Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Reimagining Pre-operative Cancer Nutrition Care: Co‑Designing a Digital Patient-led Approach to Malnutrition Screening  (145300)

Shane McAuliffe 1 2 , Judith D Bauer 3 , Jonathan R Clark 1 4 5 , Geoff P Delaney 2 6 , Merran Findlay 1 2 6 7 8
  1. Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, NSW, Australia
  2. School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
  3. School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
  4. Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney , NSW, Australia
  5. Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, NSW, Australia
  6. Ingham Institute of Applied Medical Research, Liverpool Hospital, Sydney, NSW, Australia
  7. Cancer Care Research Unit, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health , University of Sydney, Sydney, NSW, Australia
  8. The Daffodil Centre, a joint venture with Cancer Council NSW, University of Sydney , Sydney, NSW, Australia

Aims: 

To co-design and assess the usability of digital, patient-led, malnutrition screening in pre-operative cancer care.  

Methods:  

A multi-phase, mixed methods study comprising prototype development, usability testing and co-design workshops. Participants with lived experience of cancer were purposively sampled from a comprehensive cancer centre in Sydney. A digital prototype of the Malnutrition Screening Tool (MST) was developed and administered using Research Electronic Data Capture (REDCap). Usability was assessed using the System Usability Scale (SUS). Focus groups were delivered in hybrid format and structured using the NSW Agency for Clinical Innovation (ACI) solution testing template, to gather feedback on user experience of the screening process and inform refinement. Discussions were digitally recorded, transcribed and qualitative data thematically analysed using an inductive thematic approach supported by NVivo.  

Results: 

Participants (n=5; 4 patients, 1 carer) attended the co-design focus groups and completed usability testing. Mean (SD) SUS score was 77 (11.6), indicating good perceived usability. Three overarching themes, each comprising sub-themes, were identified: (1) carers as project managers of care (coordinating administrative and information-management tasks; providing emotional support); (2) understanding the purpose of malnutrition screening supports informed care (setting expectations and shared understanding to determine engagement with screening and its priority among competing demands); (3) malnutrition screening as a push and pull of information (sharing clinical information to identify nutrition risk and support triage; reinforcing key messages to support tailored nutrition care; enabling direct communication with clinicians). 

Conclusions: 

Digital, patient-led malnutrition screening may support earlier engagement and more timely nutrition care. Participants valued intuitive navigation, clear context and explanations of required tasks, and a central platform for ease of access and consistency. Carer involvement and flexibility in delivery methods may help overcome perceived barriers to uptake. Implementation feasibility will next be evaluated in patients undergoing reconstruction surgery for head and neck cancer.