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Ishii R, Ohkoshi A, Katori Y. Treatment of elderly patients with head and neck cancer in an aging society: Focus on geriatric assessment and surgical treatment. Auris Nasus Larynx 2024; 51:647-658. [PMID: 38631257 DOI: 10.1016/j.anl.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/15/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024]
Abstract
Previous studies of the treatment of elderly head and neck cancer (HNC) patients were very limited and sometimes controversial. Although conclusions differ across various reports, it is often concluded that advanced chronological age does not directly affect prognosis, but that comorbidities and declines in physical and cognitive functions promote the occurrence of adverse events, especially with surgical treatment. Geriatric assessment (GA) and its screening tools are keys to help us understand overall health status and problems, predict life expectancy and treatment tolerance, and to influence treatment choices and interventions to improve treatment compliance. In addition, personal beliefs and values play a large role in determining policies for HNC treatment for elderly patients, and a multidisciplinary approach is important to support this. In this review, past research on HNC in older adults is presented, and the current evidence is explained, focusing on the management of elderly HNC patients, with an emphasis on the existing reports on each treatment stage and modality, especially the surgical procedures.
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Affiliation(s)
- Ryo Ishii
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Japan.
| | - Akira Ohkoshi
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Japan
| | - Yukio Katori
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Japan
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Hepper EC, Wilson J, Drinnan M, Patterson JM. Psychosocial impacts of being nil-by-mouth as an adult: A scoping review. J Adv Nurs 2024. [PMID: 38414146 DOI: 10.1111/jan.16100] [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: 09/20/2023] [Revised: 01/25/2024] [Accepted: 02/06/2024] [Indexed: 02/29/2024]
Abstract
AIM To map existing evidence and identify gaps in the literature concerning psychosocial impacts of being nil by mouth (NBM) as an adult. DESIGN A scoping review of the literature was undertaken using JBI guidance. A protocol was registered on the Open Science Framework (osf.io/43g9y). Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). METHODS A comprehensive search of six databases (CINAHL, Embase, MEDLINE, PsycINFO, SCOPUS and Web of Science) was performed for studies published up to February 2023, with no restriction to study type. A scope of the grey literature was also undertaken. Two authors independently assessed eligibility and extracted data. Descriptive statistical analysis and narrative synthesis were used, and patient and public involvement included in funding discussions. RESULTS A total of 23 papers were included in the review, consisting of 14 primary studies (7 qualitative and 7 quantitative) and 9 grey literature. Both global psychological distress and distress specific to being NBM (thirst, missing food and drink) were reported. Caregivers also experience distress from their family member being NBM. Furthermore, social impacts were reported for both patient and caregiver, primarily social isolation and subsequent low mood. CONCLUSION Furthermore, research is needed to understand the prevalence of this population, how best to measure psychosocial impacts and to explore whether (and how) psychosocial impacts change over time. Advancement in this area would enable better service development to optimize care for this patient group. WHAT IS KNOWN ABOUT THIS TOPIC?: Eating and drinking provides more than nutrition and hydration. A wide range of conditions can lead to recommendations for no longer eating and drinking (nil by mouth). Being nil by mouth (NBM) for short periods such as pre-operative fasting causes distress; however, little is understood about impact on longer-term abstinence from eating and drinking. WHAT THIS PAPER ADDS?: Psychosocial consequences of being nil by mouth (NBM)have been investigated by both quantitative and qualitative studies. Being NBM impacts both patients and caregivers in various psychosocial aspects, including distress and social isolation. Several gaps remain, however, regarding ways to measure psychosocial impact of being NBM.
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Affiliation(s)
- Elizabeth C Hepper
- School of Health Sciences, Liverpool University, Liverpool, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - John Wilson
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Michael Drinnan
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Ghirotto L, Catania G, Camera H, D'Adamo C, Ignone D, Rizzuto A, Stevanin S, Losi E, Pedroni C, Peretti G, Bagnasco A, Sasso L, Bressan V. Surviving cancer following total laryngectomy: a phenomenological study. Support Care Cancer 2023; 31:457. [PMID: 37432600 DOI: 10.1007/s00520-023-07931-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/05/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE Total laryngectomy followed by radiotherapy is a life-preserving treatment for patients with locally advanced laryngeal cancer. This study explored how persons who had undergone total laryngectomy perceived themselves as cancer survivors in the follow-up phase. METHODS A descriptive phenomenological approach was adopted. We employed a purposive sampling strategy to collect data through interviews at the otorhinolaryngology outpatient clinics of two research hospitals in northern Italy. The interviews were transcribed verbatim and analysed, following the seven analytical steps of Colaizzi's descriptive analysis. RESULTS The final sample included 19 patients. The following main themes were identified: (i) accepting a life with the "without" to survive; (ii) feeling unpleasant emotions; (iii) getting the hang of communication again; and (iv) reclaiming one's role. Together, they highlight the lived experiences of laryngectomised patients during the follow-up phase and how they perceived themselves as cancer survivors. CONCLUSION Laryngectomised patients are a uniquely vulnerable population. This study provides insights into how surgical procedures change and affect their lives over time to improve care models, patient education, and support systems. Survivors must be adequately prepared to transition from treatment and return to the community. This preparation should begin before treatment is started. Functional education, accurate information, and psychological support must be arranged and provided before surgery. Regarding the post-treatment phase, it is essential to support voice rehabilitation and peer support, and improve the family network, to ensure these patients' reintegration into society and social recognition.
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Affiliation(s)
- Luca Ghirotto
- Qualitative Research Unit, Azienda USL-IRCCS di Reggio Emilia, Viale Umberto I, 50, 42123, Reggio Emilia, Italy.
| | - Gianluca Catania
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Helena Camera
- Azienda Sanitaria Locale di Alessandria, Castelnuovo Scrivia, Italy
| | | | - Danilo Ignone
- Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Antonio Rizzuto
- Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Simone Stevanin
- Health Professions Direction, Padova University Hospital, Padua, Italy
| | - Elisabetta Losi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | | | - Giorgio Peretti
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
- Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Annamaria Bagnasco
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Loredana Sasso
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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Lemoine JC, Vaitaitis V, Jarreau T, Germain JS, Son L, Pou AM, Mays A. Inpatient Decongestive Therapy for Lymphedema in Acute Postsurgical Head and Neck Cancer Patients. Int Arch Otorhinolaryngol 2023; 27:e329-e335. [PMID: 37125378 PMCID: PMC10147473 DOI: 10.1055/s-0042-1745726] [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: 11/09/2021] [Accepted: 02/14/2022] [Indexed: 05/02/2023] Open
Abstract
Introduction Head and neck lymphedema is an omnipresent morbidity related to head and neck cancer therapies. Studies on therapy for these patients in the acute postsurgical population have not been published to date. Objective To assess changes in the measurements of lymphedema in surgical head and neck cancer patients during the hospital stay with implementation of modified decongestive therapy (MDT). Methods Patients aged > 18 years undergoing neck dissection with or without primary-site resection or laryngectomy between 2016 and 2019 were included. Facial measurements were obtained prior to beginning MDT and again prior to discharge. A total facial composite measurement was calculated and used to assess change over time. Rates ≥ 2% of change were considered significant. Results A total of 38 patients were included (subsites: larynx = 27; thyroid = 4; oral cavity = 3; and neck = 4). The mean number of days between surgery and the start of lymphedema therapy was 3.0 days. The mean number of days between measurements was 5.2 days. Reduction in the total composite score was observed in 37 (97%) patients, and 35 (92%) patients had a total composite reduction score > 2%. Tumor subsite and surgery type did not portend toward greater percent change, except for those patients treated with total laryngectomy, regional flap reconstruction, and neck dissection ( p = 0.02). Conclusion Acute postsurgical inpatient MDT was associated with reduced total composite measurements in patients after head and neck surgery. As the first published study on lymphedema therapy in this acute postsurgical period, further prospective case-control studies are warranted to explore further benefits of acute therapy.
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Affiliation(s)
- John Christian Lemoine
- Department of Otolaryngology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States
| | - Vilija Vaitaitis
- Department of Otolaryngology – Head & Neck Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States
| | - Trisha Jarreau
- Department of Speech and Language Pathology, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States
| | - Joel St. Germain
- Department of Speech and Language Pathology, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States
| | - Leslie Son
- Department of Otolaryngology, Our Lady of the Lake Regional Medical Center, Louisiana, United States
| | - Anna M. Pou
- Department of Otolaryngology, Ochsner Health Center – Covington, Covington, Louisiana, United States
| | - Ashley Mays
- Department of Otolaryngology – Head & Neck Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States
- Address for correspondence Ashley C. Mays, MD Department of Otolaryngology, Head and Neck SurgeryCleveland Clinic Florida-Indian River Hospital, 1000 36th St, Vero Beach, Florida, 32960United States
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Manne SL, Hudson SV, Kashy DA, Imanguli M, Pesanelli M, Frederick S, Van Cleave J. Self-efficacy in managing post-treatment care among oral and oropharyngeal cancer survivors. Eur J Cancer Care (Engl) 2022; 31:e13710. [PMID: 36151904 PMCID: PMC9788355 DOI: 10.1111/ecc.13710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/25/2022] [Accepted: 09/07/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Physical and psychosocial effects of oral cancer result in long-term self-management needs. Little attention has been paid to survivors' self-efficacy in managing their care. Study goals were to characterise self-care self-efficacy and evaluate socio-demographics, disease, attitudinal factors and psychological correlates of self-efficacy and engagement in head and neck self-exams. METHODS Two hundred thirty-two oral cancer survivors completed measures of socio-demographics, self-care self-efficacy, head and neck self-exams and attitudinal and psychological measures. Descriptive statistics characterised self-efficacy. Hierarchical regressions evaluated predictors of self-efficacy. RESULTS Survivors felt moderately confident in the ability to manage self-care (M = 4.04, SD = 0.75). Survivors with more comorbidities (β = -0.125), less preparedness (β = 0.241), greater information (β = -0.191), greater support needs (β = -0.224) and higher depression (β = -0.291) reported significantly lower self-efficacy. Head and neck self-exam engagement (44% past month) was relatively low. Higher preparedness (OR = 2.075) and self-exam self-efficacy (OR = 2.606) were associated with more engagement in self-exams. CONCLUSION Many survivors report low confidence in their ability to engage in important self-care practices. Addressing unmet information and support needs, reducing depressive symptoms and providing skill training and support may boost confidence in managing self-care and optimise regular self-exams.
