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Supportive Care in Cancer

Erschienen in:

01.03.2016 | Original Article

Evaluation of a weekly speech pathology/dietetic service model for providing supportive care intervention to head and neck cancer patients and their carers during (chemo)radiotherapy

verfasst von: Laurelie R. Wall, Bena Cartmill, Elizabeth C. Ward, Anne J. Hill, Elizabeth Isenring, Sandro V. Porceddu

Erschienen in: Supportive Care in Cancer | Ausgabe 3/2016

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Abstract

Purpose

Dysphagia is a common and debilitating side effect for head and neck cancer (HNC) patients undergoing radiotherapy (RT) with or without chemotherapy ([C]RT) and is associated with nutritional and emotional comorbidities. Emotional sequelae and distress are also known to affect carers of HNC patients. A weekly, joint speech pathology/dietetic (SP/DN) service-delivery model has been employed to manage swallowing/nutritional and associated emotional issues during (C)RT. This study aimed to conduct a service evaluation of the weekly SP/DN clinical model.

Methods

Cross-sectional sampling of core service metrics and perceptions of key stakeholders (70 HNC patients, 30 carers, and 10 clinicians) were collated from the Metro South Radiation Oncology Service in Brisbane, Australia. Data from each source was examined separately and then triangulated.

Results

An average of 28 patients (SD = 5.54) attended SP/DN appointments per week, with 58 % reporting swallowing and/or nutritional issues. Distress was reported by 27 % of patients and 30 % of carers. Clinicians felt able to adequately identify and manage swallowing and nutrition 90 % of the time but only 10 % of the time for distress. Seventy-six percent of scheduled SP/DN sessions were perceived as necessary by either patients, clinicians or both.

Conclusions

Findings demonstrated a third of patients and their carers had a high level of distress during HNC [C]RT, supporting need for the provision of a weekly SP/DN service in a select cohort. However, the routine weekly SP/DN assessment model for all patients undergoing HNC treatment demonstrates the potential for over-servicing. Alternative service-delivery models warrant further evaluation.

Langendijk JA, Doornaert P, Verdonck-de Leeuw IM, Leemans CR, Aaronson NK, Slotman BJ (2008) Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer treated with radiotherapy. J Clin Oncol 26(22):3770–3776CrossRefPubMed

van der Molen L, van Rossman MA, Burkhead LM, Smeele LE, Hilgers FJ (2009) Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review. Eur Arch Otolaryngol 266:889–900. doi:10.1007/s00405-008-0817-3 CrossRef

Caudell JJ, Schaner PE, Meredith RF, Locher JL, Nabell LM, Carroll WR, Magnuson JS, Spencer SA, Bonner JA (2009) Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys 73(2):410–415CrossRefPubMed

Isenring E, Zabel R, Bannister M, Brown T, Findlay M, Kiss N, Loeliger J, Johnstone C, Camilleri B, Davidson W, Hill J, Bauer J (2013) Updated evidence-based practice guidelines for the nutritional management of patients receiving radiation therapy and/or chemotherapy. Nutr Diet 70:312–324CrossRef

Gillespie MB, Brodsky MB, Day TA, Lee FS, Martin‐Harris B (2004) Swallowing-related quality of life after head and neck cancer treatment. Laryngoscope 114(8):1362–1367CrossRefPubMed

McQuestion M, Fitch M, Howell D (2011) The changed meaning of food: physical, social and emotional loss for patients having received radiation treatment for head and neck cancer. Eur J Oncol Nurs 15(2):145–151CrossRefPubMed

Nguyen NP, Frank C, Moltz CC, Vos P, Smith HJ, Karlsson U, Dutta S, Midyett FA, Barloon J, Sallah S (2005) Impact of dysphagia on quality of life after treatment of head-and-neck cancer. Int J Radiat Oncol Biol Phys 61:772–778CrossRefPubMed

Semple CJ, Dunwoody L, George Kernohan W, McCaughan E, Sullivan K (2008) Changes and challenges to patients’ lifestyle patterns following treatment for head and neck cancer. J Adv Nurs 63(1):85–93CrossRefPubMed

Verdonck‐de Leeuw IM, Eerenstein SE, Van der Linden MH, Kuik DJ, de Bree R, Leemans CR (2007) Distress in spouses and patients after treatment for head and neck cancer. Laryngoscope 117(2):238–241CrossRefPubMed

10.

