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Heirman AN, de Kort DP, Petersen JF, Al-Mamgani A, Eerenstein SEJ, de Kleijn BJ, Hoebers F, Tijink BM, Stuiver MM, van der Molen L, Dirven R, Halmos GB, van den Brekel MWM. Decisional Conflict in Patients with Advanced Laryngeal Carcinoma: A Multicenter Study. Laryngoscope 2024. [PMID: 38366759 DOI: 10.1002/lary.31336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES Decision-making for patients with a locally advanced laryngeal carcinoma (T3 and T4) is challenging due to the treatment choice between organ preservation and laryngectomy, both with different and high impact on function and quality of life (QoL). The complexity of these treatment decisions and their possible consequences might lead to decisional conflict (DC). This study aimed to explore the level of DC in locally advanced laryngeal carcinoma patients facing curative decision-making, and to identify possible associated factors. METHODS In this multicenter prospective cohort study, participants completed questionnaires on DC, level of shared decision-making (SDM), and a knowledge test directly after counseling and 6 months after treatment. Descriptive statistics and Spearman correlation tests were used to analyze the data. RESULTS Directly after counseling, almost all participants (44/45; 98%) experienced Clinically Significant DC score (CSDC >25, scale 0-100). On average, patients scored 47% (SD 20%) correct on the knowledge test. Questions related to radiotherapy were answered best (69%, SD 29%), whilst only 35% (SD 29%) of the questions related to laryngectomy were answered correctly. Patients' perceived level of SDM (scale 0-100) was 70 (mean, SD 16.2), and for physicians this was 70 (SD 1.7). CONCLUSION Most patients with advanced larynx cancer experience high levels of DC. Low knowledge levels regarding treatment aspects indicate a need for better patient counseling. LEVEL OF EVIDENCE Level IV Laryngoscope, 2024.
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Affiliation(s)
- Anne N Heirman
- Department of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Daan P de Kort
- Department of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Japke F Petersen
- Department of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Abrahim Al-Mamgani
- Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Simone E J Eerenstein
- Department of Otolaryngology/Head and Neck Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Bertram J de Kleijn
- Department of Otorhinolaryngology/Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frank Hoebers
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Bernard M Tijink
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn M Stuiver
- Department of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, Center for Quality of Life, Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Lisette van der Molen
- Department of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Richard Dirven
- Department of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Gyorgy B Halmos
- Department of Otolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Michiel W M van den Brekel
- Department of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Amsterdam Center of Language and Communication, University of Amsterdam, Amsterdam, The Netherlands
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Ding Y, Xu J, Ning Y, Wang Q, Chang Z. Nurse-led telephone follow-up according to the revised nursing outcomes classification for laryngeal carcinoma surgery patients: a randomized controlled trial. BMC Nurs 2022; 21:281. [PMID: 36253750 PMCID: PMC9578269 DOI: 10.1186/s12912-022-01054-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/13/2022] [Accepted: 09/29/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study used the revised nursing outcomes classification (NOC) outlined in our previous study, "Core nursing outcomes for otorhinolaryngology head-neck," for telephone follow-up of patients who had laryngeal carcinoma surgery in China. This randomized controlled trial aimed to compare nurse-led telephone follow-up according to the revised NOC with traditional telephone follow-up. METHODS A total of 100 postoperative patients were recruited from March 2018‒March 2020. Patients were randomly assigned to nurse-led telephone follow-up groups as either revised NOC follow-up (n = 51) or traditional follow-up (n = 49). The investigated outcomes included nursing outcomes, quality of life, and self-care abilities. RESULTS The baseline characteristics of patients were well balanced. We noted that improvements in nursing outcomes in the intervention group were significantly better than for those in the control group (P = 0.018), primarily regarding psychosocial health (P < 0.001) and health knowledge and behavior (P < 0.001). Moreover, patient outcomes in the intervention group were associated with greater improvements in quality of life than those in the control group (P < 0.001), especially for social conditions (P < 0.001), emotional health (P < 0.001), functional status (P < 0.001), and additional attention (P = 0.001). Finally, compared with the control group, significant improvements were observed in self-care abilities in the intervention group (P = 0.002), mainly regarding general self-care abilities (P = 0.016) and development self-care abilities (P < 0.001). CONCLUSION This study found that nurse-led telephone follow-up according to the revised NOC improved nursing outcomes, quality of life, and self-care abilities. TRIAL REGISTRATION ChiCTR2100045941.