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Affiliation(s)
- Sharon L. Manne
- Rutgers Cancer Institute of New JerseyNew BrunswickNew JerseyUSA
| | - Shawna V. Hudson
- Institute for Health, Health Care Policy and Aging ResearchRobert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Deborah A. Kashy
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
| | - Matin Imanguli
- Rutgers Cancer Institute of New JerseyNew BrunswickNew JerseyUSA,Department of Otolaryngology‐Head and Neck SurgeryRobert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Morgan Pesanelli
- Rutgers Cancer Institute of New JerseyNew BrunswickNew JerseyUSA
| | - Sara Frederick
- Rutgers Cancer Institute of New JerseyNew BrunswickNew JerseyUSA
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Ishii R, Ohkoshi A, Kiyota N, Matsuura K, Yasuda K, Imamura Y, Saito Y, Homma A. Management of elderly patients with head and neck cancer. Jpn J Clin Oncol 2022; 52:313-321. [PMID: 35165732 DOI: 10.1093/jjco/hyac013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/20/2022] [Indexed: 12/13/2022] Open
Abstract
There are no established guidelines for managing older patients with head and neck cancer. Most clinical trials that define current standard therapy included few elderly patients. On the other hand, there is great variability in patients' comorbidities, physical functions, cognitive function, familial and financial background and values. The key point appears to be appropriate geriatric assessment, clarifying the patients' outcomes and a multidisciplinary team approach, including the treatment decision-making policy. Although these processes should be scientific in nature, the evidence for the treatment of elderly head and neck patients is very limited. This review summarizes the evidence available regarding the management of geriatric assessment, each treatment modality and the multidisciplinary team approach for older patients with head and neck cancers.
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Affiliation(s)
- Ryo Ishii
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Ohkoshi
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Kazuto Matsuura
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Koichi Yasuda
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Yoshinori Imamura
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Yuki Saito
- Department of Otolaryngology, Head and Neck Surgery, University of Tokyo, Tokyo, Japan
| | - Akihiro Homma
- Department of Otolaryngology - Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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Patel GP, McAdoo B, Eaton B, Romej M, Stack K, Wolf F. Decreased Cerebral Perfusion Under Anesthesia During Radiation Treatment: A Case Report. A A Pract 2022; 16:e01580. [DOI: 10.1213/xaa.0000000000001580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Goyal N, Day A, Epstein J, Goodman J, Graboyes E, Jalisi S, Kiess AP, Ku JA, Miller MC, Panwar A, Patel VA, Sacco A, Sandulache V, Williams AM, Deschler D, Farwell DG, Nathan C, Fakhry C, Agrawal N. Head and neck cancer survivorship consensus statement from the American Head and Neck Society. Laryngoscope Investig Otolaryngol 2022; 7:70-92. [PMID: 35155786 PMCID: PMC8823162 DOI: 10.1002/lio2.702] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/15/2021] [Accepted: 11/10/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES To provide a consensus statement describing best practices and evidence regarding head and neck cancer survivorship. METHODS Key topics regarding head and neck cancer survivorship were identified by the multidisciplinary membership of the American Head and Neck Society Survivorship, Supportive Care & Rehabilitation Service. Guidelines were generated by combining expert opinion and a review of the literature and categorized by level of evidence. RESULTS Several areas regarding survivorship including dysphonia, dysphagia, fatigue, chronic pain, intimacy, the ability to return to work, financial toxicity, lymphedema, psycho-oncology, physical activity, and substance abuse were identified and discussed. Additionally, the group identified and described the role of key clinicians in survivorship including surgical, medical and radiation oncologists; dentists; primary care physicians; psychotherapists; as well as physical, occupational, speech, and respiratory therapists. CONCLUSION Head and neck cancer survivorship is complex and requires a multidisciplinary approach centered around patients and their caregivers. As survival related to head and neck cancer treatment improves, addressing post-treatment concerns appropriately is critically important to our patient's quality of life. There continues to be a need to define effective and efficient programs that can coordinate this multidisciplinary effort toward survivorship.
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Affiliation(s)
- Neerav Goyal
- Department of Otolaryngology—Head and Neck SurgeryThe Pennsylvania State University, College of MedicineHersheyPennsylvaniaUSA
| | - Andrew Day
- Department of Otolaryngology—Head and Neck SurgeryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Joel Epstein
- Department of SurgeryCedars SinaiLos AngelesCaliforniaUSA
- City of HopeCaliforniaDuarteUSA
| | - Joseph Goodman
- Ear, Nose and Throat CenterGeorge Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Evan Graboyes
- Department of Otolaryngology—Head and Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Scharukh Jalisi
- Department of OtolaryngologyBeth Israel DeaconessBostonMassachusettsUSA
| | - Ana P. Kiess
- Department of Radiation Oncology and Molecular Radiation SciencesJohns Hopkins MedicineBaltimoreMarylandUSA
| | - Jamie A. Ku
- Head and Neck InstituteCleveland ClinicClevelandOhioUSA
| | - Matthew C. Miller
- Department of OtolaryngologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Aru Panwar
- Department of Head and Neck Surgical Oncology, Methodist Estabrook Cancer CenterNebraska Methodist HospitalOmahaNebraskaUSA
| | - Vijay A. Patel
- Department of OtolaryngologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Assuntina Sacco
- Department of Medical OncologyUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Vlad Sandulache
- Department of Otolaryngology—Head and Neck SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Amy M. Williams
- Department of Otolaryngology—Head and Neck SurgeryHenry Ford Health SystemDetroitMichiganUSA
| | - Daniel Deschler
- Department of Otolaryngology–Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
| | - D. Gregory Farwell
- Department of Otolaryngology—Head and Neck SurgeryUniversity of California DavisDavisCaliforniaUSA
| | - Cherie‐Ann Nathan
- Department of Otolaryngology—Head and Neck SurgeryLouisiana State UniversityShreveportLouisianaUSA
| | - Carole Fakhry
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Nishant Agrawal
- Department of Surgery, Section of Otolaryngology—Head and Neck SurgeryUniversity of Chicago Pritzker School of MedicineChicagoIllinoisUSA
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Adeberg S, Sauer C, Lambert L, Regnery S, Windisch P, Zaoui K, Freudlsperger C, Moratin J, Farnia B, Nikendei C, Krauss J, Ehrenthal JC, El Shafie R, Hörner-Rieber J, König L, Akbaba S, Lang K, Held T, Rieken S, Debus J, Friederich HC, Maatouk I. Screening and Psycho-Oncological Support for Patients With Head and Neck Cancer and Brain Malignancies Before Radiotherapy With Mask Fixation: Results of a Feasibility Study. Front Psychol 2021; 12:760024. [PMID: 34975651 PMCID: PMC8716729 DOI: 10.3389/fpsyg.2021.760024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
This single-center, single-arm trial investigates the feasibility of a psycho-oncological care program, which aims to reduce psychological distress and improve compliance with radiotherapy with mask fixation in patients with head and neck cancer or brain malignancies. The care program comprised (1) a screening/needs assessment and (2) the provision of a psycho-oncological intervention using imaginative stabilization techniques for distressed patients (distress due to anxiety ≥5) or in a case of subjective interest in the psycho-oncological intervention. Another allocation path to the intervention was directly through the radiation oncologist in charge who classified the patient as: in need of support to tolerate the immobilization device. Of a total of 1,020 screened patients, 257 (25.2%) patients indicated a distress ≥5 and 141 (13.8%) patients reported panic attacks. 25% of the patients reported a subjective interest in psycho-oncological support. A total of 35 patients received the psycho-oncological intervention, of which 74% were assigned by radiation oncologists. In this small patient cohort, no significant pre-post effects in terms of depression, anxiety, distress, and quality of life (mental and physical component scores) could be detected. Our results indicate a good feasibility (interdisciplinary workflow and cooperation, allocation by physicians in charge) of the psycho-oncological care program for this cohort of patients before radiotherapy with mask fixation. The screening results underline the high psychological distress and demand for psycho-oncological support. However, since the utilization of our intervention was low, future studies should reduce the barriers and improve compliance to psycho-oncological services by these patients.Clinical Trial Registration: https://www.drks.de/drks_web/setLocale_EN.do #DRKS00013493
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Affiliation(s)
- Sebastian Adeberg
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Christina Sauer
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
| | - Lena Lambert
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
| | - Sebastian Regnery
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Paul Windisch
- Department of Radiation Oncology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Karim Zaoui
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Freudlsperger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Julius Moratin
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Benjamin Farnia
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, United States
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
| | - Juergen Krauss
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Rami El Shafie
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Juliane Hörner-Rieber
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Laila König
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Sati Akbaba
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Kristin Lang
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Thomas Held
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Stefan Rieken
- Department of Radiation Oncology, Goettingen University Hospital, Goettingen, Germany
| | - Juergen Debus
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
| | - Imad Maatouk
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
- Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian University Würzburg, Würzburg, Germany
- *Correspondence: Imad Maatouk,
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Pequeno DP, Viaro EG, Carron J, Silva DR, Gaspar KC, Lima CSP, Lourenço GJ. Influence of Sociodemographic Characteristics and Inflammation-Related Gene Variants on the Comfort Level of Caregivers of Patients With Head and Neck Cancer. J Holist Nurs 2021; 40:227-237. [PMID: 34636689 DOI: 10.1177/08980101211046738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Sociodemographic characteristics and inflammatory cytokines, such as interleukin (IL)-1β, IL-1 cytokine receptor type 2 (IL1R2), IL-6, and triggering receptor expressed on myeloid cells like 2 (TREML2), may influence psychological disorders, including discomfort. Single-nucleotide variants (SNVs) determine individual differences for the modulation of cytokines and indicate that genetics may also influence the comfort levels. However, the relationship between sociodemographic characteristics, holistic comfort, and the roles played by IL1B rs16944, IL1R2 rs4141134, IL6 rs1800795, and TREML2 rs3747742 SNVs on the comfort levels of family caregivers (FCGs) of head and neck cancer (HNC) patients in palliative care (PC) is unknown. Thus, its investigation consisted in the aim of the present study. Methods: A questionnaire was applied to obtain sociodemographic information on 95 FCGs. The genotypes were identified using TaqMan assays. The Holistic Comfort Questionnaire for the Caregiver, which consists of 49 questions, was used to measure comfort levels. Differences between groups were assessed by the t test and linear regression. Results: Employed FCGs (p = .04), those youngest (p = .04), smokers (p = .04), and those with IL1R2 GA or AA genotypes (p = .03) presented lower comfort regarding the overall, environmental, sociocultural, and psychospiritual domains, respectively. Conclusions: Employment status, smoking habit, young age, and SNV IL1R2 rs4141134 could influence the comfort levels of FCGs of patients with HNC in PC.
