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Wang Y, Rae C, Tsangaris E, Nathan PC, Bouffet E, Dix D, Wong Riff K, Klassen A. Establishing Reliability and Validity of the FACE-Q Craniofacial Module for Pediatric Head and Neck Cancer. J Adolesc Young Adult Oncol 2024; 13:307-315. [PMID: 37852001 DOI: 10.1089/jayao.2023.0040] [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] [Indexed: 10/20/2023] Open
Abstract
Purpose: We aimed to establish content validity and assess the psychometric properties of the FACE-Q Craniofacial Module, a patient-reported outcome measure, for use in pediatric and adolescent patients with head and neck cancer (HNC). Methods: To establish content validity (Part 1), between June 2017 and August 2019, cognitive interviews were conducted with survivors of pediatric HNC (n = 15), and input was obtained from clinical experts (n = 21). To examine item and scale performance (Part 2), Rasch Measurement Theory (RMT) analysis was performed using data from two international studies (n = 121). Results: Part 1: Qualitative data from 15 survivors and input from 21 experts provided evidence to support the use of the FACE-Q Craniofacial Module in pediatric HNC. Part 2: The field-test study sample included 121 survivors of pediatric HNC. RMT analysis provided evidence of reliability and validity for 10 FACE-Q scales. Data for each scale fit the RMT model. Scale reliability was high, with Person Separation Index and Cronbach's alpha values ≥0.82 for 9 scales. Mean scores on the Appearance, Psychological, and Social scales were higher for those who liked aspects of their face more. For participants with (vs. without) a facial difference, mean scores were lower for the Face, Jaws, Psychological, and Social scales. Conclusion: The FACE-Q Craniofacial Module evidenced reliability and validity for HNC survivors aged 8-29 years and can be used in research and clinical care to measure quality of life of pediatric survivors with HNC.
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Affiliation(s)
- Yi Wang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Elena Tsangaris
- Patient Reported Outcomes Values and Experience Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul C Nathan
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eric Bouffet
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - David Dix
- Oncology/Hematology/BMT Program, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Karen Wong Riff
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anne Klassen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Tang Y, Hua Y, Huang X, Cao Y, Sun X. Psychological Burden of Patients with Head and Neck Cancer Undergoing Radiotherapy and Their Family Caregivers: A Cross-Sectional Survey. J Multidiscip Healthc 2023; 16:927-935. [PMID: 37051506 PMCID: PMC10083181 DOI: 10.2147/jmdh.s398064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/22/2023] [Indexed: 04/07/2023] Open
Abstract
Background The consequences of Head and neck cancer (HNC) affect both the person who receives the diagnosis and their family caregivers (FCs). Objective To investigate the psychological status of patients and their FCs, and the burden of the FCs during radiotherapy. Methods This cross-sectional study was conducted with a questionnaire survey by convenience sampling method. Patients with HNC and their caregivers (both N = 85) from the radiotherapy department of our hospital were recruited between March 2021 and March 2022. The Hospital Anxiety and Depression Scale (HADS), the Chinese version of the Connor and Davidson Resilience Scale (CD-RISC), and the Zarit Burden Interview (ZBI) were used to assess the symptoms of anxiety and depression, psychological resilience, and the impact of care work, emotions and social lives of participants. Pearson's correlation analysis and a Mann-Whitney test were used to analyse the association between the HADS and the CD-RISC scores of the patients. Results About half of the patients (56.47%) and the caregivers (62.35%) have had anxiety. The average HADS-Anxiety scores, HADS-Depression scores, and CD-RISC scores of the patients with HNC were 7.4±1.9, 6.4±2.2, and 56.8±12.6. The "Strength" and "Resilience" scores of the patients were inversely related to their HADS anxiety scores (p < 0.05). The "Resilience" and "optimism" scores of them were inversely related to HADS depression scores (p < 0.05). The average ZBI score of the caregivers was 23.8±10.1; HADS anxiety scores and HADS depression scores of the caregivers were positively associated with total ZBI scores and individual burden scores (p < 0.05). Conclusion More than half of patients with HNC undergoing radiotherapy have anxiety, and about a third have depression. The anxiety and depression status of the FCs of patients with HNC undergoing radiotherapy is related to caregiver burden, deserving the attention of clinical medical staff.
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Affiliation(s)
- Yuanyuan Tang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Yuchen Hua
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Xiaoping Huang
- Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Yuandong Cao
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Xinchen Sun
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
- Correspondence: Xinchen Sun, Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu, 210029, People’s Republic of China, Tel +86 25 68305696, Email
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Semple CJ, McKenna G, Parahoo R, Rogers SN, Tiblom Ehrsson Y. Factors that affect quality of life for older people with head and neck cancer: A systematic review. Eur J Oncol Nurs 2023; 63:102280. [PMID: 36893570 DOI: 10.1016/j.ejon.2023.102280] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/29/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
PURPOSE Quality of life is a critical aspect in the management of older head and neck cancer patients. It needs to be considered alongside survival benefit, treatment burden, and longer-term outcomes. The purpose was to undertake a systematic review of empirical peer-reviewed studies with a primary focus on factors impacting quality of life for older head and neck cancer patients. METHODS A systematic review, searching 5 electronic databases (PsychoINFO, MEDLINE, CINHAL, Embase, and Scopus) using PRISMA methodology was conducted. Data was appraised using the Newcastle-Ottawa scale and a narrative synthesis performed. RESULTS Only 10 papers fulfilled the inclusion criteria. Two main themes emerged: 1) Impact of head and neck cancer on quality of life domains and 2) quality of life in treatment decision-making. CONCLUSIONS In an era of progressive personalised care, there is an evident need for more qualitative and quantitative studies focusing on quality of life for older head and neck cancer patients. However, older head and neck cancer patients experience notable differences, especially with poorer physical functioning and greater eating and drinking challenges. Quality of life impacts older patients decision-making, treatment planning and intensifies post-treatment support.
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Affiliation(s)
- Cherith J Semple
- Institute of Nursing & Health Research, Ulster University / Cancer Services, South Eastern Health & Social Care Trust, Belfast, Northern Ireland, UK
| | - Gerry McKenna
- Centre for Public Health, Royal Victoria Hospital, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Roisin Parahoo
- Institute of Nursing & Health Research, Ulster University / Cancer Services, South Eastern Health & Social Care Trust, Belfast, Northern Ireland, UK
| | - Simon N Rogers
- Wirral University Teaching Hospital, Wirral, England, UK
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Sweden.
