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Mali SB. Role of telemedicine in head neck cancer. Oral Oncol 2024; 151:106746. [PMID: 38460287 DOI: 10.1016/j.oraloncology.2024.106746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Abstract
Chemo-radiotherapy and head and neck cancers are common adverse outcomes that impact patients' quality of life. The increasing cancer incidence and healthcare service shortages necessitate new strategies for optimal treatments and follow-ups. Digitalized healthcare, including digital health, telemedicine, and telemonitoring, is promising. HNC requires multidisciplinary team intervention, including speech language pathology telepractice models. Mobile health-based interventions can help cancer survivors increase physical activity and improve rehabilitation services. Effective self-management skills can improve outcomes. Advancements in communication technologies have led to telecommunication-based interventions incorporating swallowing exercises, education, monitoring, feedback, self-management, and communication. Home-based remote rehabilitation is urgent, especially during the COVID-19 pandemic, but the optimal strategy and effectiveness of remote interventions remain unclear. Telehealth interventions represent a possible novel approach to increase access to care across the cancer continuum, strengthen patients' knowledge and self-management, provide continuity of services, and enable remote monitoring of symptoms and response to treatment. Telehealth patients are typically younger, more likely to be English-speaking, and more likely to be female. These disparities widened slightly after the start of the pandemic but were also present prior to the pandemic.
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Affiliation(s)
- Shrikant B Mali
- Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hiray Dental College and Hospital Nashik, India.
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Kok A, Passchier E, May AM, Jager-Wittenaar H, Veenhof C, de Bree R, Stuiver MM, Speksnijder CM. Expectations and Experiences of Participating in a Supervised and Home-Based Physical Exercise Intervention in Patients with Head and Neck Cancer during Chemoradiotherapy: A Qualitative Study. Curr Oncol 2024; 31:885-899. [PMID: 38392060 PMCID: PMC10887739 DOI: 10.3390/curroncol31020066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
(1) Background: Chemoradiotherapy (CRT) for head and neck cancer (HNC) is associated with severe toxicity resulting in fatigue and weight loss, including loss of skeletal muscle mass. Exercise interventions might positively affect physical fitness and quality of life. Sufficient adherence and compliance rates are necessary for optimal effects. This study aimed to gain insight into expectations and experiences and factors influencing adherence, retention and compliance of HNC patients participating in exercise intervention during CRT. (2) Methods: Consecutive participants were invited for semi-structured interviews, conducted pre- and post-intervention. A deductive approach was used to identify themes and factors influencing adherence, retention and compliance. (3) Results: Thematic saturation was reached after interviewing 14 patients pre-intervention. Five themes were identified: planning and time management, treatment toxicity, motivation to exercise, exercise intervention and supervision by a physiotherapist. The intensity of the treatment schedule and treatment toxicity were important barriers. Facilitators mentioned were physical and emotional benefits, social support as well as the simplicity and home-based setting of the intervention. (4) Conclusions: A personalised approach, considering the individual facilitators and barriers of HNC patients, is important to increase adherence, retention and compliance to exercise intervention and to reap the optimal effects of the program.
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Affiliation(s)
- Annemieke Kok
- Department of Dietetics, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Ellen Passchier
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- Center for Quality of Life and Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
| | - Anne M. May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3584 CG Utrecht, The Netherlands;
| | - Harriët Jager-Wittenaar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
- Research Unit Experimental Anatomy, Department Physiotherapy and Human Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Cindy Veenhof
- Department of Rehabilitation, Physiotherapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands;
- Research Group Innovation of Human Movement Care, HU University of Applied Sciences, 3584 CS Utrecht, The Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Martijn M. Stuiver
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- Center for Quality of Life and Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
| | - Caroline M. Speksnijder
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
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Shibayama K, Furushima C, Saka M, Sakamoto T, Takahashi H. Barriers to lifestyle modification in patients with non-alcoholic fatty liver disease: a scoping review. J Rural Med 2024; 19:1-9. [PMID: 38196808 PMCID: PMC10774003 DOI: 10.2185/jrm.2023-026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/03/2023] [Indexed: 01/11/2024] Open
Abstract
Objective: Non-alcoholic fatty liver disease is common worldwide, and lifestyle modifications are key to its treatment. This study aimed to identify the barriers to lifestyle modifications in patients with non-alcoholic fatty liver disease and to organize the results using the Capability Opportunity Motivation-Behavior (COM-B) model. Materials and Methods: The framework of Arksey and O' Malley was used in this scoping review. We searched PubMed, Scopus, and the Cochrane Library without language restrictions for reports published up to September 11, 2022, including peer-reviewed literature reporting barriers to lifestyle modifications in patients with non-alcoholic fatty liver disease. Patient-reported barriers were analyzed inductively and organized into the components (capability, opportunity, and motivation) of the COM-B model. Results: The literature search yielded 583 articles, of which seven qualitative studies, four quantitative studies, and one mixed-methods study met the inclusion criteria. Lack of time, lack of information on the diagnosis and management of non-alcoholic fatty liver disease, negative perceptions of the prescribed exercise and diet, physical symptoms interfering with the behavior, presence of comorbidities, and lack of family cooperation were frequently reported as barriers. Conclusion: The results of this study may contribute to the development of appropriate care and education strategies to promote behavioral changes in patients with non-alcoholic fatty liver disease.