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Affiliation(s)
- Daniel Paixão Pequeno
- Laboratory of Cancer Genetics, School of Medical Sciences, University of Campinas.,Clinical Oncology Service, School of Medical Sciences, University of Campinas
| | - Elisângela Godoi Viaro
- Laboratory of Cancer Genetics, School of Medical Sciences, University of Campinas.,Clinical Oncology Service, School of Medical Sciences, University of Campinas
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11
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Nagarkar R, Patil R, Gadade K, Paleja N, Bhamre R, Ramesh Y. Psychological burden on cancer patients and their caregivers during COVID-19 pandemic in India. TAIWANESE JOURNAL OF PSYCHIATRY 2021. [DOI: 10.4103/tpsy.tpsy_35_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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12
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Baijens LWJ, Walshe M, Aaltonen LM, Arens C, Cordier R, Cras P, Crevier-Buchman L, Curtis C, Golusinski W, Govender R, Eriksen JG, Hansen K, Heathcote K, Hess MM, Hosal S, Klussmann JP, Leemans CR, MacCarthy D, Manduchi B, Marie JP, Nouraei R, Parkes C, Pflug C, Pilz W, Regan J, Rommel N, Schindler A, Schols AMWJ, Speyer R, Succo G, Wessel I, Willemsen ACH, Yilmaz T, Clavé P. European white paper: oropharyngeal dysphagia in head and neck cancer. Eur Arch Otorhinolaryngol 2020; 278:577-616. [PMID: 33341909 PMCID: PMC7826315 DOI: 10.1007/s00405-020-06507-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022]
Abstract
Purpose To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. Methods Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. Results Twenty-four sections on HNC-specific OD topics. Conclusion This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.
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Affiliation(s)
- Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. .,GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Magdeburg, Otto-von-Guericke University, Magdeburg, Germany
| | - Reinie Cordier
- Department of Special Needs Education, University of Oslo, Oslo, Norway.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Patrick Cras
- Department of Neurology, Born Bunge Institute, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Lise Crevier-Buchman
- Voice, Speech, Swallowing Lab, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital UVSQ and Research lab CNRS-UMR7018, Hôpital Foch, Suresnes, France
| | - Chris Curtis
- Swallows Head and Neck Cancer Charity, Blackpool, UK
| | - Wojciech Golusinski
- Department of Head and Neck Surgery, The Greater Poland Cancer Centre, Poznan University of Medical Sciences, Poznan, Poland
| | - Roganie Govender
- Head and Neck Cancer Centre, University College London Hospital, London, UK
| | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Kevin Hansen
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kate Heathcote
- Robert White Centre for Airway, Voice and Swallow, Poole Hospital NHS Foundation Trust, Dorset, UK
| | - Markus M Hess
- Deutsche Stimmklinik, Hamburg, Germany.,Departement of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sefik Hosal
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Atılım University, Medicana International Ankara, Ankara, Turkey
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - C René Leemans
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, The Netherlands
| | - Denise MacCarthy
- Division of Restorative Dentistry and Periodontology, Faculty of Health Sciences, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - Beatrice Manduchi
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Jean-Paul Marie
- Department of Otorhinolaryngology, Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | - Reza Nouraei
- Department of Ear Nose and Throat Surgery, The Robert White Centre for Airway Voice and Swallowing, Poole Hospital NHS Foundation Trust, University of Southampton, Southampton, UK
| | - Claire Parkes
- Department of Speech and Language Therapy, St. James's Hospital, Dublin, Ireland
| | - Christina Pflug
- Departement of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Walmari Pilz
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,MHeNs School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Julie Regan
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Nathalie Rommel
- Department Neurosciences, Experimental Otorhinolaryngology, Deglutology, University of Leuven, Leuven, Belgium
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Renee Speyer
- Department of Special Needs Education, University of Oslo, Oslo, Norway.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands.,Faculty of Health, School of Health and Social Development, Victoria, Australia
| | - Giovanni Succo
- Head and Neck Oncology Service, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy.,Department of Oncology, University of Turin, Orbassano, TO, Italy
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anna C H Willemsen
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.,Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Taner Yilmaz
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Pere Clavé
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
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13
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Twigg J, Anderson J, Humphris G, Nixon I, Rogers S, Kanatas A. Best practice in reducing the suicide risk in head and neck cancer patients: a structured review. Br J Oral Maxillofac Surg 2020; 58:e6-e15. [DOI: 10.1016/j.bjoms.2020.06.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022]
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14
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Taberna M, Gil Moncayo F, Jané-Salas E, Antonio M, Arribas L, Vilajosana E, Peralvez Torres E, Mesía R. The Multidisciplinary Team (MDT) Approach and Quality of Care. Front Oncol 2020; 10:85. [PMID: 32266126 PMCID: PMC7100151 DOI: 10.3389/fonc.2020.00085] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 01/16/2020] [Indexed: 12/17/2022] Open
Abstract
The core function of a multidisciplinary team (MDT) is to bring together a group of healthcare professionals from different fields in order to determine patients' treatment plan. Most of head and neck cancer (HNC) units are currently led by MDTs that at least include ENT and maxillofacial surgeons, radiation and medical oncologists. HNC often compromise relevant structures of the upper aerodigestive tract involving functions such as speech, swallowing and breathing, among others. The impairment of these functions can significantly impact patients' quality of life and psychosocial status, and highlights the crucial role of specialized nurses, dietitians, psycho-oncologists, social workers, and onco-geriatricians, among others. Hence, these professionals should be integrated in HNC MDTs. In addition, involving translational research teams should also be considered, as it will help reducing the existing gap between basic research and the daily clinical practice. The aim of this comprehensive review is to assess the role of the different supportive disciplines integrated in an MDT and how they help providing a better care to HNC patients during diagnosis, treatment and follow up.
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Affiliation(s)
- Miren Taberna
- Medical Oncology Department, Catalan Institute of Oncology (ICO), ONCOBELL, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Francisco Gil Moncayo
- Psicooncology Department, Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Enric Jané-Salas
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Barcelona, Spain.,Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Maite Antonio
- Oncogeriatrics Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lorena Arribas
- Clinical Nutrition Unit, Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Esther Vilajosana
- Head and Neck Nurse, Head and Neck Functional Unit, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Elisabet Peralvez Torres
- Expert SLP in Oncologic Patients, Head of SLP's Department, Atos Medical Spain, Barcelona, Spain
| | - Ricard Mesía
- Medical Oncology Department, Catalan Institute of Oncology (ICO), B-ARGO, Barcelona, Spain
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15
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Mersin S, Demiralp M, Öksüz E. Addressing the psychosocial needs of patients: Challenges for nursing students. Perspect Psychiatr Care 2019; 55:269-276. [PMID: 30740697 DOI: 10.1111/ppc.12365] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 01/26/2019] [Accepted: 01/28/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To evaluate the ability of nursing students to determine the psychosocial needs of patients and identify the needs and problems encountered by nursing students. DESIGN AND METHODS This study is a mixed method research. The nursing care plans of 40 nursing students that provided care to 129 patients with chronic medical diseases were examined retrospectively. Individual interviews were also conducted with five nursing students and six academicians. FINDINGS It was determined that nursing students defined an average of 15.77 ± 11.55 physiological and an average of 3.05 ± 2.28 psychosocial nursing diagnoses for 129 patients. Data analysis of individual interviews revealed two main themes: (1) identifying psychosocial diagnoses: teaching difficulties and (2) identifying psychosocial diagnoses: learning difficulties. PRACTICE IMPLICATIONS This can facilitate the learning process of each student to include physiological and a psychosocial care focus in their nursing care through discussions and evaluation with their mentors and instructors.