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Affiliation(s)
- Yongxia Ding
- Nursing College of Shanxi Medical University, No. 98, University Street, 030600, Jinzhong, China. .,Shanxi Key Laboratory of Otolaryngology, Head and Neck Cancer, NO.85 Jiefang South Road, 030001, Taiyuan, China.
| | - Jinxia Xu
- Shanxi Cancer Hospital, No.3 Xincun Street, 030013, Taiyuan, China
| | - Yan Ning
- Nursing College of Shanxi Medical University, No. 98, University Street, 030600, Jinzhong, China
| | - Qian Wang
- Nursing College of Shanxi Medical University, No. 98, University Street, 030600, Jinzhong, China
| | - Zhaojie Chang
- Nursing College of Shanxi Medical University, No. 98, University Street, 030600, Jinzhong, China
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Yang Y, Zhang H, Li Y, Liu Z, Liu S, Li X, Fan G, Xu Y, Wang BQ. The effectiveness of computer-assisted Cognitive Behavioral Therapy (cCBT) for psychological outcomes in patients with laryngectomy: Randomized controlled trial. J Affect Disord 2022; 300:59-65. [PMID: 34942224 DOI: 10.1016/j.jad.2021.12.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/30/2021] [Accepted: 12/19/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The symptom burden was tremendous and rates of psychological distress were high because of laryngectomy in Laryngeal carcinoma. Anxiety and depression as mainly psychological distress influenced their sleep, pain, and the quality of life (QOL). This study aimed to assess the effiacy of computer-assisted Cognitive Behavioral Therapy (cCBT) for psychological outcomes and QOL in patients with laryngectomy, in addition to overall experience with health care service, during the perioperative period. METHODS A cCBT program was be customized focused on improving anxiety and depressive symptoms among patients with laryngectomy, and then its effectiveness was assessed. Participants were randomly assigned to the TAU (treatment as usual) group (n=40) or CCBT group (cCBT+ TAU, n = 40). The primary outcome measures were the State Anxiety Inventory (SAI), Patients Health Questionnaire-9 (PHQ-9). The secondary outcome measures were the Athens Insomnia Scale (AIS), Visual Analogue Scale-10 (VAS-10). The outcomes were obtained from patients before intervention (T1), 1 hour before surgery (T2), postoperative 3-day (T3), postoperative 7-day (T4), and postoperative 10-day(T5: after intervention completed). Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) and satisfaction for health care service were assessed before discharge. RESULTS A mixed linear model displayed significant improvement in symptoms of anxiety, depression, insomnia, and pain in the two groups (all p<0.001); and revealed a significant decreasing on the SAI, PHQ-9, AIS, and VAS-10 scores in the CCBT group compared to that of TAU group during the post-intervention periods (all p<0.05). Furthermore, the other QOL of patients were higher except for physical well-being (p=0.176) and the satisfaction scores were higher in the CCBT group than that of TAU group (all p<0.05). CONCLUSION The new developed cCBT program has a positive effect on psychosomatic symptoms surgery-related among patients with laryngectomy,. And patients with cCBT program reported high levels of QOL and satisfaction during perioperative period. To minimize face-to-face contact, the computer-assisted intervention may be an attractive approach.
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Affiliation(s)
- Yang Yang
- Nursing Department, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China; Shanxi Key Laboratory of Brain Science and Neuropsychiatric Diseases, China
| | - Haibin Zhang
- Department of anesthesia, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuling Li
- Nursing Department, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Zhifen Liu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Sha Liu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xinrong Li
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Gaiping Fan
- Department of Head and Neck Surgery, Shanxi provincial Cancer Hospital, Taiyuan, China
| | - Yong Xu
- Shanxi Key Laboratory of Brain Science and Neuropsychiatric Diseases, China; Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
| | - Bin-Quan Wang
- Department of Otorhinolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
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Ding YX, Yang H, Sun YX, Xu J, Jing L, Ning Y, Wang BQ. Evaluation and revision of core postoperative nursing outcomes for laryngeal carcinoma in China. BMC Nurs 2021; 20:51. [PMID: 33757518 PMCID: PMC7989408 DOI: 10.1186/s12912-021-00569-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 03/12/2021] [Indexed: 11/29/2022] Open
Abstract
Background The core nursing outcomes for laryngeal carcinoma in China needed further screening and revision. This study aimed to evaluate and revise a questionnaire according to the “Core Nursing Outcomes for Otorhinolaryngology Head-Neck” of the Nursing Outcomes Classification (NOC, 5th Edition), and determine suitable postoperative nursing outcomes for patients with laryngeal carcinoma in China. Methods The commonly used postoperative nursing outcomes for laryngeal carcinoma were screened using a questionnaire given to 93 nurses. An initial expert consultation questionnaire was constructed to discuss the indicators for each nursing outcome. A total of 20 experts were identified using the Delphi method, and their recommendations and revisions on the selected nursing outcomes were collected. Results A total of 14 postoperative core nursing outcomes and 69 indicators were identified for postoperative patients with laryngeal carcinoma, which are subordinate to 4 domains of the NOC: “Physiologic Health”, “Psychosocial Health”, “Health Knowledge & Behavior”, and “Perceived Health”. Conclusions The screening and revision of the NOC outcomes and indicators of the Delphi method could be applied to assess the effect of nursing intervention and the quality of the nursing service in China. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00569-4.
