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27.01.2022 | Original Article

Needs assessment in patients surgically treated for head and neck cancer—a randomized controlled trial

verfasst von: Annelise Mortensen, Irene Wessel, Simon N. Rogers, Anders Tolver, Mary Jarden

Erschienen in: Supportive Care in Cancer | Ausgabe 5/2022

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Abstract

Purpose

To investigate the effect and feasibility of a head and neck cancer–specific needs assessment tool integrated into nursing rehabilitation consultations early in the post-surgical period on quality of life, symptom burden, and referrals for multidisciplinary follow-up.

Methods

Ninety-two surgically treated patients with head and neck cancer were enrolled in a two-arm randomized controlled trial. All participants received nursing rehabilitation consultations prior to discharge, and two weeks and two months post-operative. The intervention group had their needs assessed using Patient Concerns Inventory, while standard care used a systematic questioning approach. Primary outcome was quality of life. Secondary outcomes were symptom burden and referrals for multidisciplinary rehabilitation follow-up.

Results

No significant differences were found in quality of life or symptom burden between groups. However, 35% more patients in the intervention group were referred for rehabilitation. The attrition rate was similar in both groups, with a dropout rate of six in each group. No patients declined using the Patient Concerns Inventory.

Conclusion

The intervention showed no improvement in QoL or symptom burden compared to standard care. However, the results suggest that important needs were identified and addressed. Especially emotional and existential needs, which were accommodated through referrals and professional advice. Nursing rehabilitation consultations using the Patient Concerns Inventory are feasible and may ensure that patient preferences and priorities are incorporated in their care.