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Affiliation(s)
- Sevinç Mersin
- Psychiatric and Mental Health Nursing Department, School of Health, Bilecik SE University, Bilecik, Turkey
| | - Meral Demiralp
- Psychiatric and Mental Health Nursing Department, School of Health, European University of Lefke, Turkish Republic of Northern Cyprus
| | - Emine Öksüz
- Psychiatric and Mental Health Nursing Department, Gulhane School of Nursing, University of Health Sciences, Ankara, Turkey
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16
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Abu Sharour L. Lived experience of Jordanian colorectal cancer patients with recurrence: an interpretative phenomenological analysis. PSYCHOL HEALTH MED 2019; 24:827-835. [DOI: 10.1080/13548506.2019.1587481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Loai. Abu Sharour
- Faculty of nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
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17
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Papadakos J, McQuestion M, Gokhale A, Damji A, Trang A, Abdelmutti N, Ringash J. Informational Needs of Head and Neck Cancer Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:847-856. [PMID: 28155041 DOI: 10.1007/s13187-017-1176-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The patient journey with head and neck cancer (HNC) is particularly challenging given the physical and functional impact of the cancer and treatment. The ability to perform activities of daily living can be severely compromised and have a profound impact on psychosocial well-being. These complex and long-lasting effects can affect patient quality of life for months to years and the literature shows that information for HNC patients is often insufficient. This observational cross-sectional study utilized survey methodology to investigate the informational needs of HNC patients and the preferred modalities for delivery. This was done to inform the development of resources for HNC patients. Four hundred fifty surveys were analyzed. The median age was 61 years and 58% of the cohort was born in Canada. Most were Caucasian (72%), Chinese being the next largest ethnicity (12%). A third had less than high school education and most had cancer of the oral cavity (28%) and were in long-term follow-up (41%). Comparison of the percentage of items to which a patient responded "very important" across the six domains shows variation of importance by domain (overall mixed effects regression model p < 0.0001). Additionally, each domain was compared to the medical domain and all had significantly lower mean scores (all p < 0.0001) with the medical domain scoring highest (mean score 64.6). The top preferred education modalities were teaching with a healthcare professional and pamphlets. This study highlights the type of information that HNC patients want and the format they wish to receive it in. The design provides a comprehensive way to consult with patients toward building education that responds to their specific needs.
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Affiliation(s)
- Janet Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
- ELLICSR: Health, Wellness & Cancer Survivorship Centre, Princess Margaret Cancer Centre, PMB ELLICSR, 585 University Avenue, Toronto, ON, M5G 2N2, Canada.
| | - Maurene McQuestion
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Head and Neck Survivorship Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Anandita Gokhale
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ali Damji
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Aileen Trang
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Nazek Abdelmutti
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Jolie Ringash
- ELLICSR: Health, Wellness & Cancer Survivorship Centre, Princess Margaret Cancer Centre, PMB ELLICSR, 585 University Avenue, Toronto, ON, M5G 2N2, Canada
- Head and Neck Survivorship Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
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18
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Bickford J, Coveney J, Baker J, Hersh D. Validating the Changes to Self-identity After Total Laryngectomy. Cancer Nurs 2018; 42:314-322. [PMID: 29846191 DOI: 10.1097/ncc.0000000000000610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A total laryngectomy often prolongs life but results in long-term disablement, disfigurement, and complex care needs. Current clinical practice addresses the surgical options, procedures, and immediate recovery. Less support is available longer-term despite significant changes to aspects of personhood and ongoing medical needs. OBJECTIVE The aim of this study was to explore the experience of living with and/or supporting individuals with a laryngectomy at least 1 year after surgery. METHODS Constructivist grounded theory methods and symbolic interactionism were used to guide collection and analysis of interview data from 28 participants (12 individuals with a laryngectomy, 9 primary supporters, and 7 health professionals). RESULTS The phenomena of "validating the altered self after total laryngectomy" highlighted how individuals, postlaryngectomy, navigate and negotiate interactions due to the disruption of their self-expression, related competencies, and roles. Several reframing patterns representing validation of the self emerged from the narratives. They were as follows: destabilized, resigned, resolute, and transformed. The data describe the influence of the processes of developing competence and building resilience, combined with contextual factors, for example, timing and turning points; being supported; and personal factors on these reframing patterns. CONCLUSION The findings further our understanding of the long-term subjective experience of identity change after laryngectomy and call attention to the persisting need for psychosocial support. IMPLICATIONS FOR PRACTICE This research provides important evidence for evaluating and strengthening the continuum of services (specialist to community) and supporting social participation, regardless of communication method, and for competency training for all involved to optimize person-centered practices.
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Affiliation(s)
- Jane Bickford
- Authors Affiliations: College of Nursing and Health Sciences, Flinders University, Adelaide (Dr Bickford and Adjunct Associate Professor Baker and Professor Coveney); and School of Medicine and Health Sciences, Edith Cowan University, Western Australia (Associate Professor Hersh)
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19
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Bickford JM, Coveney J, Baker J, Hersh D. Support following total laryngectomy: Exploring the concept from different perspectives. Eur J Cancer Care (Engl) 2018; 27:e12848. [DOI: 10.1111/ecc.12848] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 11/29/2022]
Affiliation(s)
- J. M. Bickford
- College of Nursing and Health Sciences; Flinders University South Australia; Adelaide SA Australia
| | - J. Coveney
- College of Nursing and Health Sciences; Flinders University South Australia; Adelaide SA Australia
| | - J. Baker
- College of Nursing and Health Sciences; Flinders University South Australia; Adelaide SA Australia
| | - D. Hersh
- School of Medical and Health Sciences; Edith Cowan University; Joondalup WA Australia
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20
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Budhrani-Shani P, Chau NG, Berry DL. Psychosocial distress and the preferred method of delivery of mind-body interventions among patients with head-and-neck cancer. PATIENT-RELATED OUTCOME MEASURES 2018; 9:129-136. [PMID: 29662331 PMCID: PMC5892963 DOI: 10.2147/prom.s149978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective To describe the psychosocial distress of head-and-neck cancer patients at the completion of therapy and the interest in and the preferred method of delivery of mind-body interventions (MBIs) among head-and-neck cancer patients. Materials and methods A descriptive, cross-sectional design was used to measure sleep disturbance, depression, anxiety, and the interest in and the preference for MBIs using anonymous, self-report questionnaires among a convenience sample of 30 males at their 3-month follow-up. Questionnaires included the Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, and the self-created Survey for Preferred Methods of MBI. Frequency distributions and descriptive statistics were used to describe the sample demographic and clinical characteristics. Results The mean age of the sample was 59 years. Oral cancer (63%) was the most common type of cancer. Nineteen participants (63%, 90% CI 47%-78%) had some interest in MBIs. Of interested participants, 8 (42%) preferred participating in MBIs alone, 10 (53%) preferred participating in MBIs at homes, 10 (53%) preferred participating in MBIs using a computer or mobile device, and 8 (42%) preferred participating in MBIs after the diagnosis, but before treatment started. Mean depression, anxiety, and sleep disturbance scores were 8.25 (SD 2.93), 5.41 (SD 3.52), and 6.3 (SD 3.86), respectively. Results from the independent-samples t-test and Mann-Whitney U tests revealed no significant differences in anxiety, depression, and sleep disturbance by MBI interest. Conclusion Asking about depression, anxiety, and sleep disturbances may help to identify head-and-neck cancer patients at risk for psychosocial distress. These findings suggest an interest in MBIs, but further research is warranted.
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Affiliation(s)
- Pinky Budhrani-Shani
- Nelda C Stark College of Nursing, Texas Woman's University, Houston, TX.,Phyllis F Cantor Center for Research in Nursing and Patient Care Services
| | - Nicole G Chau
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Donna L Berry
- Phyllis F Cantor Center for Research in Nursing and Patient Care Services.,Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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21
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Paek MS, Nightingale CL, Tooze JA, Milliron BJ, Weaver KE, Sterba KR. Contextual and stress process factors associated with head and neck cancer caregivers' physical and psychological well-being. Eur J Cancer Care (Engl) 2018; 27:e12833. [PMID: 29461649 PMCID: PMC5867245 DOI: 10.1111/ecc.12833] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 01/09/2023]
Abstract
Head and neck cancer (HNC) caregivers are especially vulnerable to poor outcomes because the HNC patients are at high risk for physical and functional impairments. This study examines contextual and stress process variables potentially associated with HNC caregivers' physical and psychological well-being. Patient-caregiver variables included socio-demographics, primary stressors (caregiving, patient clinical characteristics, HNC-related symptoms/dysfunction), secondary stressors (caregiver employment, childcare responsibilities and sleep duration <7 hr), appraisal, and response (physical activity). General linear models modeled caregiver well-being, along with depression and anxiety. A total of 33 patient-caregiver dyads were included. Most caregivers were female (81.8%) and patient spouses/partners (72.7%). Factors significantly associated with better caregiver physical well-being included caregiver older age, <2 comorbidities, ≥7 hr of sleep, ≥3 days/week physical activity, and patient swallowing and speech dysfunction. Factors significantly associated with better caregiver mental health functioning were less patient social dysfunction and less perceived caregiving burden. Short nighttime sleep, higher caregiver burden, and <3 days/week physical activity were also significantly related to caregivers' depression and anxiety. Results suggested caregiver behaviors and perceived burden, along with patient HNC concerns are linked with caregiver well-being. These behavioral, cognitive, and patient factors should be incorporated into caregiver screening tools or targeted with behavioral interventions to improve caregiver well-being.