Nund RL, Ward EC, Scarinci NA, Cartmill B, Kuipers P, Porceddu SV (2014) The lived experience of dysphagia following non-surgical treatment for head and neck cancer. Int J Speech Lang Path 16(3):282–289CrossRef

11.

Nund RL, Ward EC, Scarinci NA, Cartmill B, Kuipers P, Porceddu SV (2014) Carers’ experiences of dysphagia in people treated for head and neck cancer: a qualitative study. Dysphagia 29(4):450–458CrossRefPubMed

12.

Manne S, Badr H, Kashy DA (2012) A longitudinal analysis of intimacy processes and psychological distress among couples coping with head and neck or lung cancers. J Behav Med 35(3):334–346PubMedCentralCrossRefPubMed

13.

Precious E, Haran S, Lowe D, Rogers S (2012) Head and neck cancer patients’ perspective of carer burden. Br J Oral Maxillofac Surg 50(3):202–207CrossRefPubMed

14.

Girgis A, Lambert S (2009) Caregivers of cancer survivors: the state of the field. Cancer Forum 33(3):164–167

15.

National Comprehensive Cancer Network (2012) NCCN Clinical practice guidelines in oncology: head and neck cancers version 1.2012. http://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf. Accessed 19 March 2015

16.

Lazenby M (2014) The international endorsement of US distress screening and psychosocial guidelines in oncology: a model for dissemination. J Natl Compr Cancer Netw 12(2):221–227

17.

Borras JM, Albreht T, Audisio R, Briers E, Casali P, Esperou H, Grube B, Hamoir M, Henning G, Kelly J (2014) Policy statement on multidisciplinary cancer care. Eur J Cancer 50(3):475–480CrossRefPubMed

18.

Allied Health Professionals Office of Queensland (2012) Discussion paper: allied health staffing in Queensland Health Cancer Care Services. Queensland Health, Brisbane

19.

Health Workforce Australia (2012) The national cancer workforce strategy. http://www.hwa.gov.au/work-programs/workforce-innovation-and-reform/national-cancer-workforce-strategy. Accessed 19 March 2015

20.

Roe JW, Carding PN, Rhys-Evans PH, Newbold KL, Harrington KJ, Nutting CM (2012) Assessment and management of dysphagia in patients with head and neck cancer who receive radiotherapy in the United Kingdom–a web-based survey. Oral Oncol 48(4):343–348CrossRefPubMed

21.

Krisciunas GP, Sokoloff W, Stepas K, Langmore SE (2012) Survey of usual practice: dysphagia therapy in head and neck cancer patients. Dysphagia 27(4):538–549PubMedCentralCrossRefPubMed

22.

Lawson NR, Ward EC (2014) Patient support and multidisciplinary management. In: Head and Neck Cancer: Treatment, Rehabilitation, and Outcomes. 2nd edn. Plural Publishing, San Diego, CA, pp 447-492

23.

Maclean J, Ward E, Findlay M, Rees G (2013) Dysphagia and nutritional management in Australia and New Zealand head and neck cancer centers. Dysphagia 28(4):601–601

24.

Riddle B, Davidson W, Elliott R, Balsillie F, Porceddu SV (2005) Collaborative management of acute side effects for head and neck cancer patients receiving radiotherapy. Asia–Pac. J Clin Oncol 1(Suppl):A18

25.

Platteaux N, Dirix P, Dejaeger E, Nuyts S (2010) Dysphagia in head and neck cancer patients treated with chemoradiotherapy. Dysphagia 25(2):139–152CrossRefPubMed

26.