Trial registration

ClinicalTrials.com (NCT03443258). Date of registration: May 31st, 2018.
Literatur
1.
Zurück zum Zitat Mortensen A, Jarden M (2016) “Early and late physical and psychosocial effects of primary surgery in patients with oral and oropharyngeal cancers: a systematic review,” Oral Surg Oral Med Oral Pathol Oral Radiol, vol. 121, no. 6 Mortensen A, Jarden M (2016) “Early and late physical and psychosocial effects of primary surgery in patients with oral and oropharyngeal cancers: a systematic review,” Oral Surg Oral Med Oral Pathol Oral Radiol, vol. 121, no. 6
2.
Zurück zum Zitat Nelke KH, Pawlak W, Gerber H, Leszczyszyn J (2014) Head and neck cancer patients’ quality of life. Adv Clin Exp Med 23(6):1019–1027CrossRef Nelke KH, Pawlak W, Gerber H, Leszczyszyn J (2014) Head and neck cancer patients’ quality of life. Adv Clin Exp Med 23(6):1019–1027CrossRef
3.
Zurück zum Zitat Ringash J (2015), “Survivorship and quality of life in head and neck cancer,” J Clin Oncol Ringash J (2015), “Survivorship and quality of life in head and neck cancer,” J Clin Oncol
4.
Zurück zum Zitat Nguyen NTA, Ringash J (2018) “Head and neck cancer survivorship care: a review of the current guidelines and remaining unmet needs,” Curr Treat Options Oncol, vol. 19, no. 8 Nguyen NTA, Ringash J (2018) “Head and neck cancer survivorship care: a review of the current guidelines and remaining unmet needs,” Curr Treat Options Oncol, vol. 19, no. 8
5.
Zurück zum Zitat Giuliani M (2016) “Prevalence and nature of survivorship needs in patients with head and neck cancer,” Head Neck, vol. July, pp. 1097–1103 Giuliani M (2016) “Prevalence and nature of survivorship needs in patients with head and neck cancer,” Head Neck, vol. July, pp. 1097–1103
6.
Zurück zum Zitat Ringash J, et al. (2018) “Head and neck cancer survivorship: learning the needs, meeting the needs,” in Seminars in Radiation Oncology Ringash J, et al. (2018) “Head and neck cancer survivorship: learning the needs, meeting the needs,” in Seminars in Radiation Oncology
7.
Zurück zum Zitat Ba Murphy, Gilbert J (2009) Dysphagia in head and neck cancer patients treated with radiation: assessment, sequelae, and rehabilitation. Semin Radiat Oncol 19(1):35–42CrossRef Ba Murphy, Gilbert J (2009) Dysphagia in head and neck cancer patients treated with radiation: assessment, sequelae, and rehabilitation. Semin Radiat Oncol 19(1):35–42CrossRef
8.
Zurück zum Zitat Danish Health Authority (2018) Forløbsprogram for rehabilitering og palliation i forbindelse med kraeft (Guideline for rehabilitation and Palliation in Cancer). Danish Health Authority (2018) Forløbsprogram for rehabilitering og palliation i forbindelse med kraeft (Guideline for rehabilitation and Palliation in Cancer).
10.
Zurück zum Zitat Hansson E, Carlström E, Olsson LE, Nyman J, Koinberg I (2017) Can a person-centred-care intervention improve health-related quality of life in patients with head and neck cancer? A randomized, controlled study. BMC Nurs 16(1):1–12CrossRef Hansson E, Carlström E, Olsson LE, Nyman J, Koinberg I (2017) Can a person-centred-care intervention improve health-related quality of life in patients with head and neck cancer? A randomized, controlled study. BMC Nurs 16(1):1–12CrossRef
11.
Zurück zum Zitat Van Der Meulen IC et al (2014) 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 110(3):593–601CrossRef Van Der Meulen IC et al (2014) 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 110(3):593–601CrossRef
12.
Zurück zum Zitat Rogers S, Barber B (2017) Using PROMs to guide patients and practitioners through the head and neck cancer journey. Patient Relat Outcome Meas 8:133–142CrossRef Rogers S, Barber B (2017) Using PROMs to guide patients and practitioners through the head and neck cancer journey. Patient Relat Outcome Meas 8:133–142CrossRef
13.
Zurück zum Zitat Rogers SN, Lowe D, Brown JS, Vaughan ED (1999) The University of Washington head and neck cancer measure as a predictor of outcome following primary surgery for oral cancer. Head Neck 21(5):394–401CrossRef Rogers SN, Lowe D, Brown JS, Vaughan ED (1999) The University of Washington head and neck cancer measure as a predictor of outcome following primary surgery for oral cancer. Head Neck 21(5):394–401CrossRef
14.
Zurück zum Zitat Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the Hospital Anxiety and Depression Scale. J Psychosom Res 52(2):69–77CrossRef Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the Hospital Anxiety and Depression Scale. J Psychosom Res 52(2):69–77CrossRef
15.
Zurück zum Zitat Rosenthal DI (2007) Measuring head and neck cancer symptom burden: the development and validation of the M. D. Anderson symptom inventory, Head and Neck module. Head Neck 29(10):923–931CrossRef Rosenthal DI (2007) Measuring head and neck cancer symptom burden: the development and validation of the M. D. Anderson symptom inventory, Head and Neck module. Head Neck 29(10):923–931CrossRef
16.
Zurück zum Zitat Shunmugasundaram C, Rutherford C, Butow PN, Sundaresan P, Dhillon HM (2019) Content comparison of unmet needs self-report measures used in patients with head and neck cancer: a systematic review. Psychooncology 28(12):2295–2306CrossRef Shunmugasundaram C, Rutherford C, Butow PN, Sundaresan P, Dhillon HM (2019) Content comparison of unmet needs self-report measures used in patients with head and neck cancer: a systematic review. Psychooncology 28(12):2295–2306CrossRef