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Affiliation(s)
- M-S Paek
- Department of Social Welfare, Konkuk University, Chungju-si, Chungcheongbuk-do, South Korea
| | - C L Nightingale
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - J A Tooze
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - B-J Milliron
- Department of Nutrition Sciences, College of Nursing and Health, Drexel University, Philadelphia, PA, USA
| | - K E Weaver
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - K R Sterba
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
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22
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Madnick AL, Morasso EG. Changes at the Dinner Table and Beyond: Nourishing Our Patients Throughout the Trajectory of Their Cancer Journey. Otolaryngol Clin North Am 2017; 50:825-836. [PMID: 28606601 DOI: 10.1016/j.otc.2017.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patients with head and neck cancers (HNC) can experience significant distress from presentation of symptoms to surveillance/survivorship and end-of-life. It is of value to all members of the HNC team to practice patient-centered care in assessment and interventions with patients and their support systems to achieve the best possible outcome given patient health status. Early assessment and referral to ancillary support provide a strong foundation across the illness trajectory. Specific attention should be given to the psychosocial implications of changes in physiologic functioning. Support around these changes involves a strong multidisciplinary team familiar with the biopsychosocial effects of HNC and its treatment.
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Affiliation(s)
- Amy Lewis Madnick
- Department of Care Coordination and Clinical Social Work, UCLA Health, 757 Westwood Plaza, B788, Los Angeles, CA 90095, USA.
| | - Elizabeth Grace Morasso
- Department of Radiation Oncology, UCLA Health, 200 Medical Plaza, B265, Los Angeles, CA 90095, USA
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Algtewi E, Owens J, Baker SR. Online support groups for head and neck cancer and health-related quality of life. Qual Life Res 2017; 26:2351-2362. [PMID: 28417218 PMCID: PMC5548849 DOI: 10.1007/s11136-017-1575-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2017] [Indexed: 11/26/2022]
Abstract
Purpose To investigate the association between using online support groups (OSGs) and health-related quality of life (HRQoL), and the psychosocial factors that may influence this association among individuals with head and neck (H&N) cancer. Method A sample of 199 persons with H&N cancer using four OSGs completed an online questionnaire using six pre-validated measures for social network, self-efficacy, anxiety and depression, adjustment, empowerment and quality of life. In addition, socio-demographic as well as illness-related and OSGs-related information was collected. Results Participants who had better HRQoL had been using OSGs for a longer time than those who had worse HRQoL (B = 0.07, p < 0.05). Depression and adjustment were the only direct mediators in this association, whereas self-efficacy, anxiety and empowerment appeared as indirect mediators. Conclusion Participation in OSGs was found to be associated to better HRQoL either directly or indirectly through decreasing depression, anxiety and the negative adjustment behaviours and increasing self-efficacy and empowerment of the users. The study presented a potential model of pathways linking OSG use and HRQoL for those with H&N cancer. However, the model needs to be tested in future longitudinal studies and the associations proposed need to be explored in greater detail.
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Affiliation(s)
- Eamar Algtewi
- The Academic Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, 19 Laremont Crescent, Sheffield, S10 2TA, UK.
| | - Janine Owens
- The Academic Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, 19 Laremont Crescent, Sheffield, S10 2TA, UK
| | - Sarah R Baker
- The Academic Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, 19 Laremont Crescent, Sheffield, S10 2TA, UK
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Lee YH, Lai YH, Yueh B, Chu PY, Chen YJ, Chen SC, Wang CP. Validation of the University of Washington Quality of Life Chinese Version (UWQOL-C) for head and neck cancer patients in Taiwan. J Formos Med Assoc 2017; 116:249-256. [PMID: 28214178 DOI: 10.1016/j.jfma.2017.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/PURPOSE The purposes of this three-phase study were to: (1) translate and evaluate the burden, content, and face validity of the Chinese version of the University of Washington Quality of Life Scale, version 4 (UWQOL-v4-C); and (2) examine the psychometric properties of the UWQOL-v4-C in oral cancer and laryngeal cancer patients in Taiwan. METHODS This instrument translation and validation study was part of a major research project. The first phase of this study developed and validated the content of the UWQOL-v4-C. The second phase sought to validate the internal consistency, reliability, and construct and discriminant validity in two major groups of head and neck cancer (HNC) patients: oral cavity cancers (n=109) and laryngeal cancer (n=102). Construct validity was measured using theoretically supported correlations between the UWQOL and related constructs. Discriminant validity was also assessed. In the third phase, test-retest reliability of UWQOL-v4-C was examined through the 1-week interval in another group of HNC patients (n=50). RESULTS The translated UWQOL-v4-C demonstrated satisfactory face validity, content validity, and minimal patient burden. Additionally, the UWQOL-v4-C showed excellent construct validity in patient testing, supported by significant correlations between the UWQOL-v4-C and hypothesized constructs, including generic measures of QOL and performance status. The developed scale correlated inversely with symptom severity and psychological distress. Discriminant validity was seen in patients with different cancer diagnoses, stages, and treatments. Finally, excellent stability was supported by a 1-week test-retest reliability of 0.88. CONCLUSION The UWQOL-v4-C was a brief, low-burden, and valid instrument to measure the QOL in Chinese-speaking HNC patients in Taiwan.
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Affiliation(s)
- Yun-Hsiang Lee
- Department of Nursing, Mackay Medical College, Taipei, Taiwan
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan.
| | - Bevan Yueh
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Pen-Yuan Chu
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Ju Chen
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Shu-Ching Chen
- Department of Nursing, Chang Gung University of Science and Technology, Kweishan, Taoyuan, Taiwan
| | - Cheng-Ping Wang
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
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Fang CY, Heckman CJ. Informational and Support Needs of Patients with Head and Neck Cancer: Current Status and Emerging Issues. CANCERS OF THE HEAD & NECK 2016; 1. [PMID: 28670482 PMCID: PMC5488795 DOI: 10.1186/s41199-016-0017-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The objective of this article is to review and summarize the extant literature on head and neck cancer (HNC) patients’ informational needs and to characterize emerging issues in this patient population in order to define priorities for future research. HNC patients may undergo challenging treatment regimens and experience treatment-related alterations in primary daily functions such as speech and eating. These changes often persist following treatment and may lead to significant deficits in quality of life and interpersonal relations. Despite empirical evidence demonstrating that receipt of adequate information and support is predictive of improved outcomes post-treatment, relatively limited attention has been paid to the informational and support needs of HNC patients. This review focuses primarily on three topic domains: (1) managing treatment-related side effects; (2) addressing alcohol and tobacco dependence; and (3) informational needs in the areas of human papillomavirus (HPV) and clinical trials. While there is increasing awareness of the rehabilitation and survivorship needs in this patient population, patients note that the impact of treatment on social activities and interactions is under-discussed and of key concern. In addition, there is a significant gap in addressing communication and informational needs of caregivers and family members who are integral for promoting healthy behaviors and self-care post-treatment. Greater integration of programs that address tobacco or alcohol dependency within a comprehensive treatment and support plan may increase patient motivation to seek help and enhance patient success in maintaining long-term abstinence. Finally, emerging patient-provider communication needs, particularly in the context of decision making about clinical trials or surrounding an HPV-related diagnosis, have been noted among both patients and healthcare providers. Future research on the development of novel programs that offer feasible and acceptable methods for addressing unmet informational and support needs is warranted and may yield benefit for improving patient-reported outcomes.
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Affiliation(s)
- Carolyn Y Fang
- Fox Chase Cancer Center, 333 Cottman Ave., Philadelphia, PA
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McQuestion M, Fitch M. Patients' experience of receiving radiation treatment for head and neck cancer: Before, during and after treatment. Can Oncol Nurs J 2016; 26:325-335. [PMID: 31148680 DOI: 10.5737/23688076264325335] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Most research to date in the area of head and neck cancer has focused on the efficacy of treatment modalities and the assessment and management of treatment side effects and toxicities. Little or no attention has been directed toward understanding patients' experience of receiving radiation treatment for the management of their cancer. The purpose of this qualitative study was to explore the experience of individuals receiving radiation treatment for a cancer of the head and neck. Face-to-face interviews were conducted with 17 individuals. Thorne's (1997) approach of interpretive description along with Giorgi's analytical technique for analysis were used. Experiences across interviews revealed five main themes: 1) making sense of the diagnosis, 2) distress from disrupted expectations, 3) heightened awareness of self, others and the health care system, 4) strategies to 'get through' treatment, and 5) living with uncertainty. Findings from the study have contributed to the development of head and neck cancer-specific patient support and education programs for patients and families.
