta-analysis of 48 studies to determine if BID differed between lesbian versus heterosexual women, lesbian women versus gay men, and gay versus heterosexual men. Body image measures were grouped according to similarities in constructs measured, resulting in five different categories (global satisfaction, figural-rating scales, cognitive measures, affect measures, and male body image). The results indicated that lesbian women reported experiencing less BID compared to heterosexual women on measures of global satisfaction, but more compared to gay men, and gay men reported experiencing greater BID compared to heterosexual men on three out of five analyses. Moderation analyses indicated that the study quality was not a statistically significant moderator of the effect sizes. Results from this updated meta-analysis indicate that, to some degree, BIDs affect individuals regardless of gender and sexual orientation; however, there is some variability associated with sexual orientation.

Core outcome sets in cancer and their approaches to identifying and selecting patient-reported outcome measures: a systematic review.

OBJECTIVES: Issues arising from a lack of outcome standardisation in health research may be addressed by the use of core outcome sets (COS), which represent agreed-upon recommendations regarding what outcomes should be measured as a minimum in studies of a health condition. This review investigated the scope, outcomes, and development methods of consensus-based COS for cancer, and their approaches and criteria for selecting instruments to assess core patient-reported outcomes (PROs). METHODS: Studies that used a consensus-driven approach to develop a COS containing PROs, for use in research with cancer populations, were sought via MEDLINE, CINAHL, Embase, Cochrane Library, and grey literature. RESULTS: Seventeen studies met the inclusion criteria. Most COS (82%) were specific to a cancer type (prostate, esophageal, head and neck, pancreatic, breast, ovarian, lung, or colorectal) and not specific to an intervention or treatment (76%). Conducting a systematic review was the most common approach to identifying outcomes (88%) and administering a Delphi survey was the most common approach to prioritising outcomes (71%). The included COS contained 90 PROs, of which the most common were physical function, sexual (dys) function, pain, fatigue, and emotional function. Most studies (59%) did not address how to assess the core PROs included in a set, while 7 studies (41%) recommended specific instruments. Their approaches to instrument appraisal and selection varied. CONCLUSION: Efforts to standardise outcome assessment via the development of COS may be undermined by a lack of recommendations on how to measure core PROs. To optimise COS usefulness and adoption, valid and reliable instruments for the assessment of core PROs should be recommended with the aid of resources designed to facilitate this process.

Diet and cognitive function in cancer survivors with cancer-related cognitive impairment: A qualitative study.

OBJECTIVE: To identify cancer survivors' perceptions of the role diet plays in their cognitive function, and how their cancer-related cognitive changes influence their diet. METHODS: Cancer survivors diagnosed with cancer in the past 5 years, not on active treatment, and with self-reported cognitive changes since diagnosis were recruited from the general population. Semi-structured interviews were conducted with 15 Australian breast (n = 13) and colorectal (n = 2) survivors (mean time since diagnosed: 27.0 months ± SD=16.8). Questions related to how their diet and cognitive changes influenced each other. Interviews were recorded, and transcripts were analysed using thematic analysis. RESULTS: Four themes related to how diet impacted cognition: (a) directly (e.g. healthy diet improves cognition), (b) indirectly (e.g. diet affects tiredness which affects cognition); (c) no impact; and (d) potentially (e.g. poorer diet quality would worsen cognition). Three themes emerged for how cognitive changes were thought to impact survivors' diets: (a) planning meals is harder; (b) cooking is more difficult and complex; and, (c) choosing healthy is more challenging. CONCLUSIONS: Many cancer survivors perceived a bidirectional influence between diet and cognition that has cognitive and behavioural consequences. Diet could be investigated as a modifiable lifestyle behaviour to improve cancer-related cognitive impairment and fatigue. Survivors may benefit from dietary guidance with meal planning and preparing.