17.
Zurück zum Zitat Rogers SN, Ahiaku S, Lowe D (2018) Is routine holistic assessment with a prompt list feasible during consultations after treatment for oral cancer ? Br J Oral Maxillofac Surg 56(1):24–28CrossRef Rogers SN, Ahiaku S, Lowe D (2018) Is routine holistic assessment with a prompt list feasible during consultations after treatment for oral cancer ? Br J Oral Maxillofac Surg 56(1):24–28CrossRef
18.
Zurück zum Zitat Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381CrossRef Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381CrossRef
19.
Zurück zum Zitat Ribeiro K, Kowalski LP (2003) APACHE II, POSSUM and ASA scores and the risk of perioperative complications in patients with oral or oropharyngeal cancer. Arch Otolaryngol Neck Surg 129:739–745CrossRef Ribeiro K, Kowalski LP (2003) APACHE II, POSSUM and ASA scores and the risk of perioperative complications in patients with oral or oropharyngeal cancer. Arch Otolaryngol Neck Surg 129:739–745CrossRef
21.
Zurück zum Zitat Ren J, et al. (2021) “Longitudinal health utility and symptom-tocixity trajectories in patients with head and neck cancer,” Cancer, vol. October 1, 2021. Ren J, et al. (2021) “Longitudinal health utility and symptom-tocixity trajectories in patients with head and neck cancer,” Cancer, vol. October 1, 2021.
22.
Zurück zum Zitat Allen-Ayodabo CO et al (2019) Symptom burden among head and neck cancer patients in the first year after diagnosis: association with primary treatment modality. Oral Oncol. 99(June):104434CrossRef Allen-Ayodabo CO et al (2019) Symptom burden among head and neck cancer patients in the first year after diagnosis: association with primary treatment modality. Oral Oncol. 99(June):104434CrossRef
23.
Zurück zum Zitat Rogers SN, El-Sheikha J, Lowe D (2009) The development of a Patients Concerns Inventory (PCI) to help reveal patients concerns in the head and neck clinic. Oral Oncol 45(7):555–561CrossRef Rogers SN, El-Sheikha J, Lowe D (2009) The development of a Patients Concerns Inventory (PCI) to help reveal patients concerns in the head and neck clinic. Oral Oncol 45(7):555–561CrossRef
24.
Zurück zum Zitat Dwamena and Fortin (2012) Smith’s Patient Centered Interviewing, 3rd ed. McGraw-Hill Education Medical Dwamena and Fortin (2012) Smith’s Patient Centered Interviewing, 3rd ed. McGraw-Hill Education Medical
25.
Zurück zum Zitat Aaronson NK (1993) The European Organisation for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRef Aaronson NK (1993) The European Organisation for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRef
26.
Zurück zum Zitat Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of- life scores. J Clin Oncol 16(1):139–144CrossRef Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of- life scores. J Clin Oncol 16(1):139–144CrossRef
27.
Zurück zum Zitat Cleeland CS (2007) Symptom burden: multiple symptoms and their impact as patient-reported outcomes. J Natl Cancer Inst Monogr 77030(37):16–21CrossRef Cleeland CS (2007) Symptom burden: multiple symptoms and their impact as patient-reported outcomes. J Natl Cancer Inst Monogr 77030(37):16–21CrossRef
28.
Zurück zum Zitat Cleeland CS, Mendoza TR (2011) Cancer Symptom Science. Measurement, Mechanisms and Management, 1st ed. New York: Cambridge University Press Cleeland CS, Mendoza TR (2011) Cancer Symptom Science. Measurement, Mechanisms and Management, 1st ed. New York: Cambridge University Press
29.
Zurück zum Zitat Charlson M (1987) A new method of classification of prognostic comorbidity for longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRef Charlson M (1987) A new method of classification of prognostic comorbidity for longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRef
30.
Zurück zum Zitat Bowen DJ et al (2009) How we design feasibility studies. Am J Prev Med 36(5):452–457CrossRef Bowen DJ et al (2009) How we design feasibility studies. Am J Prev Med 36(5):452–457CrossRef
31.
Zurück zum Zitat Carrillo JF (2016) The impact of treatment on quality of life of patients with head and neck cancer and its association with prognosis. J Cancer Surg 42(2016):1614–1621 Carrillo JF (2016) The impact of treatment on quality of life of patients with head and neck cancer and its association with prognosis. J Cancer Surg 42(2016):1614–1621
32.
Zurück zum Zitat R Core Team, “R: a language and environment for statistical computing.” R Foundation for Statistical Computing, Vienna, 2013. R Core Team, “R: a language and environment for statistical computing.” R Foundation for Statistical Computing, Vienna, 2013.
33.
Zurück zum Zitat Rogers SN, Thomson F, Lowe D (2018) The Patient Concerns Inventory integrated as part of routine head and neck cancer follow-up consultations: frequency, case-mix, and items initiated by the patient. Ann R Coll Surg Engl 100(3):209–215CrossRef Rogers SN, Thomson F, Lowe D (2018) The Patient Concerns Inventory integrated as part of routine head and neck cancer follow-up consultations: frequency, case-mix, and items initiated by the patient. Ann R Coll Surg Engl 100(3):209–215CrossRef
34.