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Affiliation(s)
- Kaoru Shibayama
- Institute of Nursing, Faculty of Medicine, Saga University, Japan
| | - Chie Furushima
- Institute of Nursing, Faculty of Medicine, Saga University, Japan
| | - Minako Saka
- Department of Nursing, School of Nursing at Narita, International University of Health and Welfare, Japan
| | - Takako Sakamoto
- Institute of Nursing, Faculty of Medicine, Saga University, Japan
| | - Hirokazu Takahashi
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Japan
- Liver Center, Saga University Hospital, Faculty of Medicine, Saga University, Japan
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Ning Y, Dong Z, Jia Z, Zhao W, Ding Y, Wang Q, Zhu R, Han S. Development of mobile health-based interventions to promote physical activity in patients with head and neck cancer: a qualitative study. Front Public Health 2023; 11:1260804. [PMID: 38074711 PMCID: PMC10703461 DOI: 10.3389/fpubh.2023.1260804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
Background Despite the well-grounded benefits of physical activity (PA), poor compliance with the PA guidelines has been reported among head and neck cancer (HNC) patients. Mobile health (mHealth)-based interventions can help cancer survivors increase their PA levels and increase the reach or efficiency of rehabilitation services. However, there is limited knowledge about the needs and perceptions of HNC patients regarding these interventions. This study explored the perceptions and needs of HNC patients regarding mHealth-based PA programs before developing such interventions to ensure their improved effectiveness. Study design A constructivist qualitative study. Methods We purposively selected 17 adult HNC patients aged 40-80 years to determine their needs and perceptions of future mHealth-based PA programs. Semi-structured face-to-face interviews were conducted, and the data were analyzed via thematic analysis. The report followed the Consolidated Criteria for Qualitative Research Reports guidelines. Results Four themes were analyzed from the interview transcripts regarding the needs and perceptions of mHealth-based PA programs: (1) functionality needs; (2) system usage requirements; (3) social support; and (4) perceived barriers and facilitators. HNC patients expect highly customized and specialized mHealth interventions that consider individual factors, address their concerns about security, network, and cost, and prefer improved comfort. Moreover, they expect to receive support from their healthcare providers, families, and peers. Conclusion The study provides pragmatic ready-to-use recommendations to design interventions for inactive HNC patients to achieve the recommended PA levels. Future mHealth interventions should be tailored according to the needs of the HNC patients by utilizing perceived facilitators and removing perceived barriers to help them engage in PA actively.