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Wen L, Cui Y, Chen X, Han C, Bai X. Psychosocial adjustment and its influencing factors among head and neck cancer survivors after radiotherapy: A cross-sectional study. Eur J Oncol Nurs 2023; 63:102274. [PMID: 36893573 DOI: 10.1016/j.ejon.2023.102274] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/11/2023] [Accepted: 01/22/2023] [Indexed: 02/05/2023]
Abstract
PURPOSE Psychosocial adjustment is an important issue in patients' long-term survival. Understanding psychosocial adjustment and its influencing factors in head and neck cancer survivors after radiotherapy is essential to help them return to society and lead a normal life. The purpose of this study was to describe the level of psychosocial adjustment and explore its influencing factors in head and neck cancer patients. METHODS Between May 2019 and May 2022, 253 head and neck cancer survivors at a tertiary hospital in northeast China were enrolled in a cross-sectional study. The research instruments comprised the Demographic and Clinical Characteristics Questionnaire, the Self-report Psychosocial Adjustment to Illness Scale (PAIS-SR), the General Self-efficacy Scale (GSES), the Social Support Rating Scale (SSRS) and the M.D. Anderson Symptom Survey-head and neck Questionnaire (MDASI-H&N). RESULTS The mean PAIS-SR score was 42.31 ± 16.70 (moderate). The multiple regression model revealed that 73.2% of the variance in psychosocial adjustment was explained by marital status (β = -0.114, P = 0.005), return to work or not (β = -0.275, P < 0.01), self-efficacy (β = -0.327, P < 0.01), subjective support (β = -0.106, P = 0.043), utilization of support (β = -0.172, P < 0.01), and trouble with symptoms in daily life (β = 0.138, P = 0.021). CONCLUSION The psychosocial adjustment of head and neck cancer survivors after radiotherapy is an issue that needs to be addressed, and medical staff should develop effective, individualized interventions to improve their psychosocial adjustment by increasing their social support, improving their self-efficacy and strengthening symptom management according to their actual situation.
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Affiliation(s)
- Liying Wen
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, PR China
| | - Yuanyuan Cui
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, PR China
| | - Xingyu Chen
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, PR China
| | - Chong Han
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, PR China
| | - Xinghua Bai
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, PR China.
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Mavragani A, Imanguli M, Kashy D, Pesanelli M, Frederick S, Van Cleave JH, Paddock L, Hudson S, Steinberg M, Clifford P, Domider M, Singh N. Enhancing Self-care Among Oral Cancer Survivors: Protocol for the Empowered Survivor Trial. JMIR Res Protoc 2023; 12:e39996. [PMID: 36662561 PMCID: PMC9898837 DOI: 10.2196/39996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Survivors of oral cavity and oropharyngeal cancer frequently experience difficulties in swallowing; tasting; speaking; chewing; and maintaining comfortable movements of the head, neck, and shoulder. Engagement in regular self-care can reduce further loss of function and mitigate late effects. Despite the substantial self-care requirements, there are no empirically based interventions to enhance the skills and confidence of these survivors in managing their ongoing care. OBJECTIVE The aim of this study is to describe the rationale and methodology for a randomized controlled trial evaluating Empowered Survivor (ES) versus Springboard Beyond Cancer, a general web-based program for cancer survivors, on self-efficacy in managing care, preparedness for managing survivorship, and health-related quality of life (QOL). METHODS This study will recruit a total of 600 individuals who were diagnosed with oral cavity or oropharyngeal cancer in the past 3 years and are currently cancer free primarily from state cancer registries; these individuals will be randomly assigned to either the ES or Springboard Beyond Cancer condition. The participants complete measures of self-efficacy in managing care, preparedness for survivorship, health-related QOL, and engagement in oral self-examination and head and neck strengthening and flexibility exercises at baseline and 2 and 6 months after baseline. The primary aim of this study is to evaluate the impact of ES versus Springboard Beyond Cancer on self-efficacy, preparedness, and health-related QOL. The secondary aim is to examine the mediators and moderators of ES's impact on self-efficacy in managing care, preparedness, and health-related QOL at 6 months. The exploratory aim is to conduct a process evaluation of ES to identify potential oncology or community settings for future implementation. RESULTS Multilevel modeling will be used to examine whether there are significant differences between the ES and Springboard Beyond Cancer interventions over time. Mediational models will evaluate the indirect effects of ES on outcomes. Quantitative analyses will evaluate the predictors of ES use, and qualitative analyses will evaluate the preferred timing and settings for the implementation of ES. CONCLUSIONS This randomized controlled trial evaluates a completely web-based intervention, ES, versus a general web-based program for cancer survivors, Springboard Beyond Cancer, on self-efficacy in managing care, preparedness for managing survivorship, and health-related QOL and identifies the putative mediators and moderators of the intervention's effects. If an effect on the primary outcomes is illustrated, the next step could be an implementation trial to evaluate the intervention's uptake in and impact on an oncology care setting or nonprofit organizations. TRIAL REGISTRATION ClincalTrials.gov NCT04713449; https://clinicaltrials.gov/ct2/show/NCT04713449. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39996.
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Affiliation(s)
| | - Matin Imanguli
- Division of Head and Neck Oncologic and Reconstructive Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Deborah Kashy
- College of Social Science, Department of Psychology, Michigan State University, Lansing, MI, United States
| | - Morgan Pesanelli
- School of Public Health, Rutgers State University of New Jersey, Piscataway, NJ, United States
| | - Sara Frederick
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Janet H Van Cleave
- Rory Meyers College of Nursing, New York University, New York, NY, United States
| | - Lisa Paddock
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Shawna Hudson
- Department of Family Medicine and Community Health, Institute for Health Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Michael Steinberg
- Department of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Patrick Clifford
- Department of Health Behavior, Society, and Policy, School of Public Health, Rutgers State University of New Jersey, Piscataway, NJ, United States
| | - Mara Domider
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Neetu Singh
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
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Christou CN, Ehrsson YT, Westerbergh J, Risérus U, Laurell G. Longitudinal Changes in the Fatty Acid Profile in Patients with Head and Neck Cancer: Associations with Treatment and Inflammatory Response. Cancers (Basel) 2022; 14:3696. [PMID: 35954360 PMCID: PMC9367269 DOI: 10.3390/cancers14153696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023] Open
Abstract
Studies on fatty acids (FAs) in patients with head and neck cancer (HNC) are limited. We aimed to investigate the longitudinal changes of circulating FAs in patients with HNC and to examine potential correlations of FA changes with treatment. The secondary aims were to investigate correlations of FAs with cytokines and patient-related factors, and if any FAs correlated with disease recurrence or death. A total of 174 patients with HNC were included before treatment and followed-up at three time points after the start of the treatment through blood sampling and body weight measurements. Serum FA profiling was assessed by gas chromatography. The total follow-up time was 3 years. The levels of almost all FAs changed from baseline to 7 weeks. The change in FA 14:0 was associated with treatment and the change in 18:3n-6 was associated with the patients' pre-treatment BMI. FAs 14:0 and 18:0 were correlated with weight changes from baseline to 7 weeks. IL-6 was correlated with three FAs at 7 weeks and with two FAs at 1 year. Patients with higher levels 20:5n-3 at 3 months had a higher risk of all-cause death within 3 years (HR 2.75, 95% CI 1.22-6.21). Treatment, inflammation, and weight loss contributed in a complex manner to the altered FA profile in the studied cohort. The association between IL-6 and FAs in patients with HNC is in line with earlier studies and suggests the opportunity for regulating inflammation in HNC patients through modulation of FAs.