Basch E, Jia X, Heller G, Barz A, Sit L, Fruscione M, Appawu M, Iasonos A, Atkinson T, Goldfarb S (2009) Adverse symptom event reporting by patients vs clinicians: relationships with clinical outcomes. J Natl Cancer Inst 101(23):1624–1632PubMedCentralCrossRefPubMed

27.

Meyer F, Fortin A, Wang CS, Liu G, Bairati I (2012) Predictors of severe acute and late toxicities in patients with localized head-and-neck cancer treated with radiation therapy. Int J Radiat Oncol Biol Phys 82(4):1454–1462CrossRefPubMed

28.

Poulsen MG, Riddle B, Keller J, Porceddu SV, Tripcony L (2008) Predictors of acute grade 4 swallowing toxicity in patients with stages III and IV squamous carcinoma of the head and neck treated with radiotherapy alone. Radiother Oncol 87(2):253–259CrossRefPubMed

29.

Wilson JA, Carding PN, Patterson JM (2011) Dysphagia after nonsurgical head and neck cancer treatment patients’ perspectives. Otolaryngol Head Neck Surg 145(5):767–771CrossRefPubMed

30.

Patterson J, Wilson JA (2011) The clinical value of dysphagia pre-assessment in the management of head and neck cancer patients. Curr Opinion Otolaryngol Head Neck Surg 19(3):177–181CrossRef

31.

Bultz BD, Carlson LE (2006) Emotional distress: the sixth vital sign-future directions in cancer care. Psychol Oncol 15(2):93–95CrossRef

32.

National Comprehensive Cancer Network (2014) Distress management NCCN clinical practice guidelines in oncology. https://www.nccn.org/store/login/login.aspx?ReturnURL=http://www.nccn.org/professionals/physician_gls/pdf/distress.pdf. Accessed 19 March 2015

33.

American Speech-Language-Hearing Association (2007) Scope of practice in speech language pathology. www.asha.org/policy. Accessed 19 March 2015

34.

Speech Pathology Australia (2003) Scope of practice in speech pathology. http://www.speechpathologyaustralia.org.au/library/Core_Assoc_Doc/Scope_of_Practice.pdf. Accessed 19 March 2015

35.

Brown T, Findlay M, Dincklage J, Davidson W, Hill J, Isenring E, Talwar B, Bell K, Kiss N, Kurmis R, Loeliger J, Sandison A, Taylor K, Bauer J (2013) Using a wiki platform to promote guidelines internationally and maintain their currency: evidence‐based guidelines for the nutritional management of adult patients with head and neck cancer. J Hum Nutr Diet 26(2):182–190. doi:10.1111/jhn.12036

36.

Velikova G, Booth L, Smith AB, Brown PM, Lynch P, Brown JM, Selby PJ (2004) Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol 22(4):714–724CrossRefPubMed

37.

Wall L, Ward E, Cartmill B, Hill A (2013) Technology-assisted screening of patient-reported functional outcomes in the head and neck cancer population: what’s the evidence? Open Access Cancer 1(2):13–20

38.

Abbott J, Teleni L, McKavanagh D, Watson J, McCarthy A, Isenring E (2014) A novel, automated nutrition screening system as a predictor of nutritional risk in an oncology day treatment unit (ODTU). Support Care Cancer 22(8):2107–2112. doi:10.1007/s00520-014-2210-7 CrossRefPubMed

Titel: Evaluation of a weekly speech pathology/dietetic service model for providing supportive care intervention to head and neck cancer patients and their carers during (chemo)radiotherapy
verfasst von: Laurelie R. Wall
Bena Cartmill
Elizabeth C. Ward
Anne J. Hill
Elizabeth Isenring
Sandro V. Porceddu
Publikationsdatum: 01.03.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 3/2016
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-015-2912-5

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Evaluation of a weekly speech pathology/dietetic service model for providing supportive care intervention to head and neck cancer patients and their carers during (chemo)radiotherapy