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Affiliation(s)
- Yan Ning
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Zhen Dong
- Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Zehuan Jia
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Wenting Zhao
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Yongxia Ding
- School of Nursing, Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Otolaryngology, Head and Neck Cancer, Taiyuan, China
| | - Qian Wang
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Ruifang Zhu
- School of Nursing, Shanxi Medical University, Taiyuan, China
- Editorial Department, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Shifan Han
- School of Nursing, Shanxi Medical University, Taiyuan, China
- Editorial Department, First Hospital of Shanxi Medical University, Taiyuan, China
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Yang W, Du Y, Chen M, Li S, Zhang F, Yu P, Xu X. Effectiveness of Home-Based Telerehabilitation Interventions for Dysphagia in Patients With Head and Neck Cancer: Systematic Review. J Med Internet Res 2023; 25:e47324. [PMID: 37682589 PMCID: PMC10517384 DOI: 10.2196/47324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Multimodal treatment-induced dysphagia has serious negative effects on survivors of head and neck cancer. Owing to advances in communication technologies, several studies have applied telecommunication-based interventions that incorporate swallowing exercises, education, monitoring, feedback, self-management, and communication. It is especially urgent to implement home-based remote rehabilitation in the context of the COVID-19 pandemic. However, the optimal strategy and effectiveness of remote interventions are unclear. OBJECTIVE This systematic review aimed to examine the evidence regarding the efficacy of telerehabilitation for reducing physiological and functional impairments related to swallowing and for improving adherence and related influencing factors among head and neck cancer survivors. METHODS The PubMed, MEDLINE, CINAHL, Embase, and Cochrane Library databases were systematically searched up to July 2023 to identify relevant articles. In total, 2 investigators independently extracted the data and assessed the methodological quality of the included studies using the quality assessment tool of the Joanna Briggs Institute. RESULTS A total of 1465 articles were initially identified; ultimately, 13 (0.89%) were included in the systematic review. The quality assessment indicated that the included studies were of moderate to good quality. The results showed that home-based telerehabilitation improved the safety of swallowing and oral feeding, nutritional status, and swallowing-related quality of life; reduced negative emotions; improved swallowing rehabilitation adherence; was rated by participants as highly satisfactory and supportive; and was cost-effective. In addition, this review investigated factors that influenced the efficacy of telerehabilitation, which included striking a balance among swallowing training strategy, intensity, frequency, duration, and individual motor ability; treating side effects of radiotherapy; providing access to medical, motivational, and educational information; providing feedback on training; providing communication and support from speech pathologists, families, and other survivors; and addressing technical problems. CONCLUSIONS Home-based telerehabilitation has shown great potential in reducing the safety risks of swallowing and oral feeding, improving quality of life and adherence, and meeting information needs for dysphagia among survivors of head and neck cancer. However, this review highlights limitations in the current literature, and the current research is in its infancy. In addition, owing to the diversity of patient sociodemographic, medical, physiological and functional swallowing, and behavioral factors, we recommend the development of tailored telemedicine interventions to achieve the best rehabilitation effects with the fewest and most precise interventions.
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Affiliation(s)
- Wenwen Yang
- The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou City, Henan Province, China
| | - Yifei Du
- The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou City, Henan Province, China
| | - Mengran Chen
- The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou City, Henan Province, China
| | - Sufang Li
- The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou City, Henan Province, China
| | - Fan Zhang
- The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou City, Henan Province, China
| | - Peiyang Yu
- The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou City, Henan Province, China
| | - Xiaoxia Xu
- The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou City, Henan Province, China
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Doughty HC, Hill RA, Riley A, Midgley AW, Patterson JM, Boddy LM, Rogers SN, Maden M, Williams NH. Barriers to and facilitators of physical activity in adults living with and beyond cancer, with special emphasis on head and neck cancer: a systematic review of qualitative and mixed methods studies. Support Care Cancer 2023; 31:471. [PMID: 37458858 PMCID: PMC10352410 DOI: 10.1007/s00520-023-07925-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Physical activity can improve health outcomes for cancer patients; however, only 30% of patients are physically active. This review explored barriers to and facilitators of physical activity promotion and participation in patients living with and beyond cancer. Secondary aims were to (1) explore similarities and differences in barriers and facilitators experienced in head and neck cancer versus other cancers, and (2) identify how many studies considered the influence of socioeconomic characteristics on physical activity behaviour. METHODS CINAHL Plus, MEDLINE, PsycINFO, Scopus and Cochrane (CDSR) were searched for qualitative and mixed methods evidence. Quality assessment was conducted using the Mixed Methods Appraisal Tool and a Critical Appraisal Skills Programme Tool. Thematic synthesis and frequency of reporting were conducted, and results were structured using the Capability-Opportunity-Motivation-Behaviour model and Theoretical Domains Framework. RESULTS Thirty qualitative and six mixed methods studies were included. Socioeconomic characteristics were not frequently assessed across the included studies. Barriers included side effects and comorbidities (physical capability; skills) and lack of knowledge (psychological capability; knowledge). Having a dry mouth or throat and choking concerns were reported in head and neck cancer, but not across other cancers. Facilitators included improving education (psychological capability; knowledge) on the benefits and safety of physical activity. CONCLUSION Educating patients and healthcare professionals on the benefits and safety of physical activity may facilitate promotion, uptakeand adherence. Head and neck cancer patients experienced barriers not cited across other cancers, and research exploring physical activity promotion in this patient group is required to improve physical activity engagement.