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Affiliation(s)
- Constantina N Christou
- Department of Surgical Sciences, Uppsala University, 751 85 Uppsala, Sweden; (Y.T.E.); (G.L.)
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Uppsala University, 751 85 Uppsala, Sweden; (Y.T.E.); (G.L.)
| | - Johan Westerbergh
- Uppsala Clinical Research Center, Uppsala University, 751 85 Uppsala, Sweden;
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Uppsala University, 752 37 Uppsala, Sweden;
| | - Göran Laurell
- Department of Surgical Sciences, Uppsala University, 751 85 Uppsala, Sweden; (Y.T.E.); (G.L.)
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Cherba M, Brummans BHJM, Hier MP, Giguère L, Chartier G, Jacobs H, Forest VI, Mlynarek A, Sultanem K, Henry M. Framing Concerns about Body Image during Pre- and Post-Surgical Consultations for Head and Neck Cancer: A Qualitative Study of Patient–Physician Interactions. Curr Oncol 2022; 29:3341-3363. [PMID: 35621662 PMCID: PMC9139818 DOI: 10.3390/curroncol29050272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/25/2022] [Accepted: 05/02/2022] [Indexed: 12/04/2022] Open
Abstract
Patients with head and neck cancer report high unmet psychosocial needs as they undergo lifesaving treatments that can significantly alter their appearance and cause functional impairments. This qualitative analysis of recordings of 88 pre- and post-surgical consultations involving 20 patients respond to the need for empirical studies of patient–provider conversations about body image concerns. It indicates that the emphasis on concerns about survival, cure, and physical recovery during clinical consultations may leave concerns about the impacts of surgery on appearance and function unexplored and even silenced. The interviews with patients and medical team members that complement the analysis of the recordings suggest that an emphasis on survival, cure, and physical recovery can respond to the need for reassurance in the context of serious illness. However, it can also be problematic as it contributes to the silencing of patients’ concerns and to a potential lack of preparedness for the consequences of surgery. The results of this study can contribute to raising surgeons’ awareness of the interactional dynamics during clinical consultations. Moreover, the results highlight the unique role that surgeons can play in validating patients’ psychosocial concerns to support patients’ rehabilitation in both physical and psychosocial domains.
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Affiliation(s)
- Maria Cherba
- Department of Communication, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Correspondence:
| | | | - Michael P. Hier
- Department of Otolaryngology—Head and Neck Surgery, McGill University, Montreal, QC H3A 0G4, Canada; (M.P.H.); (V.-I.F.); (A.M.)
- Department of Otolaryngology—Head and Neck Surgery, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Lauriane Giguère
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Gabrielle Chartier
- Department of Nursing, Oncology Division, Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
| | - Hannah Jacobs
- Department of Audiology and Speech-Language Pathology, Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
| | - Véronique-Isabelle Forest
- Department of Otolaryngology—Head and Neck Surgery, McGill University, Montreal, QC H3A 0G4, Canada; (M.P.H.); (V.-I.F.); (A.M.)
- Department of Otolaryngology—Head and Neck Surgery, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Alex Mlynarek
- Department of Otolaryngology—Head and Neck Surgery, McGill University, Montreal, QC H3A 0G4, Canada; (M.P.H.); (V.-I.F.); (A.M.)
- Department of Otolaryngology—Head and Neck Surgery, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Khalil Sultanem
- Division of Radiation Oncology, Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Melissa Henry
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H3A 0G4, Canada;
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Segal Cancer Centre, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
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Balance and Physical Functioning in Patients After Head and Neck Cancer Post–Neck Dissection Surgery: A Case Series. REHABILITATION ONCOLOGY 2021. [DOI: 10.1097/01.reo.0000000000000240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Manne S, Hudson S, Frederick S, Mitarotondo A, Baredes S, Kalyoussef E, Ohman‐Strickland P, Kashy DA. e‐Health
self‐management intervention for oral and oropharyngeal cancer survivors: design and single‐arm pilot study of empowered survivor. Head Neck 2020; 42:3375-3388. [DOI: 10.1002/hed.26403] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/23/2020] [Accepted: 07/14/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Sharon Manne
- Behavioral Science Rutgers Cancer Institute of New Jersey New Brunswick NJ USA
| | - Shawna Hudson
- Department of Family Medicine Rutgers Cancer Institute of New Jersey New Brunswick NJ USA
| | - Sara Frederick
- Behavioral Science Rutgers Cancer Institute of New Jersey New Brunswick NJ USA
| | - Anna Mitarotondo
- Behavioral Science Rutgers Cancer Institute of New Jersey New Brunswick NJ USA
| | - Soly Baredes
- Otolaryngology Rutgers New Jersey Medical School Newark NJ USA
| | - Evelyne Kalyoussef
- Department of Otolaryngology Rutgers New Jersey Medical School Newark NJ USA
| | - Pamela Ohman‐Strickland
- Department of Biostatistics and Epidemiology Rutgers School of Public Health Piscataway NJ USA
| | - Deborah A. Kashy
- Department of Psychology Michigan State University East Lansing Michigan USA
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Einarsson S, Laurell G, Tiblom Ehrsson Y. Mapping the frequency of malnutrition in patients with head and neck cancer using the GLIM Criteria for the Diagnosis of Malnutrition. Clin Nutr ESPEN 2020; 37:100-106. [PMID: 32359730 DOI: 10.1016/j.clnesp.2020.03.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/07/2020] [Accepted: 03/11/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Patients with head and neck cancer are defined as high-risk patients for malnutrition, but the inconsistent practice of diagnosing malnutrition is a barrier in comparing studies and in assessing patients in clinical practice. The aim of the study was to describe the frequency of malnutrition over time in patients treated for head and neck cancer using the GLIM Criteria for the Diagnosis of Malnutrition. METHODS Data from a prospective observational study on patients with head and neck cancer were used (n = 210). Patients were assessed for malnutrition using the combination of one phenotypic and one etiologic criterion. The following phenotypic criteria for malnutrition were used: body weight loss (either >5% within the past six months or >10% beyond six months), body mass index (<20 kg/m2 if <70 years or <22 kg/m2 if ≥70 years), and fat free mass index measured by bioelectrical impedance analysis (<17 FFM/m2 for males and <15 FFM/m2 for females). The following etiologic criteria for malnutrition were used: reduced food intake (partial or no food intake with the need for artificial nutrition) and C-reactive protein (>5 mg/L). RESULTS For all eight possible combinations of GLIM, the frequency of malnutrition reached its highest point at seven weeks after the start of treatment. A total of 32% of the patients fulfilled the criteria for malnutrition using weight loss >5% within the past six months (phenotypic) in combination with C-reactive protein >5 mg/L (etiologic). CONCLUSIONS GLIM Criteria for the Diagnosis of Malnutrition can be used to assess malnutrition in patients with head and neck cancer during treatment. Using the same criteria to define malnutrition in nutritional research will make it possible to produce multiple lines of evidence on malnutrition in head and neck cancer and its adverse effects on treatment, prognosis, and survival.