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Affiliation(s)
- Maurene McQuestion
- Clinical Nurse Specialist, Princess Margaret Cancer Centre, University Health Network; Adjunct Faculty, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
| | - Margaret Fitch
- Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
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Nightingale CL, Curbow BA, Wingard JR, Pereira DB, Carnaby GD. Burden, quality of life, and social support in caregivers of patients undergoing radiotherapy for head and neck cancer: A pilot study. Chronic Illn 2016; 12:236-45. [PMID: 27068111 PMCID: PMC5515480 DOI: 10.1177/1742395316644305] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/30/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this pilot study was to (1) obtain preliminary data on changes in burden and quality of life in head and neck cancer caregivers during and shortly following patient radiotherapy, (2) assess the relationship between perceived social support and burden as well as perceived social support and quality of life in caregivers during radiotherapy, and (3) identify preferences for sources of support among caregivers during radiotherapy. METHODS Caregivers completed burden and quality of life instruments at the start of patient radiotherapy (T1), 5 weeks into radiotherapy (T2), and 1 month post-radiotherapy (T3) and instruments for perceived social support and support preferences at T2 only. RESULTS Caregivers showed a trend toward increased burden and worsened quality of life for the majority of subscales at T2 or T3 than at T1. Caregivers reported significantly lower esteem and significantly greater disruption at T2 than at T1 and significantly worse health at T3 than at T2. Higher perceived social support was typically associated with lower burden and higher quality of life at T2. Spouses/partners were the most commonly preferred source of support. DISCUSSION These pilot findings suggest that caregivers experience psychosocial impairments during and shortly after patient radiotherapy, but more research using larger samples is warranted.
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Affiliation(s)
- Chandylen L Nightingale
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Barbara A Curbow
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - John R Wingard
- College of Medicine, Division of Hematology/Oncology, University of Florida, Gainesville, FL, USA
| | - Deidre B Pereira
- College of Public Health and Health Professions, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Giselle D Carnaby
- College of Health and Public Affairs, Department of Communication Science and Disorders, University of Central Florida, Orlando, FL, USA
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From an illusion of certainty into a reality of uncertainty: A longitudinal qualitative study of how people affected by laryngeal cancer use information over time. Eur J Oncol Nurs 2016; 23:15-23. [PMID: 27456371 DOI: 10.1016/j.ejon.2016.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 03/04/2016] [Accepted: 03/09/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Patients diagnosed with laryngeal cancer and their families face unique challenges. Providing information is an essential component of care. However little is known about the way in which they use information. This study aims to explore the different types of information used by laryngeal cancer patients and their carers from diagnosis into the follow up phase. METHOD The study adopted an interpretive longitudinal design using qualitative interviews at two specific time points. Twenty laryngeal cancer patients and 17 carers were interviewed. Data were analysed using Framework Analysis. RESULT Two main categories of information: professional and experiential, were found to be used, drawn from a range of sources. The information received at diagnosis appeared to contribute to an 'illusion of certainty' that life would return to normal at the end of treatment. However, as patients progressed into follow-up, many were propelled into a 'reality of uncertainty' due to the "disconnect" between the expectations both patient and carer developed from information received over the cancer trajectory. CONCLUSION The findings from this longitudinal study suggest that people affected by laryngeal cancer use two broad categories of information derived from a range of different sources and influenced by their own experiences. Health professionals need to situate information in the context of the individual's understanding and prior knowledge of health and illness to help generate more realistic expectations of treatment outcomes. The level of uncertainty experienced by both patients and their carers after treatment suggests a clear need for continued supportive care.
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Nightingale CL, Pereira DB, Curbow BA, Wingard JR, Carnaby GD. A Prospective Biopsychosocial Investigation Into Head and Neck Cancer Caregiving. Biol Res Nurs 2016; 19:87-96. [PMID: 27465999 DOI: 10.1177/1099800416660760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Head and neck cancer (HNC) patients suffer from significant morbidity, which may introduce challenging care demands and subsequent stress-induced mind-body interactions for informal caregivers. This prospective study evaluated patient and caregiver predictors of diurnal cortisol rhythm among HNC caregivers during radiation treatment. METHOD Patient-caregiver dyads completed measures at radiation treatment start (T1; n = 32) and 5 weeks into treatment (T2; n = 29). Measures included the Functional Assessment of Cancer Therapy-Head and Neck, the Caregiver Quality of Life (QOL) Index-Cancer, the Caregiver Reaction Assessment, the Medical Outcomes Social Support Survey, and the Eating Assessment tool. Patients also received a clinical swallowing evaluation using the Functional Assessment of Oral Intake Scale. Caregiver cortisol concentrations were assessed from salivary samples at T1 and T2. RESULTS Caregiver cortisol slope became significantly flatter during radiation treatment. Greater caregiver schedule burden was associated with a flatter cortisol slope (β = .35, p = .05) in caregivers at T1. Lower patient functional QOL (β = -.41, p = .05) and lower overall caregiver QOL at T1 (β = -.39, p = .04) were each separately associated with a flatter cortisol slope in caregivers over treatment. CONCLUSIONS Results suggest the presence of a mind-body interaction in HNC caregivers. Dysregulation in diurnal cortisol rhythm in caregivers was significantly associated with increased caregiver schedule burden and lower patient and caregiver QOL. Targeted interventions developed for HNC caregivers may help to prevent negative health outcomes associated with dysregulated cortisol.
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Affiliation(s)
- Chandylen L Nightingale
- 1 Department of Social Science and Health Policy, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Deidre B Pereira
- 2 Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Barbara A Curbow
- 3 Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - John R Wingard
- 4 Division of Hematology/Oncology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Giselle D Carnaby
- 5 Department of Communication Science & Disorders, College of Health and Public Affairs, University of Central Florida, Gainesville, FL, USA
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Della Justina LB, Dias M. Head and neck lymphedema: what is the physical therapy approach? A literature review. FISIOTERAPIA EM MOVIMENTO 2016. [DOI: 10.1590/0103-5150.029.002.ao20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Head and neck lymphedema is considered a chronic and complex complication with potential to cause physical, functional, emotional and social impairment. Objective: To identify the approaches to physical therapy used to treat head and neck cancer-related lymphedema. Method: A bibliographic search was conducted in February and March 2012 in books and electronic databases, LILACS, MEDLINE, SCIELO, Cochrane, PEDro, and BDTD using the following keywords: lymphedema, treatment, head and neck cancer, and physical therapy connected by the Boolean operator AND without a specific time frame. Results and discussion: Early diagnosis and assessment is key to properly managing and effectively treating lymphedema. Diagnosis is reached through clinical history and physical assessment by measuring the distance between two anatomical landmarks, circumference measures, and lymphedema rating scales. Complex decongestive therapy, which includes manual lymph drainage, compressive bandaging, kinesiotherapy and skin care, is the technique most frequently used and currently considered to be the gold standard. Conclusions: No consensus is reported in the literature in regard to a standard procedure to assess and treat head and neck cancer-related lymphedema. Assessments and treatments described in the literature are mainly restricted to the limbs; therefore, further studies are needed to support effective clinical actions in the physical therapy approach to this condition.
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Reeve BB, Cai J, Zhang H, Weissler MC, Wisniewski K, Gross H, Olshan AF. Factors that impact health-related quality of life over time for individuals with head and neck cancer. Laryngoscope 2016; 126:2718-2725. [PMID: 27224024 DOI: 10.1002/lary.26073] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/30/2016] [Accepted: 04/06/2016] [Indexed: 01/31/2023]
Abstract
OBJECTIVES/HYPOTHESIS To identify sociodemographic, behavioral, and clinical factors associated with health-related quality of life (HRQOL) for head and neck cancer (HNC) patients over time. STUDY DESIGN A population-based longitudinal cohort study. METHODS Newly diagnosed HNC patients (N = 587) were administered the Functional Assessment of Cancer Therapy-Head and Neck questionnaire at baseline (median 3 months postdiagnosis) and two follow-up assessments (median 22 and 42 months). Linear mixed-effect models were used with backward variable selection to identify factors associated with HRQOL over time (P < .05). Adjusted means reported at 2 years postdiagnosis. RESULTS African Americans reported better Functional Well-Being than whites (mean of 20.01 vs. 18.53) and fewer HNC symptoms over time. Older patients (75+ years) reported better HRQOL than younger patients (< 50 years). Current tobacco use compared to no tobacco use had worse Physical (20.20 vs. 21.50), Emotional (17.55 vs. 19.06), Social (21.28 vs. 22.88), and Functional (17.32 vs. 19.29) Well-Being and more HNC symptoms (21.50 vs. 23.71). Radiation therapy was associated with worse Physical and Functional Well-Being and more head and neck symptoms over time, but HRQOL was similar to those who were not irradiated by 2 to 4 years postdiagnosis. CONCLUSION This study identified key factors for individuals at risk for poorer HRQOL that may help clinicians and caregivers find solutions to address these decrements. Smoking cessation programs can be encouraged for survivors who use tobacco. Psychological and social support and medications may help for dealing with emotional distress and dealing with the physical symptoms from treatment. LEVEL OF EVIDENCE 4. Laryngoscope, 126:2718-2725, 2016.