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Affiliation(s)
- Hannah C. Doughty
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, L69 3GL UK
| | - Ruaraidh A. Hill
- Department of Health Data Science, University of Liverpool, L69 3GL Liverpool, UK
| | - Andrew Riley
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, L69 3GL UK
| | - Adrian W. Midgley
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, L39 4QP UK
| | - Joanne M. Patterson
- Liverpool Head and Neck Centre, University of Liverpool, L69 3GB Liverpool, UK
| | - Lynne M. Boddy
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 2EX UK
| | - Simon N. Rogers
- Head and Neck Centre, Wirral University Teaching Hospital, Wirral, CH49 5PE UK
| | - Michelle Maden
- Department of Health Data Science, University of Liverpool, L69 3GL Liverpool, UK
| | - Nefyn H. Williams
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, L69 3GL UK
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Parmet T, Yusufov M, Braun IM, Pirl WF, Matlock DD, Sannes TS. Willingness toward psychosocial support during cancer treatment: a critical yet challenging construct in psychosocial care. Transl Behav Med 2023; 13:511-517. [PMID: 36940406 PMCID: PMC10465092 DOI: 10.1093/tbm/ibac121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
Psychosocial distress screening, mandated by the American College Surgeons' Commission on Cancer, continues to be implemented across cancer centers nationwide. Although measuring distress is critical to identifying patients who may benefit from additional support, several studies suggest that distress screening may not actually increase patients' utilization of psychosocial services. While various investigators have identified barriers that may impede effective implementation of distress screening, we posit that patients' intrinsic motivation, which we term patients' willingness, may be the biggest predictor for whether cancer patients choose to engage with psychosocial services. In this commentary, we define patient willingness towards psychosocial services as a novel construct, distinct from the intention toward a certain behavior described across pre-existing models of health behavior change. Further, we offer a critical perspective of models of intervention design that focus on acceptability and feasibility as preliminary outcomes thought to encompass the willingness construct described herein. Finally, we summarize several health service models that successfully integrate psychosocial services alongside routine oncology care. Overall, we present an innovative model that acknowledges barriers and facilitators and underscores the critical role of willingness in health behavior change. Consideration of patients' willingness toward psychosocial care will move the field of psychosocial oncology forward in clinical practice, policy initiatives, and study design.
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Affiliation(s)
- Tamar Parmet
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
- Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, CO, USA
| | - Miryam Yusufov
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
| | - Ilana M Braun
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
| | - William F Pirl
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
| | - Daniel D Matlock
- Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, CO, USA
- Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Veteran Affairs (VA) Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA
| | - Timothy S Sannes
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
- University of Massachusetts Medical School/UMass Memorial Hospital, Worcester, MA, USA
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Ning Y, Jia Z, Zhu R, Ding Y, Wang Q, Han S. Effect and feasibility of gamification interventions for improving physical activity and health-related outcomes in cancer survivors: an early systematic review and meta-analysis. Support Care Cancer 2022; 31:92. [PMID: 36585478 DOI: 10.1007/s00520-022-07550-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite the well-documented advantages of regular physical activity (PA), patients with cancer show suboptimal participation. By using game design elements, gamification could be used to motivate individuals to engage in PA. It has been demonstrated that gamification interventions positively affect children, adolescents and older adults in health-related contexts. There are, however, inconsistent findings regarding the impact of gamification interventions on cancer survivors' PA and health-related outcomes, according to the literature. OBJECTIVES The aim of this study is to examine the effectiveness and feasibility of gamification interventions for improving PA and health-related outcomes among cancer survivors. METHODS A systematic review and meta-analysis were conducted following the Cochrane Handbook and PRISMA guidelines. Eight English databases and three Chinese databases were searched to identify eligible articles from inception to February 2022. Two reviewers independently performed the literature screening and data extraction. The Cochrane Risk of Bias tool was used to assess the risk of bias. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) Working Group levels of evidence was used to evaluate the certainty of the findings. RESULTS Ten randomised controlled trials (RCTs) published between 2014 and 2022 were included. The meta-analysis revealed no significant differences in the step counts and for moderate to vigorous PA, and the certainty of the findings was very low, according to GRADE. Meta-analysis for most outcomes could not be performed owing to the fewer included studies and significant heterogeneity. Most studies reported positive effects in improving moderate PA, sedentary behaviour, fatigue and at least one domain of quality of life. This review proved that gamified interactions are associated with low adverse event rates. CONCLUSION Gamification interventions could be a feasible way to promote the adoption of mobile health (mHealth) technology in patients with cancer. Individual studies have demonstrated some positive effects of gamification interventions on PA and health-related outcomes. However, limited studies, small sample sizes and methodological heterogeneity weaken the evidence. Larger, well-designed RCTs are required to confirm the impact of gamification interventions on PA and health-related outcomes in cancer survivors.