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Affiliation(s)
- Sandra Einarsson
- Department of Food, Nutrition and Culinary Science, Umeå University, SE-901 87, Umeå, Sweden.
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, SE-751 85, Uppsala, Sweden.
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, SE-751 85, Uppsala, Sweden.
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Granström B, Tiblom Ehrsson Y, Holmberg E, Hammerlid E, Beran M, Tano K, Laurell G. Return to work after oropharyngeal cancer treatment-Highlighting a growing working-age population. Head Neck 2020; 42:1893-1901. [PMID: 32092226 DOI: 10.1002/hed.26123] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 01/17/2020] [Accepted: 02/11/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To describe the frequency of patients returning to work after treatment for oropharyngeal cancer and to identify predictors and physical barriers that might interfere with the return to work process. METHODS Cross-sectional study including 295 patients. Data were collected regarding work/sick leave situation at 1 month before diagnosis and 15 months after diagnosis. The situation before diagnosis was retrospectively recalled by the patients. Two subscales and two single items from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35 were used. Data were analyzed with multivariate logistic regression. RESULTS Fifteen months after diagnosis, 212 patients (72%) were working. To be working 15 months after diagnosis was associated with working before diagnosis. Swallowing difficulties, problems talking on the telephone, and physical appearance were negatively associated with returning to work. CONCLUSIONS The large number of individuals returning to work is encouraging for patients diagnosed with oropharyngeal cancer.
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Affiliation(s)
- Brith Granström
- Department of Clinical Science, Unit of Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Erik Holmberg
- Region Västra Götaland, Regional Cancer Centre West, Gothenburg, Sweden, and Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Hammerlid
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Beran
- Department of ENT and Maxillofacial Surgery, NAL Medical Center Hospital, Trollhättan, Sweden
| | - Krister Tano
- Department of Clinical Science/ENT/Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
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12
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Einarsson S, Laurell G, Tiblom Ehrsson Y. Experiences and coping strategies related to food and eating up to two years after the termination of treatment in patients with head and neck cancer. Eur J Cancer Care (Engl) 2018; 28:e12964. [DOI: 10.1111/ecc.12964] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 08/20/2018] [Accepted: 10/21/2018] [Indexed: 12/14/2022]
Affiliation(s)
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery; Uppsala University; Uppsala Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery; Uppsala University; Uppsala Sweden
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13
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Lee YH, Chang KH, Escorpizo R, Chi WC, Yen CF, Liao HF, Huang SW, Liou TH. Accuracy of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) score as an objective assessment tool for predicting return-to-work status after head and neck cancer in male survivors. Support Care Cancer 2018; 27:433-441. [DOI: 10.1007/s00520-018-4322-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
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14
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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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15
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Loughran K, Rice S, Robinson L. Living with incurable cancer: what are the rehabilitation needs in a palliative setting? Disabil Rehabil 2017; 41:770-778. [PMID: 29185362 DOI: 10.1080/09638288.2017.1408709] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Increasing numbers of people are living with incurable cancers. Symptoms, side effects, and treatment burdens impact on physical functioning, yet little is known about the impact on people's lives and how best to provide rehabilitation. MATERIALS AND METHODS A qualitative study employing a phenomenological approach explored the lived experience of incurable cancer. A purposive sample of six people participated in semi-structured interviews. The data were analysed thematically at a semantic level to identify the functional difficulties experienced by people living with incurable cancer, the meanings of those difficulties, and participants perceived rehabilitation needs. RESULTS People living with incurable cancer described cancer-related issues spanning all five domains of the International Classification of Functioning, Disability and Health (ICF). Although highly valued amongst study participants, rehabilitation services were difficult to access, poorly utilised, and referrals were sporadic and consequential; indicative of poor awareness of rehabilitation for people with incurable cancer amongst potential referrers. DISCUSSION Participants valued a change in terminology away from "palliative" towards more positive language in line with enhanced supportive care movements. Validated tools such as the Palliative Care Therapy Outcome Measure, which align with the ICF, would allow rehabilitation professionals to demonstrate maintenance or improvement in participation and wellbeing. Implications for Rehabilitation Incurable cancer leads to a fluctuating multifactorial disability. People living with incurable cancer can benefit from rehabilitation input throughout their illness. Offering flexible and varied rehabilitation options for people living with incurable cancer will increase physical and emotional well-being, function, and coping. Allied health professionals should take and create opportunities to promote rehabilitation for people living with incurable cancer and their services to other potentially referring healthcare professionals to increase understanding of benefits and utilisation of available services for people living with incurable cancer.