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Affiliation(s)
- Bryce B Reeve
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.,Sheps Health Services Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Hongtao Zhang
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Mark C Weissler
- Department of Otolaryngology-Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Kathy Wisniewski
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Heather Gross
- Sheps Health Services Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.,Department of Otolaryngology-Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
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Balfe M, Butow P, O'Sullivan E, Gooberman-Hill R, Timmons A, Sharp L. The financial impact of head and neck cancer caregiving: a qualitative study. Psychooncology 2016; 25:1441-1447. [DOI: 10.1002/pon.4079] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/08/2015] [Accepted: 12/26/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Myles Balfe
- National Cancer Registry Ireland; Cork Ireland
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-based Decision-making; The University of Sydney; Sydney Australia
| | | | | | | | - Linda Sharp
- Newcastle University; Newcastle upon Tyne UK
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Individualised quality of life as a measure to guide treatment choices in squamous cell carcinoma of the head and neck. Oral Oncol 2016; 52:18-23. [DOI: 10.1016/j.oraloncology.2015.10.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 10/19/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
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Abstract
BACKGROUND The prevalence of head and neck cancers is lower (3.5% of total cancers in Australia) than for a number of other cancers. Treatment for head and neck cancer is often drastic and debilitating and patient outcomes are poorer. OBJECTIVE This qualitative study explored the experiences of cancer patients who underwent surgery for head and neck cancer. METHODS In-depth face-to-face interviews were conducted with 12 patients 7 to 26 months after surgery. Interviews were thematically analyzed to produce a rich description of patients' experiences from diagnosis through surgery and beyond. RESULTS Critical aspects of patients' experiences are described through the following themes: only having half the story, shocks and aftershocks, living with the aftermath, and being supported. Participants identified difficulties arising from receiving insufficient, confusing, and often untimely information. The persistent and traumatic nature of what patients endure challenges their physical, mental, and emotional coping capacity and, in some cases, their motivation to live. CONCLUSIONS There is a need to address gaps in support and education of patients and carers. Of particular concern is the problem related to information provision and comprehension. Critical examination of current practices, together with efforts toward coordinated care tailored to individual needs, is required, along with outreach services for patients in rural areas. IMPLICATIONS FOR PRACTICE The development and evaluation of targeted resources in a variety of forms such as DVD, Internet, and pamphlets are needed. Robust assessment strategies are required to inform supportive interventions matched to stages and significant events in patients' journeys.
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Walking the line. Palliative sedation for existential distress: still a controversial issue? Wien Med Wochenschr 2015; 165:487-90. [PMID: 26628315 DOI: 10.1007/s10354-015-0402-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 11/08/2015] [Indexed: 10/22/2022]
Abstract
Adequate symptom relief is a central aspect of medical care of all patients especially in those with an incurable disease. However, as an illness progresses and the end of life approaches, physical or psychoexistential symptoms may remain uncontrollable requiring palliative sedation. Although palliative sedation has become an increasingly implemented practice in the care of terminally ill patients, sedation in the management of refractory psychological symptoms and existential distress is still a controversial issue and much debated. This case report presents a patient who received palliative sedation for the treatment of existential distress and discusses considerations that may arise from such a therapeutic approach.
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Becker C, Becker AM, Pfeiffer J. Health-related quality of life in patients with nasal prosthesis. J Craniomaxillofac Surg 2015; 44:75-9. [PMID: 26643389 DOI: 10.1016/j.jcms.2015.10.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/07/2015] [Accepted: 10/26/2015] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To evaluate the health-related quality of life (QOL) in patients with nasal prosthesis after tumour resection with partial or total rhinectomy. MATERIAL AND METHODS Patients with nasal prosthesis were asked to complete a quality of life questionnaire. 43 patients with prosthesis after partial or total rhinectomy completed the University of Washington quality of life questionnaire. Answers were systematically analysed. RESULTS 27 patients were male, 16 were female. Mean age was 62 years, and the mean interval between tumour resection and date of study inclusion was 45.3 months. There are gender-specific differences for the QOL domain 'recreation' and age-specific differences for the domains 'appearance' and 'saliva'. The fields 'activity', 'mood' and 'appearance' are the most severely affected QOL domains in patients with nasal prosthesis. CONCLUSION Similar to other head and neck cancers there is a need and a deficiency in psycho-oncological support after partial or total rhinectomy, the influence on QOL however was much lower than initially expected. This should be considered with regard to the oncological benefits of this surgical procedure. Compared to the results of other head and neck malignancies the 'appearance' is only slightly affected. A stable prosthesis is needed to enable the maintenance of the accustomed activities.
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Affiliation(s)
- Christoph Becker
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg, Germany.
| | | | - Jens Pfeiffer
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg, Germany
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Pearce AM, Hanly P, Timmons A, Walsh PM, O'Neill C, O'Sullivan E, Gooberman-Hill R, Thomas AA, Gallagher P, Sharp L. Productivity Losses Associated with Head and Neck Cancer Using the Human Capital and Friction Cost Approaches. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2015; 13:359-367. [PMID: 25691128 DOI: 10.1007/s40258-015-0155-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Previous studies suggest that productivity losses associated with head and neck cancer (HNC) are higher than in other cancers. These studies have only assessed a single aspect of productivity loss, such as temporary absenteeism or premature mortality, and have only used the Human Capital Approach (HCA). The Friction Cost Approach (FCA) is increasingly recommended, although has not previously been used to assess lost production from HNC. The aim of this study was to estimate the lost productivity associated with HNC due to different types of absenteeism and premature mortality, using both the HCA and FCA. METHODS Survey data on employment status were collected from 251 HNC survivors in Ireland and combined with population-level survival estimates and national wage data. The cost of temporary and permanent time off work, reduced working hours and premature mortality using both the HCA and FCA were calculated. RESULTS Estimated total productivity losses per employed person of working age were EUR253,800 using HCA and EUR6800 using FCA. The main driver of HCA costs was premature mortality (38% of total) while for FCA it was temporary time off (73% of total). CONCLUSIONS The productivity losses associated with head and neck cancer are substantial, and return to work assistance could form an important part of rehabilitation. Use of both the HCA and FCA approaches allowed different drivers of productivity losses to be identified, due to the different assumptions of the two methods. For future estimates of productivity losses, the use of both approaches may be pragmatic.
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Abstract
PURPOSE OF REVIEW Head and neck lymphedema (HNL) is a common and often debilitating cancer treatment effect that is under-researched and ill defined. We examined current literature and reviewed historical treatment approaches. We propose a model for evaluation and treatment of HNL used at The University of Texas M. D. Anderson Cancer Center (MDACC) for patients with head and neck cancer (HNC). RECENT FINDINGS Despite the morbidity associated with HNL in patients with HNC, to our knowledge, no article has been published within the past 18 months whose primary focus is HNL. Eight publications included HNL but only as a secondary focus related to treatment effect, risk of dysphagia, prognostic indicator of underlying disease, and quality of life. A potential benefit of selenium treatment to reduce HNL was reported. SUMMARY This article highlights the recent literature regarding HNL in patients treated for HNC. Although HNL is reported as a potential complication of HNC treatment, no clear definition of the disease or its management are published. Our early experience using an objective evaluation and treatment protocol holds promise for a better understanding of HNL in patients treated for head and neck malignancy.
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Pateman KA, Ford PJ, Batstone MD, Farah CS. Coping with an altered mouth and perceived supportive care needs following head and neck cancer treatment. Support Care Cancer 2015; 23:2365-73. [DOI: 10.1007/s00520-015-2607-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 01/05/2015] [Indexed: 12/28/2022]
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40
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Psychosocial Distress in Patients with Thyroid Cancer. Otolaryngol Head Neck Surg 2015; 152:644-9. [DOI: 10.1177/0194599814565761] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 12/05/2014] [Indexed: 11/15/2022]
Abstract
Objective The purpose of this study is to evaluate levels of psychosocial distress in thyroid cancer patients. An analysis of factors contributing to levels of distress is included. Study Design Individual retrospective cohort study. Setting Head and neck cancer clinic at the Huntsman Cancer Institute. Subjects and Methods A total of 118 newly diagnosed thyroid cancer patients were included in the study. Univariate and multivariate analyses evaluated levels of and factors contributing to distress. Results Almost half (43.3%) of patients had significant distress. Those with self-reported psychiatric history, use of antidepressant medication, and history of radiation treatment had higher levels of distress. On multivariate analysis, patient endorsement of emotional issues predicted a higher distress level. Conclusions Thyroid cancer patients have high distress levels. Identification of thyroid cancer patients with high distress levels is important to offer additional support during cancer therapy.
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Nightingale CL, Lagorio L, Carnaby G. A prospective pilot study of psychosocial functioning in head and neck cancer patient-caregiver dyads. J Psychosoc Oncol 2014; 32:477-92. [PMID: 24988320 DOI: 10.1080/07347332.2014.936649] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study explored the psychosocial functioning of 10 head and neck cancer patient-caregiver dyads over the radiation/chemoradiation (radiation or combined chemoradiation) treatment period, including the interdependence in patient-caregiver quality of life (QOL). Dyads were recruited prior to or at the initiation of radiation/chemoradiation treatment. Patient QOL decreased across the treatment trajectory, and many caregiver QOL subscales decreased during the middle of treatment. Caregiver burden increased over the treatment trajectory with levels remaining relatively low. Patients and caregivers demonstrated interdependence in QOL toward the middle and conclusion of treatment. Patients demonstrated more depression than caregivers at all time points. Results suggest that both members of the dyad should be targeted for psychosocial interventions during radiation/chemoradiation treatment period.