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Fordham B, Smith TO, Lamb S, Morris A, Winter SC. Patient and physiotherapist perceptions of the Getting Recovery Right After Neck Dissection (GRRAND) rehabilitation intervention: a qualitative interview study embedded within a feasibility trial. BMJ Open 2022; 12:e064269. [PMID: 36375975 PMCID: PMC9664296 DOI: 10.1136/bmjopen-2022-064269] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The Getting Recovery Right After Neck Dissection (GRRAND) intervention is a physiotherapy programme for patients with head and neck cancer who have undergone neck dissection. The aim of this qualitative study was to understand if the intervention was useful, acceptable and whether it was feasible to conduct a randomised controlled trial (RCT). DESIGN This qualitative study was embedded within the GRRAND-Feasibility (GRRAND-F) Study. SETTING Participants were recruited from four acute National Health Service hospitals in England between 2020 and 2021. PARTICIPANTS We interviewed four usual care and four intervention patient-participants from a single study site (Oxford). Six were male, two were female. All were white British ethnicity. We interviewed two physiotherapists from Oxford who delivered the GRRAND-F intervention, and physiotherapists from Birmingham, Poole and Norwich who were trained to deliver the intervention but were not able to deliver it within the study time frame. RESULTS The analysis identified five themes: (1) Acceptability, (2) Adherence, (3) Outcomes, (4) Feasibility and (5) Stand-alone themes (prehabilitation, video consultations, healthcare use).Patient-participants and physiotherapist-participants agreed that usual care was not meeting patients' rehabilitation needs. The GRRAND intervention provided biopsychosocial support. In comparison to the usual care group, patient-participants who received the intervention were more confident that they could perform rehabilitation exercises and were more motivated to engage in long-term adaptive behaviour change. Physiotherapists felt they needed more administrative support to participate in an RCT. CONCLUSION Participants felt that usual care was insufficient. GRRAND provided much needed, biopsychosocial support to patients. Participants were supportive that it would be feasible to test GRRAND in an RCT. TRIAL REGISTRATION NUMBER ISRCTN11979997.
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Affiliation(s)
- Beth Fordham
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Toby O Smith
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Sarah Lamb
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Alana Morris
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Stuart C Winter
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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Nehlsen AD, Sindhu KK, Jones BM, Lehrer EJ, Rowley JP, Bakst RL. Moving beyond Definitive Therapy: Increasing Physical Activity in Survivors of Cancers of the Head and Neck. Curr Oncol 2022; 29:1213-1222. [PMID: 35200602 PMCID: PMC8870667 DOI: 10.3390/curroncol29020103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/29/2022] [Accepted: 02/10/2022] [Indexed: 11/16/2022] Open
Abstract
As chemotherapeutic, radiation, and surgical techniques have improved, there has been a dramatic improvement in survival in patients diagnosed with cancers of the head and neck. As a result, a heightened focus on survivorship by clinicians will increasingly prove necessary. In particular, medical care teams will have to pay special attention to mitigating the long-term sequelae of definitive cancer treatments, many of which act as barriers to exercise. This is unfortunate, as the benefits of exercise in patients with cancer have become increasingly recognized. In this review, we discuss the potential benefits of and barriers to exercise in survivors of cancers of the head and neck. We also review existing exercise guidelines and strategies by which clinicians can promote exercise in this unique patient population.
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