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Affiliation(s)
- Kirsti Loughran
- a School of Health and Social Care , Teesside University , Middlesbrough , UK.,b Specialist Palliative Care Team , Newcastle upon Tyne NHS Foundation Trust, Arthur's Hill Clinic , Newcastle upon Tyne , UK
| | - Sarah Rice
- b Specialist Palliative Care Team , Newcastle upon Tyne NHS Foundation Trust, Arthur's Hill Clinic , Newcastle upon Tyne , UK
| | - Lisa Robinson
- c Rehabilitation Department , The Newcastle upon Tyne NHS Foundation Trust, Royal Victoria Infirmary , Newcastle upon Tyne , UK.,d Newcastle University Faculty of Medical Sciences Graduate School , Newcastle University , Newcastle upon Tyne , UK
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16
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Andersson C, Röing M, Tiblom Ehrsson Y, Johansson B. It's a question of endurance - Patients with head and neck cancer experiences of 18F-FDG PET/CT in a fixation mask. Eur J Oncol Nurs 2017; 29:85-90. [PMID: 28720271 DOI: 10.1016/j.ejon.2017.05.009] [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: 02/26/2017] [Revised: 04/27/2017] [Accepted: 05/25/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to explore how patients with head and neck cancer experienced undergoing an 18F-fluoro-deoxy-glucose positrons emissions tomography/computed tomography (18F-FDG PET/CT) examination in a fixation mask. METHOD Interviews were conducted with nine patients with known or suspected head and neck cancer who were scheduled for the examination for the first time. The phenomenological method according to van Manen and his four lifeworld existentials; lived space, lived body, lived time, and lived relation was used to analyse the interviews. RESULTS The thoughts and feelings of the patients during the PET/CT examination varied, some found it very difficult, while others did not. However, for all the patients, it was an experience that required some form of coping to maintain composure for example distraction. CONCLUSIONS PET/CT examnation in a fixation mask may be strenuous for some patients. Patients need more detailed information, including suggestions for coping behaviours, prior to the examination, as well as higher level of support during and after the examination. The results of this study may be used to improve patient care and optimize the procedure of PET/CT examination in a fixation mask.
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Affiliation(s)
- Camilla Andersson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Marta Röing
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Birgitta Johansson
- Department of Immunology, Genetics & Pathology, Uppsala University, Uppsala, Sweden
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17
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Stenhammar C, Isaksson J, Granström B, Laurell G, Ehrsson YT. Changes in intimate relationships following treatment for head and neck cancer—A qualitative study. J Psychosoc Oncol 2017; 35:614-630. [DOI: 10.1080/07347332.2017.1339224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Christina Stenhammar
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Brith Granström
- Department of Clinical Science, Unit of Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
- Department of Public Health and Caring Sciences, Uppsala, Sweden
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18
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Bressan V, Bagnasco A, Aleo G, Catania G, Zanini MP, Timmins F, Sasso L. The life experience of nutrition impact symptoms during treatment for head and neck cancer patients: a systematic review and meta-synthesis. Support Care Cancer 2017; 25:1699-1712. [DOI: 10.1007/s00520-017-3618-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 02/06/2017] [Indexed: 02/02/2023]
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19
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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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20
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Associations between neighbourhood support and financial burden with unmet needs of head and neck cancer survivors. Oral Oncol 2016; 65:57-64. [PMID: 28109469 DOI: 10.1016/j.oraloncology.2016.12.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/15/2016] [Accepted: 12/18/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the unmet needs of head and neck cancer survivors and investigate associated factors. In particular, to explore whether social support (family/friends and neighbours) and financial burden are associated with unmet needs of head and neck cancer (HNC) survivors. METHODS This was a cross-sectional study of HNC survivors, with 583 respondents included in the analysis. Information was collected on unmet supportive care needs as measured by the Supportive Care Needs Survey (SCNS-SF34). Poisson regression with robust standard errors was used to examine factors associated with having one or more needs in each of the five domains (physical; psychological; sexuality; patient care and support; and health system and information). RESULTS The mean age of respondents was 62.9years (standard deviation 11.3years) and one third of respondents were female. The top ten unmet needs was composed exclusively of items from the physical and psychological domains. Financial strain due to cancer and finding it difficult to obtain practical help from a neighbour were both associated with unmet needs in each of the five domains, in the adjusted analyses. CONCLUSION Whilst in each domain, a minority of respondents have unmet needs, approximately half of respondents reported at least one unmet need, with the commonest unmet needs in the psychological domain. Providing services to people with these needs should be a priority for healthcare providers. We suggest that studies, which identify risk factors for unmet needs, could be used to develop screening tools or aid in the targeting of support.
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21
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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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22
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Sandstrom SK, Mazanec SR, Gittleman H, Barnholtz-Sloan JS, Tamburro N, Daly BJ. A Descriptive, Longitudinal Study of Quality of Life and Perceived Health Needs in Patients With Head and Neck Cancer. J Adv Pract Oncol 2016; 7:640-651. [PMID: 29588869 PMCID: PMC5866130 DOI: 10.6004/jadpro.2016.7.6.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Patients with head and neck cancer have numerous concerns and symptoms in the first year of posttreatment survivorship and are especially vulnerable at the end of treatment and 1 month posttreatment. This article shares the findings of a descriptive, longitudinal study of health-related quality of life (HRQOL) in patients with head and neck cancer from the beginning of treatment through 12 months posttreatment. The primary objective of this study was to describe the symptom experience and health needs of patients receiving radiation for head and neck cancer to support the establishment of an advanced practitioner (AP) clinic for head and neck cancer survivors. Significant findings in this study showed HRQOL at the end of treatment was significantly lower than baseline (p < .001). Low scores persisted through 1 month, with gradual recovery by 12 months. Fatigue and anxiety had the highest mean scores, yet anxiety improved with time, whereas fatigue did not. Positive human papillomavirus status was statistically associated with higher anxiety. Socioeconomic status negatively impacted HRQOL. Themes of perceived health needs were managing oral symptoms, returning to a normal life, and regaining energy. The AP in oncology can play a pivotal role in providing comprehensive assessment, symptom management, health education, and supportive counseling in this population throughout treatment and survivorship.