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Affiliation(s)
- Chandylen L Nightingale
- a Department of Behavioral Science and Community Health, College of Public Health and Health Professions , University of Florida , Gainesville , FL , USA
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42
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Reich M, Leemans C, Vermorken J, Bernier J, Licitra L, Parmar S, Golusinski W, Lefebvre J. Best practices in the management of the psycho-oncologic aspects of head and neck cancer patients: recommendations from the European Head and Neck Cancer Society Make Sense Campaign. Ann Oncol 2014; 25:2115-2124. [DOI: 10.1093/annonc/mdu105] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Isaksson J, Salander P, Granström B, Laurell G. Critical incidents reveal how patients with head and neck cancer construct their "secure base" as a "helping system". J Psychosoc Oncol 2014; 32:322-41. [PMID: 24611865 DOI: 10.1080/07347332.2014.897289] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Most studies of the psychosocial needs of patients with head and neck cancers (HNC) use predefined categories and explicitly ask for specified needs. These studies are important but should be complemented with inductive studies based on patients' own descriptions of experiences. This qualitative study is such a contribution. In repeated interviews positive and negative incidents were collected from 137 patients with HNC, and these experiences were categorized in dimensions expressing needs. A core category--"being included--neglected by a helping system"--emerged from the narrated incidents and was based on the dimensions engagement, competence, and information. The findings are easily related to attachment theory by stressing the significance of establishing trustful relationships with the health care staff, as attachment figures, who respond flexibly and sensitively to the patient's needs. In the constitution of health care as a helping system, all encounters between the patient and health care staff matters. Further research should preferably focus on the creation of guidelines for the constitution of health care as a helping system, that is, how the found factors of a helping system can be operationalized in clinical practice.
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Affiliation(s)
- Joakim Isaksson
- a Department of Social Work , Umeå University , Umeå , Sweden
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Moore K, Ford P, Farah C. “I have quality of life…but…”: Exploring support needs important to quality of life in head and neck cancer. Eur J Oncol Nurs 2014; 18:192-200. [DOI: 10.1016/j.ejon.2013.10.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 09/30/2013] [Accepted: 10/10/2013] [Indexed: 12/01/2022]
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van der Meulen IC, May AM, de Leeuw JRJ, Koole R, Oosterom M, Hordijk GJ, Ros WJG. Long-term effect of a nurse-led psychosocial intervention on health-related quality of life in patients with head and neck cancer: a randomised controlled trial. Br J Cancer 2014; 110:593-601. [PMID: 24280999 PMCID: PMC3915114 DOI: 10.1038/bjc.2013.733] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 10/24/2013] [Accepted: 10/30/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Head and neck cancer (HNC) patients are prone to have a poor health-related quality of life after cancer treatment. This study investigated the effect of the nurse counselling and after intervention (NUCAI) on the health-related quality of life and depressive symptoms of HNC patients between 12 and 24 months after cancer treatment. METHODS Two hundred and five HNC patients were randomly allocated to NUCAI (N=103) or usual care (N=102). The 12-month nurse-led NUCAI is problem-focused and patient-driven and aims to help HNC patients manage with the physical, psychological and social consequences of their disease and its treatment. Health-related quality of life was evaluated with the EORTC QLQ-C30 and QLQ H&N35. Depressive symptoms were evaluated with the CES-D. RESULTS At 12 months the intervention group showed a significant (P<0.05) improvement in emotional and physical functioning, pain, swallowing, social contact, mouth opening and depressive symptoms. At 18 months, global quality of life, role and emotional functioning, pain, swallowing, mouth opening and depressive symptoms were significantly better in the intervention group than in the control group, and at 24 months emotional functioning and fatigue were significantly better in the intervention group. CONCLUSION The NUCAI effectively improved several domains of health-related quality of life and depressive symptoms in HNC patients and would seem a promising intervention for implementation in daily clinical practice.
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Affiliation(s)
- I C van der Meulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Street 6.131, PO Box: 85500, 3508GA Utrecht, The Netherlands
- Departments of Oral Maxillofacial Surgery and Otorhinolaryngology, University Medical Center Utrecht, G05. 129, PO Box: 85500, 3508GA Utrecht, The Netherlands
| | - A M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Street 6.131, PO Box: 85500, 3508GA Utrecht, The Netherlands
| | - J R J de Leeuw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Street 6.131, PO Box: 85500, 3508GA Utrecht, The Netherlands
| | - R Koole
- Departments of Oral Maxillofacial Surgery and Otorhinolaryngology, University Medical Center Utrecht, G05. 129, PO Box: 85500, 3508GA Utrecht, The Netherlands
| | - M Oosterom
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Street 6.131, PO Box: 85500, 3508GA Utrecht, The Netherlands
| | - G-J Hordijk
- Departments of Oral Maxillofacial Surgery and Otorhinolaryngology, University Medical Center Utrecht, G05. 129, PO Box: 85500, 3508GA Utrecht, The Netherlands
| | - W J G Ros
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Street 6.131, PO Box: 85500, 3508GA Utrecht, The Netherlands
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Shuman AG, Khan AA, Moyer JS, Prince ME, Fins JJ. When Negative Rights Become Positive Entitlements: Complicity, Conscience, and Caregiving. THE JOURNAL OF CLINICAL ETHICS 2012. [DOI: 10.1086/jce201223403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Howren MB, Christensen AJ, Karnell LH, Funk GF. Psychological factors associated with head and neck cancer treatment and survivorship: evidence and opportunities for behavioral medicine. J Consult Clin Psychol 2012; 81:299-317. [PMID: 22963591 DOI: 10.1037/a0029940] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Individuals diagnosed with head and neck cancer (HNC) not only face a potentially life-threatening diagnosis but must endure treatment that often results in significant, highly visible disfigurement and disruptions of essential functioning, such as deficits or complications in eating, swallowing, breathing, and speech. Each year, approximately 650,000 new cases are diagnosed, making HNC the 6th most common type of cancer in the world. Despite this, however, HNC remains understudied in behavioral medicine. In this article, the authors review available evidence regarding several important psychosocial and behavioral factors associated with HNC diagnosis, treatment, and recovery, as well as various psychosocial interventions conducted in this patient population, before concluding with opportunities for behavioral medicine research and practice.
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Affiliation(s)
- M Bryant Howren
- Veterans Affairs Iowa City Healthcare System, Iowa City, Iowa 52242, USA.
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van de Bovenkamp HM, Trappenburg MJ. Comparative review of family-professional communication: what mental health care can learn from oncology and nursing home care. Int J Ment Health Nurs 2012; 21:366-85. [PMID: 22510087 DOI: 10.1111/j.1447-0349.2011.00798.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Because family members take on caring tasks and also suffer as a consequence of the illness of the patient, communication between health-care professionals and family members of the patient is important. This review compares communication practices between these two parties in three different parts of health care: oncology, nursing home care, and mental health care. It shows that there are important differences between sectors. Mental health stands out because contacts between family members and professionals are considered problematic due to the autonomy and confidentiality of the patient. The article explores several explanations for this, and, by comparing the three health sectors, distils lessons to improve the relationship between family members and health-care professionals.
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Fear of recurrence significantly influences quality of life in oral cancer patients. Oral Oncol 2012; 48:1276-80. [PMID: 22818822 DOI: 10.1016/j.oraloncology.2012.06.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 06/21/2012] [Accepted: 06/25/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Besides survival time quality of life (QoL) is the most important criterion for measuring the success of the therapy and rehabilitation of patients with carcinoma of the oral cavity. Interestingly, assessments by doctors sometimes differ from those of patients concerning QoL and level of information. Particularly the probability of cancer recurrence is unclear for many patients. MATERIAL AND METHODS Fear of recurrence (FOR) data were gathered from a total collective of 1761 patients from 38 hospitals within the German-language area of Germany, Austria and Switzerland (DÖSAK-REHAB-STUDIE) yielding 1652 patient questionnaires containing 147 items which were evaluated. They refer to periods at least 6 months after therapy. QoL was determined by the patient and ranges from 0% to 100% and FOR was measured using a Likert scale. Statistical analysis was performed using SPSS 19.0. RESULTS FOR affected 80% of the patients to a varying degree and influenced QoL very significantly. Patients with a high level of FOR were also more mentally instable. Their functional impairment in particular contributed to a reduced QoL. They felt less informed by their doctors about their illness and rehabilitation. The medical parameters had a smaller influence on FOR and QoL. CONCLUSION The patients' knowledge of their medical situation must be improved to make patient assessment of QoL more realistic, particularly when patients with good prospects indicate low QoL. The patients' subjective evaluations have to be more strongly integrated into the concept of the multi-disciplinary team in establishing a comprehensive therapy and rehabilitation plan.
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Shuman AG, Fins JJ, Prince ME. Improving end-of-life care for head and neck cancer patients. Expert Rev Anticancer Ther 2012; 12:335-43. [PMID: 22369325 DOI: 10.1586/era.12.6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite improvements in the treatment of head and neck cancer, many patients still succumb to their disease. A litany of medical, psychosocial and ethical challenges arise in managing the end-of-life experiences within this patient population. In this article, we attempt to review existing data about the end-of-life experiences of this cohort, extrapolate relevant data from other cancer patients, and suggest the most promising avenues for additional research and practice improvement for terminal head and neck cancer patients. Clinical decision-making for patients dying of head and neck cancer requires proactive consideration of quality of life, functionality, symptom control and other patient-centered objectives, and frequently benefits from palliative care team involvement. Additional research aimed toward optimizing the end of life experience of head and neck cancer patients and their families is greatly needed.
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Affiliation(s)
- Andrew G Shuman
- Division of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA.
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