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Affiliation(s)
- Yong-Xia Ding
- Nursing College of Shanxi Medical University, Taiyuan City, Shanxi, China.,Shanxi Key Laboratory of Otolaryngology, Head and Neck Cancer, Taiyuan City, Shanxi, China
| | - Hui Yang
- Nursing College of Shanxi Medical University, Taiyuan City, Shanxi, China.,Nursing Department of the First Hospital, Shanxi Medical University, Taiyuan City, Shanxi, China
| | - Ya-Xuan Sun
- Department of Neurology, Shanxi People's Hospital, Taiyuan City, Shanxi, China
| | - Jinxia Xu
- Shanxi Cancer Hospital, Taiyuan City, Shanxi, China
| | - Li Jing
- Nursing Department of the First Hospital, Shanxi Medical University, Taiyuan City, Shanxi, China
| | - Yan Ning
- Nursing College of Shanxi Medical University, Taiyuan City, Shanxi, China
| | - Bin-Quan Wang
- Nursing College of Shanxi Medical University, Taiyuan City, Shanxi, China. .,Shanxi Key Laboratory of Otolaryngology, Head and Neck Cancer, Taiyuan City, Shanxi, China. .,Department of Otolaryngology, Head and Neck Surgery, The First Hospital of Shanxi Medical University, Taiyuan City, Shanxi, China.
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Yang H, Han D, Ren X, Luo H, Li X. Investigation of swallowing function and swallowing-related quality of life after partial laryngectomy in Chinese patients with laryngeal carcinoma. Health Qual Life Outcomes 2019; 17:132. [PMID: 31349839 PMCID: PMC6660951 DOI: 10.1186/s12955-019-1199-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/18/2019] [Indexed: 12/24/2022] Open
Abstract
Background Swallowing function and swallowing-related quality of life (QoL) can be adversely affected in patients after partial laryngectomy, but are often neglected by patients and clinical workers. This study aimed to investigate the degree of swallowing function and swallowing-related QoL after partial laryngectomy in patients with laryngeal carcinoma. Methods Sixty-eight hospitalized patients undergoing partial laryngectomy due to laryngeal carcinoma at the Second Affiliated Hospital of Xi’an Jiao Tong University were included in this prospective study. A general information questionnaire was used to collect baseline characteristics. The water swallow test and swallowing quality of life questionnaire (SWAL-QOL) were carried out the day before surgery and at 2, 4, 12, 24 and 48 weeks after surgery. Results Swallowing dysfunction occurred in 1 case (1.5%) the day before surgery and in 49 (72.1%), 44 (64.7%), 33 (49.3%), 19 (28.4%) and 8 (11.9%) cases at 2, 4, 12, 24 and 48 weeks after surgery, respectively. Mean SWAL-QOL total scores were 4266.3 ± 232.0 the day before surgery, and 1992.9 ± 1062.4, 2473.9 ± 962.9, 3169.2 ± 753.6, 3696.7 ± 718.3 and 3910.8 ± 1510.4 at 2, 4, 12, 24 and 48 weeks, respectively. SWAL-QOL total scores increased gradually after operation, and the differences were statistically significant (P < 0.05). There was no statistical difference between postoperative 24 and 48 weeks (P = 0.379). Conclusions Partial laryngectomy affects swallowing function and swallowing-related QoL in patients with laryngeal carcinoma. While swallowing function and swallowing-related QoL increase gradually over time, in some patients, nearly a year after surgery they are not fully restored. Therefore, attention should be paid during postoperative nursing to improve swallowing function.
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Affiliation(s)
- Hui Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Dongfang Han
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoyong Ren
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Huanan Luo
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaomei Li
- School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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Laccourreye O, Bonfils P, Malinvaud D, Ménard M, Giraud P. Survival and laryngeal preservation tradeoff in advanced laryngeal cancer: From the otorhinolaryngology patient to the managing physician. Head Neck 2017; 39:1984-1989. [PMID: 28786181 DOI: 10.1002/hed.24833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 02/27/2017] [Accepted: 04/17/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The purpose of this study was to document the tradeoff between survival and laryngeal preservation in advanced-stage laryngeal cancer amenable to chemoradiation or total laryngectomy. METHODS We conducted a prospective analysis based on a questionnaire completed by 209 laryngeal cancer specialists and 269 volunteers from an otorhinolaryngology clinic. RESULTS Of the responders, 34.5% would not consider any decrease in survival to preserve their larynx. This percentage varied from 52% in otorhinolaryngologists to 27.3% in radiotherapists and 28.6% in volunteers (P < .001). Among the responders prepared to trade, the percentage of survival they were willing to trade to preserve their larynx varied from 5% to 100% (median 30%). On univariate analysis, 3 variables significantly affected this percentage: (1) the living status (single or not); (2) the existence of children; and (3) the study group (volunteers, radiation therapists, or otorhinolaryngologists) to whom the responders belong. CONCLUSION The significant variations noted should develop modes of practice that cater to this and stimulate further research in this field.
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Affiliation(s)
- Ollivier Laccourreye
- Department of Otorhinolaryngology - Head Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Pierre Bonfils
- Department of Otorhinolaryngology - Head Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - David Malinvaud
- Department of Otorhinolaryngology - Head Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Madeleine Ménard
- Department of Otorhinolaryngology - Head Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Paris, France
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Survival after refusal of surgical treatment for locally advanced laryngeal cancer. Oral Oncol 2017; 71:34-40. [DOI: 10.1016/j.oraloncology.2017.05.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 05/22/2017] [Accepted: 05/27/2017] [Indexed: 12/20/2022]
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