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Affiliation(s)
- S Kate Sandstrom
- Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Susan R Mazanec
- Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio.,Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Haley Gittleman
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | | | - Nancy Tamburro
- Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Barbara J Daly
- Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio.,Case Western Reserve University School of Medicine, Cleveland, Ohio
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23
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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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24
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Nightingale CL, Sterba KR, Tooze JA, Milliron BJ, Tetrick LA, Paek MS, Weaver KE. Vulnerable characteristics and interest in wellness programs among head and neck cancer caregivers. Support Care Cancer 2016; 24:3437-45. [PMID: 26992407 PMCID: PMC4919231 DOI: 10.1007/s00520-016-3160-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Head and neck cancer (HNC) caregivers have poorer psychological health compared to patients and the general population but have not yet been targeted for wellness programs to reduce adverse psychosocial or physical health outcomes. To inform development of such programs, we identified potential vulnerabilities to poor outcomes and examined wellness program preferences among HNC caregivers. We also examined whether interest in wellness programs varied by potential vulnerabilities among HNC caregivers. METHODS Surveys were administered to caregivers (n = 33) of HNC patients undergoing major surgery. Sociodemographic factors, caregiving characteristics, psychosocial functioning, and health behavior data were collected. Fisher's exact tests and t tests were used to examine characteristics associated with interest in the different types of wellness programs. RESULTS Many caregivers reported a heavy caregiving load (88 % live with patient and 73 % provide daily care), a smoking history (42 %), and compromised psychosocial functioning (45 % with depressive symptoms and 33 % with anxiety above population norms). Most caregivers were interested in wellness programs focused on diet/exercise (71.9 %); cancer education (66.7 %); stress reduction (63.6 %); and finances, caregiving, and well-being (57.6 %). Caregivers endorsed highest interest in programs offered during the patient's medical treatment (63.6 %), and mail was the preferred program format (50.0 %). Those with more depressive symptoms reported more interest in programs focused on cancer education (p = 0.03); stress reduction (p = 0.05); and educational classes on finances, caregiving, and well-being (p = 0.01). CONCLUSIONS Wellness programs offering a menu of options should be developed for HNC caregivers.
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Affiliation(s)
- Chandylen L Nightingale
- Department of Social Sciences and Health Policy and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
| | - Katherine R Sterba
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street MSC 955, Charleston, SC, 29425, USA
| | - Janet A Tooze
- Department of Biostatistical Sciences and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Brandy-Joe Milliron
- Department of Nutrition Sciences, College of Nursing and Health, Drexel University, 1601 Cherry Street, MS 31030, Philadelphia, PA, 19102, USA
| | - Lee Anne Tetrick
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street MSC 955, Charleston, SC, 29425, USA
| | - Min-So Paek
- Department of Social Sciences and Health Policy and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Kathryn E Weaver
- Department of Social Sciences and Health Policy and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
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25
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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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26
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Manne S, Hudson SV, Baredes S, Stroup A, Virtue SM, Paddock L, Kalyoussef E. Survivorship care experiences, information, and support needs of patients with oral and oropharyngeal cancer. Head Neck 2016; 38 Suppl 1:E1935-46. [PMID: 26788714 PMCID: PMC4844877 DOI: 10.1002/hed.24351] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 09/23/2015] [Accepted: 10/17/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is little research documenting the posttreatment experiences and needs of oral/oropharyngeal cancer survivors. METHODS In this cross-sectional study, 92 patients with oral/oropharyngeal cancer diagnosed between 2 and 5 years prior completed a survey about oral cancer information and support needs. RESULTS About half retrospectively reported that they did not receive a written treatment summary. The desire for more oral cancer information was common; one-third or more desired more information about long-term effects, recommended follow-up, and symptoms that should prompt contacting a doctor. Support needs were less common; only a lack of energy was rated as a significant support need. Patients who had a recurrence, did not drink alcohol, and had a greater recurrence fear desired more information. Smokers and more distressed patients reported more support needs. CONCLUSION Survivors reported the desire for more oral cancer information. A desire for assistance was less common. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1935-E1946, 2016.
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Affiliation(s)
- Sharon Manne
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Shawna V Hudson
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Soly Baredes
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Antoinette Stroup
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
- Department of Nutritional Sciences, Rutgers School of Public Health, Piscataway, New Jersey
| | - Shannon Myers Virtue
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Lisa Paddock
- Department of Nutritional Sciences, Rutgers School of Public Health, Piscataway, New Jersey
| | - Evelyne Kalyoussef
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
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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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Wells M, Swartzman S, Lang H, Cunningham M, Taylor L, Thomson J, Philp J, McCowan C. Predictors of quality of life in head and neck cancer survivors up to 5 years after end of treatment: a cross-sectional survey. Support Care Cancer 2015; 24:2463-72. [DOI: 10.1007/s00520-015-3045-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 11/29/2015] [Indexed: 11/29/2022]
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29
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Feasibility and impact of a dedicated multidisciplinary rehabilitation program on health-related quality of life in advanced head and neck cancer patients. Eur Arch Otorhinolaryngol 2015; 273:1577-87. [DOI: 10.1007/s00405-015-3648-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 05/03/2015] [Indexed: 11/12/2022]
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Isaksson J, Wilms T, Laurell G, Fransson P, Ehrsson YT. Meaning of work and the process of returning after head and neck cancer. Support Care Cancer 2015; 24:205-213. [PMID: 26003423 DOI: 10.1007/s00520-015-2769-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 05/12/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE The purposes of this study were (1) to investigate employment status at diagnosis, sick leave, and returning to work patterns in correlation to quality of life, anxiety, and depression in patients treated for head and neck cancer (HNC) and (2) to explore patients' experiences of the process of returning to work. METHODS Sixty-six patients with HNC (aged 34-66 years) were repeatedly interviewed over a period of 24 months. Interview responses that concerned the patients' experiences and ideas about work were categorised using the similarities-differences technique. Questionnaires on quality of life, anxiety, and depression were used to describe the patient characteristics and the differences between groups. RESULTS In total, 53% of the patients had returned to work at 24 months after treatment, and 17% were deceased. Several quality of life parameters were significantly worse for patients not working at 24 months after treatment. Nine categories were found to describe the return-to-work process starting with symptoms causing sick leave, thoughts about the sick leave, and ending with the return to work and/or retirement. CONCLUSIONS Returning to work is an important part of life because it structures everyday life and strengthens the individual's identity. The quality of life results showed significant differences between workers and non-workers at the 24-month follow-up. The patients need to be both physically and mentally prepared for the process of returning to work. It is important to take an individual rehabilitation approach to guide and support the patients in returning to work and regaining an important aspect of their everyday life. In such an approach, it is vital to understand the patients' overall life context and the patients' own perspective on the process and meaning associated with work.