Zurück zum Zitat Bjordal K et al (2000) A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck patients. Eur J Cancer 36:1796–1807CrossRef Bjordal K et al (2000) A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck patients. Eur J Cancer 36:1796–1807CrossRef
35.
Zurück zum Zitat Kanatas A, Ghazali N, Lowe D, Rogers SN (2012) The identification of mood and anxiety concerns using the patients concerns inventory following head and neck cancer. Int J Oral Maxillofac Surg 41:429–436CrossRef Kanatas A, Ghazali N, Lowe D, Rogers SN (2012) The identification of mood and anxiety concerns using the patients concerns inventory following head and neck cancer. Int J Oral Maxillofac Surg 41:429–436CrossRef
36.
Zurück zum Zitat Ghazali N, Cadwallader E, Lowe D, Humphris G, Ozakinci G, Rogers SN (2013) “Fear of recurrence among head and neck cancer survivors: longitudinal trends,” Psychooncology, 22(4) Ghazali N, Cadwallader E, Lowe D, Humphris G, Ozakinci G, Rogers SN (2013) “Fear of recurrence among head and neck cancer survivors: longitudinal trends,” Psychooncology, 22(4)
37.
Zurück zum Zitat Protheroe J, Brooks H, Chew-Graham C, Gardner C, Rogers A (2013) ‘Permission to participate?’ A qualitative study of participation in patients from differing socio-economic backgrounds. J Health Psychol 18(8):1046–1055CrossRef Protheroe J, Brooks H, Chew-Graham C, Gardner C, Rogers A (2013) ‘Permission to participate?’ A qualitative study of participation in patients from differing socio-economic backgrounds. J Health Psychol 18(8):1046–1055CrossRef
38.
Zurück zum Zitat Singer S, et al. (2012) “Predictors of emotional distress in patients with head and neck cancer,” Head Neck, vol. February, pp. 180–187 Singer S, et al. (2012) “Predictors of emotional distress in patients with head and neck cancer,” Head Neck, vol. February, pp. 180–187
39.
Zurück zum Zitat Kjaer T et al (2016) Do we reach the patients with the most problems? Baseline data from the WebCan study among survivors of head-and-neck cancer, Denmark. J Cancer Surviv 10(2):251–260CrossRef Kjaer T et al (2016) Do we reach the patients with the most problems? Baseline data from the WebCan study among survivors of head-and-neck cancer, Denmark. J Cancer Surviv 10(2):251–260CrossRef
40.
Zurück zum Zitat Larsson M, Hedelin B, Athlin E (2007) A supportive nursing care clinic: conceptions of patients with head and neck cancer. Eur J Oncol Nurs 11(1):49–59CrossRef Larsson M, Hedelin B, Athlin E (2007) A supportive nursing care clinic: conceptions of patients with head and neck cancer. Eur J Oncol Nurs 11(1):49–59CrossRef
41.
Zurück zum Zitat Boyes H, Barraclough J, Ratansi R, Rogers SN, Kanatas A (2018) Structured review of the patient-reported outcome instruments used in clinical trials in head and neck surgery. Br J Oral Maxillofac Surg 56(3):161–167CrossRef Boyes H, Barraclough J, Ratansi R, Rogers SN, Kanatas A (2018) Structured review of the patient-reported outcome instruments used in clinical trials in head and neck surgery. Br J Oral Maxillofac Surg 56(3):161–167CrossRef
42.
Zurück zum Zitat Young J, Cund A, Renshaw M, Quigley A, Snowden A (2015) Improving the care of cancer patients: holistic needs assessment. Br J Nurs. 24(4):S 17-20CrossRef Young J, Cund A, Renshaw M, Quigley A, Snowden A (2015) Improving the care of cancer patients: holistic needs assessment. Br J Nurs. 24(4):S 17-20CrossRef
43.
Zurück zum Zitat Duman-Lubberding S et al (2017) Durable usage of patient-reported outcome measures in clinical practice to monitor health-related quality of life in head and neck cancer patients. Support Care Cancer 25(12):3775–3783CrossRef Duman-Lubberding S et al (2017) Durable usage of patient-reported outcome measures in clinical practice to monitor health-related quality of life in head and neck cancer patients. Support Care Cancer 25(12):3775–3783CrossRef
44.
Zurück zum Zitat Derks W, De Leeuw RJ, Hordijk GJ, Winnubst JA (2004) Quality of life in elderly patients with head and neck cancer one year after diagnosis. Head Neck 26(12):1045–1052CrossRef Derks W, De Leeuw RJ, Hordijk GJ, Winnubst JA (2004) Quality of life in elderly patients with head and neck cancer one year after diagnosis. Head Neck 26(12):1045–1052CrossRef
45.
Zurück zum Zitat Olsen MH et al (2015) Socioeconomic position and stage at diagnosis of head and neck cancer - a nationwide study from DAHANCA. Acta Oncol 54(5):759–766CrossRef Olsen MH et al (2015) Socioeconomic position and stage at diagnosis of head and neck cancer - a nationwide study from DAHANCA. Acta Oncol 54(5):759–766CrossRef
46.
Zurück zum Zitat Winn DM et al (2015) The INHANCE consortium: toward a better understanding of the causes and mechanisms of head and neck cancer. Oral Dis 21(6):685–693CrossRef Winn DM et al (2015) The INHANCE consortium: toward a better understanding of the causes and mechanisms of head and neck cancer. Oral Dis 21(6):685–693CrossRef
Metadaten
Titel
Needs assessment in patients surgically treated for head and neck cancer—a randomized controlled trial
verfasst von
Annelise Mortensen
Irene Wessel
Simon N. Rogers
Anders Tolver
Mary Jarden
Publikationsdatum
27.01.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 5/2022
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-021-06759-9

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