Rethinking the Head and Neck Cancer Population

Survivors' experiences of dysphagia-related services following head and neck cancer: implications for clinical practice

BACKGROUND

It is known that people with dysphagia experience a number of negative consequences as a result of their swallowing difficulties following head and neck cancer management (HNC). However their perceptions and experiences of adjusting to dysphagia in the post-treatment phase, and the services received to assist this process, has not been studied.

AIMS

To explore the lived experience of people with dysphagia following non-surgical treatment for HNC and examine their perceptions of service needs.

METHODS & PROCEDURES

A demographically diverse group of 24 people who had received radiotherapy for HNC in the past five years, and experienced dysphagia as a result of treatment, were recruited using maximum variation sampling. Each participant took part in a semi-structured, in-depth interview, where they reflected on their adjustment to, and recovery from dysphagia following treatment for HNC, as well as the dysphagia-related services they received during their treatment. Thematic analysis was used to analyse the transcripts and to identify key themes that emerged from the data.

RESULTS

The main integrative theme was the desire for ongoing access to dysphagia-related services in order to adequately manage dysphagia. Within this integrative theme were five additional themes including: (1) entering the unknown: life after treatment for HNC; (2) making practical adjustments to live with dysphagia; (3) making emotional adjustments to live with dysphagia; (4) accessing support outside the hospital services; and (5) perceptions of dysphagia-related services.

CONCLUSIONS & IMPLICATIONS

The interviews revealed the need for both greater access to services and a desire for services which address the multitude of issues faced by people with dysphagia following HNC in the post-treatment period. Speech and language therapists managing this caseload need to ensure post-treatment services are available and address not only the physical but also the emotional and psychosocial changes impacting people with dysphagia in order to assist them to adjust to, and live successfully with dysphagia. Further research should be conducted to support the development of innovative services and to highlight dysphagia-related survivorship issues to governing bodies/policy makers.

Menopausal symptoms, sexual function, depression, and quality of life in Korean patients with breast cancer receiving chemotherapy

PURPOSE

The purpose of this study was to study the relationships among menopausal symptoms, sexual function, depression, and quality of life in women with breast cancer undergoing chemotherapy.

METHODS

Two hundred women participated in this cross-sectional study. Data were collected with the Menopause Rating Scale (MRS), Female Sexual Function Index (FSFI), Beck Depression Inventory II (BDI-II), and the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B). Data were analyzed using descriptive statistics, t-tests, ANOVA, Scheffe's test, and Pearson product moment correlations using SPSS v. 20.

RESULTS

Participants had alterations in menopausal symptoms and sexual function, and were depressed with a decreased quality of life. These factors are known to influence satisfaction with family support (p < 0.05) and sexual relationships (p < 0.05).

CONCLUSIONS

Nurses should provide education to women with breast cancer on their sexual issues and encourage them to attend family support programs. They should also encourage family members to be proactive in addressing menopausal and depressive symptoms in these women with a goal to enhance their sexual functioning and quality of life.