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Affiliation(s)
- Joakim Isaksson
- Department of Social Work, Umeå University, SE-901 87, Umeå, Sweden.
| | - Torben Wilms
- Department of Medical Biosciences, Umeå University, Umeå, Sweden.,Department of Clinical Sciences, Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Per Fransson
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
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31
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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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32
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Chasen M, Bhargava R, MacDonald N. Rehabilitation for patients with advanced cancer. CMAJ 2014; 186:1071-5. [PMID: 25047989 DOI: 10.1503/cmaj.131402] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Martin Chasen
- Division of Palliative Care (Chasen, Bhargava), Élisabeth-Bruyère Hospital; Department of Medicine (Chasen, Bhargava), University of Ottawa; Bruyère Research Institute (Chasen, Bhargava, MacDonald); Department of Medicine (Chasen), The Ottawa Hospital, Ottawa, Ont.; Department of Oncology (MacDonald), McGill University, Montréal, Que.
| | - Ravi Bhargava
- Division of Palliative Care (Chasen, Bhargava), Élisabeth-Bruyère Hospital; Department of Medicine (Chasen, Bhargava), University of Ottawa; Bruyère Research Institute (Chasen, Bhargava, MacDonald); Department of Medicine (Chasen), The Ottawa Hospital, Ottawa, Ont.; Department of Oncology (MacDonald), McGill University, Montréal, Que
| | - Neil MacDonald
- Division of Palliative Care (Chasen, Bhargava), Élisabeth-Bruyère Hospital; Department of Medicine (Chasen, Bhargava), University of Ottawa; Bruyère Research Institute (Chasen, Bhargava, MacDonald); Department of Medicine (Chasen), The Ottawa Hospital, Ottawa, Ont.; Department of Oncology (MacDonald), McGill University, Montréal, Que
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33
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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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34
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Shoulder pain, functional status, and health-related quality of life after head and neck cancer surgery. Rehabil Res Pract 2013; 2013:601768. [PMID: 24455274 PMCID: PMC3886217 DOI: 10.1155/2013/601768] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 10/22/2013] [Accepted: 12/02/2013] [Indexed: 11/18/2022] Open
Abstract
Head and neck cancer (HNC) patients experience treatment-related complications that may interfere with health-related quality of life (HRQOL). The purpose of this study was to describe the symptom experience (shoulder pain) and functional status factors that are related to global and domain-specific HRQOL at one month after HNC surgery. In this exploratory study, we examined 29 patients. The outcome variables included global HRQOL as well as physical, functional, emotional, and social well-being. Symptom experience and functional status factors were the independent variables. In the symptom experience variables, shoulder pain distress was negatively associated with physical well-being (R (2) = 0.24). Among the functional status variables, eating impairment was negatively related to global HRQOL (R (2) = 0.18) and physical well-being (R (2) = 0.21). Speaking impairment and impaired body image explained a large amount of the variance in functional well-being (R (2) = 0.45). This study provided initial results regarding symptom experience and functional status factors related to poor HRQOL in the early postoperative period for HNC patients.
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Chasen MR, Feldstain A, Gravelle D, Macdonald N, Pereira J. An interprofessional palliative care oncology rehabilitation program: effects on function and predictors of program completion. ACTA ACUST UNITED AC 2013; 20:301-9. [PMID: 24311945 DOI: 10.3747/co.20.1607] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND After treatment, patients with active cancer face a considerable burden from the effects of both the disease and its treatment. The Palliative Rehabilitation Program (prp) is designed to ameliorate disease effects and to improve the patient's functioning. The present study evaluated predictors of program completion and changes in functioning, symptoms, and well-being after the program. METHODS The program received referrals for 173 patients who had finished anticancer therapy. Of those 173 patients, 116 with advanced cancer were eligible and enrolled in the 8-week interprofessional prp; 67 completed it. Measures of physical, nutritional, social, and psychological functioning were evaluated at entry to the program and at completion. RESULTS Participants experienced significant improvements in physical performance (p < 0.000), nutrition (p = 0.001), symptom severity (p = 0.005 to 0.001), symptom interference with functioning (p = 0.003 to 0.001), fatigue (p = 0.001), and physical endurance, mobility, and balance or function (p = 0.001 to 0.001). Reasons that participants did not complete the prp were disease progression, geographic inaccessibility, being too well (program not challenging enough), death, and personal or unknown reasons. A normal level of C-reactive protein (<10 mg/L, p = 0.029) was a predictor of program completion. CONCLUSIONS Patients living with advanced cancers who underwent the interprofessional prp experienced significant improvement in functioning across several domains. Program completion can be predicted by a normal level of C-reactive protein.
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Affiliation(s)
- M R Chasen
- Department of Palliative Medicine, Bruyère Continuing Care, Ottawa, ON. ; Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON. ; School of Psychology, University of Ottawa, Ottawa, ON
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36
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Ma L, Poulin P, Feldstain A, Chasen M. The association between malnutrition and psychological distress in patients with advanced head-and-neck cancer. Curr Oncol 2013; 20:e554-60. [PMID: 24311956 PMCID: PMC3851352 DOI: 10.3747/co.20.1651] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Malnutrition and psychological distress are often seen in patients with head-and-neck cancer, but little is known about the interrelationships between those two symptoms. The present study examined the relationship between malnutrition and psychological distress in patients with advanced head-and-neck cancer. METHODS Using the Patient-Generated Subjective Global Assessment, 99 patients with advanced-stage head-and-neck cancer were screened for nutrition status. The patients were also screened for psychosocial distress (using the Distress Thermometer) and for psychosocial issues (using the Problem Checklist). Any relationship between malnutrition and psychosocial distress was determined by regression and correlation analysis. We also used t-tests to compare distress levels for patients with and without specific nutrition-related symptoms. RESULTS The study group included 80 men and 19 women [mean age: 58.4 ± 10.9 years (range: 23-85 years)]. The correlation between poorer nutrition status and level of psychological distress was significant r = 0.37 (p < 0.001). Specifically, reduced food intake and symptoms were both positively associated with distress: r = 0.27 and r = 0.29 respectively, both significant at p < 0.01. After controlling for the effects of psychosocial problems and pain, nutrition status remained a significant predictor of distress, explaining 3.8% of the variance in the distress scores of the patients (p < 0.05). CONCLUSIONS Malnutrition and symptoms were strongly related to distress in patients with advanced head-and-neck cancer. Our results suggest the need for further research into the complex relationship between nutrition status and distress and into the management of both nutrition and distress in cancer care.
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Affiliation(s)
- L. Ma
- Ottawa Hospital Research Institute, The Ottawa Hospital Cancer Centre, Ottawa, ON
| | - P. Poulin
- Psychosocial Oncology Program, The Ottawa Hospital Health Institute, Ottawa, ON
| | - A. Feldstain
- School of Psychology, University of Ottawa, Ottawa, ON
| | - M.R. Chasen
- Ottawa Hospital Research Institute, The Ottawa Hospital Cancer Centre, Ottawa, ON
- Division of Palliative Care, The Ottawa Hospital Cancer Centre, Ottawa, ON
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Reinwand D, Kuhlmann T, Wienert J, de Vries H, Lippke S. Designing a theory- and evidence-based tailored eHealth rehabilitation aftercare program in Germany and the Netherlands: study protocol. BMC Public Health 2013; 13:1081. [PMID: 24245493 PMCID: PMC3840618 DOI: 10.1186/1471-2458-13-1081] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 10/29/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiac rehabilitation programs aim to improve health status and to decrease the risk of further cardiac events. Persons undergoing rehabilitation often have difficulties transferring the learned health behaviors into their daily routine after returning home and maybe to work. This includes physical activity as well as fruit and vegetable consumption. Computer-based tailored interventions have been shown to be effective in increasing physical activity as well as fruit and vegetable consumption. The aim of this study is, to support people in transferring these two learned behavior changes and their antecedents into their daily life after cardiac rehabilitation. METHODS The study will have a randomized controlled design and will be conducted among German and Dutch people who participated in cardiac rehabilitation. The study will consist of one intervention group which will be compared to a waiting list control group. During the eight week duration of the intervention, participants will be invited to participate in the online after-care program once per week. The intervention encourages participants to define individual health behavior goals as well as action, and coping plans to reach these self-determined goals. The effectiveness of the program will be compared between the intervention condition and the control group in terms of behavior change, antecedents of behavior change (e.g., self-efficacy), ability to return to work and increased well-being. Further, subgroup-differences will be assessed including differences between the two countries, socioeconomic inequalities and across age groups. DISCUSSION The present study will make a contribution to understanding how such an online-based tailored interventions enables study participants to adopt and maintain a healthy lifestyle. Implications can include how such an online program could enrich cardiac rehabilitation aftercare further. TRIAL REGISTRATION NTR 3706, NCT01909349.
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Affiliation(s)
- Dominique Reinwand
- CAPHRI, Department of Health Promotion, Maastricht University, P. O. Box 616, Maastricht 6200, MD, the Netherlands
- Jacobs Center for Lifelong Learning and Institutional Development, Jacobs University Bremen, Campus Ring 1, 28759 Bremen, Germany
| | - Tim Kuhlmann
- Jacobs Center for Lifelong Learning and Institutional Development, Jacobs University Bremen, Campus Ring 1, 28759 Bremen, Germany
| | - Julian Wienert
- Jacobs Center for Lifelong Learning and Institutional Development, Jacobs University Bremen, Campus Ring 1, 28759 Bremen, Germany
| | - Hein de Vries
- CAPHRI, Department of Health Promotion, Maastricht University, P. O. Box 616, Maastricht 6200, MD, the Netherlands
| | - Sonia Lippke
- Jacobs Center for Lifelong Learning and Institutional Development, Jacobs University Bremen, Campus Ring 1, 28759 Bremen, Germany
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The significance of fellow patients for head and neck cancer patients in the radiation treatment period. Eur J Oncol Nurs 2013; 17:618-24. [DOI: 10.1016/j.ejon.2013.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 12/19/2012] [Accepted: 01/05/2013] [Indexed: 11/19/2022]
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Lang H, France E, Williams B, Humphris G, Wells M. The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis. Psychooncology 2013; 22:2648-63. [PMID: 23840037 DOI: 10.1002/pon.3343] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 05/29/2013] [Accepted: 05/31/2013] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To summarise patients' experiences of head and neck cancer (HNC) by examining the findings of existing qualitative studies METHODS We undertook a systematic review and meta-synthesis of qualitative studies in 29 published articles using Noblit and Hare's 'meta-ethnography' approach to synthesise findings. The inclusion criteria were primary qualitative studies, focusing on HNC patients' experience and an English abstract. Seven databases were systematically searched. RESULTS The articles focused on the experience of having HNC, the experience of treatments and the role of information. Our synthesis identified six core concepts-uncertainty and waiting, disruption to daily life, the diminished self, making sense of the experience, sharing the burden and finding a path. People experienced significant disruption to normal daily activities, because of the physical and emotional effects of HNC and its treatment. Day-to-day challenges were compounded by social and existential changes and a palpable loss of the individual's sense of self and future. In order to find a way through the considerable uncertainty and daily challenge of living with and beyond HNC, patients made continual efforts to make sense of their experience. Supportive relationships with their social network, HNC peers and healthcare professionals were particularly important, but support following treatment completion was sometimes limited. Perceptions of the future were affected by whether they saw life as diminished, merely changed or even enhanced by the experience of cancer. CONCLUSIONS This review supports further specific research into these emerging themes and provides a context for future work, informing interventions to improve patients' experiences.
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Affiliation(s)
- Heidi Lang
- School of Nursing and Midwifery, University of Dundee, Dundee City, UK
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Egestad H. How does the radiation therapist affect the cancer patients' experience of the radiation treatment? Eur J Cancer Care (Engl) 2013; 22:580-8. [DOI: 10.1111/ecc.12062] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2013] [Indexed: 12/01/2022]
Affiliation(s)
- H. Egestad
- Department of Health and Care Sciences; Faculty of Health Sciences; University of Tromsø; Tromsø; Norway
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A systematic review of interventions for eating and drinking problems following treatment for head and neck cancer suggests a need to look beyond swallowing and trismus. Oral Oncol 2013; 49:387-400. [DOI: 10.1016/j.oraloncology.2012.12.002] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 11/30/2012] [Accepted: 12/05/2012] [Indexed: 11/20/2022]
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van der Meulen IC, de Leeuw JRJ, Gamel CJ, Hafsteinsdóttir TB. Educational intervention for patients with head and neck cancer in the discharge phase. Eur J Oncol Nurs 2013; 17:220-7. [DOI: 10.1016/j.ejon.2012.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 05/26/2012] [Accepted: 05/26/2012] [Indexed: 11/17/2022]
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Haisfield-Wolfe ME, McGuire DB, Soeken K, Geiger-Brown J, De Forge B, Suntharalingam M. Prevalence and correlates of symptoms and uncertainty in illness among head and neck cancer patients receiving definitive radiation with or without chemotherapy. Support Care Cancer 2011; 20:1885-93. [DOI: 10.1007/s00520-011-1291-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 09/26/2011] [Indexed: 11/30/2022]
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Chen SC, Lai YH, Cheng SY, Liao CT, Chang JTC. Psychometric testing of the Chinese-version cancer needs questionnaire short form head and neck cancer-specific version in oral cavity cancer patients. Support Care Cancer 2010; 19:647-56. [DOI: 10.1007/s00520-010-0877-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Accepted: 04/08/2010] [Indexed: 10/19/2022]
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