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Head and neck cancer patients want us to support them psychologically in the posttreatment period: Survey results

Published online by Cambridge University Press:  24 October 2013

Melissa Henry ,
Laura-Anne Habib ,
Matthew Morrison ,
Ji Wei Yang ,
Xuejiao Joanna Li ,
Shiru Lin ,
Anthony Zeitouni ,
Richard Payne ,
Christina MacDonald  and
Alexander Mlynarek
...Show all authors
Melissa Henry*
Affiliation:
McGill University, Montreal, Quebec, Canada
Laura-Anne Habib
Affiliation:
McGill University, Montreal, Quebec, Canada
Matthew Morrison
Affiliation:
McGill University, Montreal, Quebec, Canada
Ji Wei Yang
Affiliation:
McGill University, Montreal, Quebec, Canada
Xuejiao Joanna Li
Affiliation:
McGill University, Montreal, Quebec, Canada
Shiru Lin
Affiliation:
McGill University, Montreal, Quebec, Canada
Anthony Zeitouni
Affiliation:
McGill University, Montreal, Quebec, Canada McGill University Health Centre, Montreal, Quebec, Canada
Richard Payne
Affiliation:
McGill University, Montreal, Quebec, Canada Jewish General Hospital, Montreal, Quebec, Canada McGill University Health Centre, Montreal, Quebec, Canada
Christina MacDonald
Affiliation:
McGill University, Montreal, Quebec, Canada Jewish General Hospital, Montreal, Quebec, Canada
Alexander Mlynarek
Affiliation:
McGill University, Montreal, Quebec, Canada Jewish General Hospital, Montreal, Quebec, Canada
Karen Kost
Affiliation:
McGill University, Montreal, Quebec, Canada McGill University Health Centre, Montreal, Quebec, Canada
Martin Black
Affiliation:
McGill University, Montreal, Quebec, Canada Jewish General Hospital, Montreal, Quebec, Canada
Michael Hier
Affiliation:
McGill University, Montreal, Quebec, Canada Jewish General Hospital, Montreal, Quebec, Canada
*
Address correspondence and reprint requests to: Melissa Henry, Jewish General Hospital, 3755 Côte Ste. Catherine Road, Pavilion E, Room E-904, Montreal, Quebec, Canada, H3T 1E2. E-mail: [email protected]
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Abstract

Objectives:

No study systematically has investigated the supportive care needs of general head and neck cancer patients using validated measures. These needs include physical and daily living needs, health system and information needs, patient care and support needs, psychological needs, and sexuality needs. Identifying the unmet needs of head and neck cancer patients is a necessary first step to improving the care we provide to patients seen in our head and neck oncology clinics. It is recommended as the first step in intervention development in the Pan-Canadian Clinical Practice Guideline of the Canadian Partnership Against Cancer (see Howell, 2009). This study aimed to identify: (1) met and unmet supportive care needs of head and neck cancer patients, and (2) variability in needs according to demographics, disease variables, level of distress, and quality-of-life domains.

Methods:

Participants were recruited from the otolaryngology–head and neck surgery clinics of two university teaching hospitals. Self-administered questionnaires included sociodemographic and medical questions, as well as validated measures such as the Supportive Care Needs Survey–Short Form (SCNS-SF34), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy–General (FACT-G) and Head and Neck Module (FACT-H&N) (quality of life measures).

Results:

One hundred and twenty-seven patients participated in the survey. 68% of them experienced unmet needs, and 25% revealed a clinically significant distress level on the HADS. The highest unmet needs were psychological (7 of top 10 needs). A multiple linear regression indicated a higher level of overall unmet needs when patients were divorced, had a high level of anxiety (HADS subscale), were in poor physical condition, or had a diminished emotional quality of life (FACT-G subscales).

Significance of results:

The results of this study highlight the overwhelming presence of unmet psychological needs in head and neck cancer patients and underline the importance of implementing interventions to address these areas perceived by patients as important. In line with hospital resource allocation and cost-effectiveness, one may also contemplate screening patients for high levels of anxiety, as well as target patients who are divorced and present low levels of physical well-being, as these patients may have more overall needs to be met.

Keywords

Head and neck cancerSupportive care needsPosttreatmentOutpatientPsychological
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 6 , December 2014 , pp. 481 - 493
Copyright
Copyright © Cambridge University Press 2013 

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References

REFERENCES

Allal, A.S., Nicoucar, K., Mach, N., et al. (2003). Quality of life in patients with oropharynx carcinomas: Assessment after accelerated radiotherapy with or without chemotherapy versus radical surgery and postoperative radiotherapy. Head & Neck, 25, 833–840.Google Scholar
Allison, P.J., Edgar, L., Nicolau, B., et al. (2004). Results of a feasibility study for a psychoeducational intervention in head and neck cancer. Psycho-Oncology, 13(7), 482–485.CrossRefGoogle ScholarPubMed
Arcavi, L. & Benowitz, N.L. (2004). Cigarette smoking and infection. Archives of Internal Medicine, 164(20), 2206–2216.CrossRefGoogle ScholarPubMed
Bertrand, P.C., Piquet, M.A., Bordier, I., et al. (2002). Preoperative nutritional support at home in head and neck cancer patients: From nutritional benefits to the prevention of the alcohol withdrawal syndrome. Current Opinion in Clinical Nutrition and Metabolic Care, 5(4), 435–440.Google Scholar
Bjordal, K., Ahlner-Elmqvist, M. & Hammerlid, E. (2001). A prospective study of quality of life in head and neck cancer patients, part II: Longitudinal data. Laryngoscope, 111, 1440–1452.Google Scholar
Bonevski, B., Sanson-Fisher, R., Girgis, A., et al. (2000). Evaluation of an instrument to assess the needs of patients with cancer. Cancer, 88(1), 217–225.Google Scholar
Boyes, A., Girgis, A. & Lecathelinais, C. (2009). Brief assessment of adult cancer patients' perceived needs: Development and validation of the 34-item Supportive Care Needs Survey (SCNS-SF34). Journal of Evaluation in Clinical Practice, 15, 602–606.Google Scholar
Boyes, A., Hall, A., Zucca, A., et al. (2010). Supportive care needs survey, supplement 2: Reference data for cancer survivors 5–9 months post-diagnosis. Newcastle: Centre for Health Research & Psycho-Oncology.Google Scholar
Bredart, A., Kop, J.L., Griesser, A.C., et al. (2012). Validation of the 34-item Supportive Care Needs Survey and 8-item Breast Module French versions (SCNS-SF34-Fr and SCNS-BR8-Fr) in breast cancer patients. European Journal of Cancer Care, 21(4), 450–459.CrossRefGoogle ScholarPubMed
Brintzenhofe-Szoc, K.M., Levin, T.T., Li, Y., et al. (2009). Mixed anxiety/depression symptoms in a large cancer cohort: Prevalence by cancer type. Psychosomatics: Journal of Consultation and Liaison Psychiatry, 50(4), 383–391.Google Scholar
Campbell, B.H., Marbella, A. & Layde, P.M. (2000). Quality of life and recurrence concern in survivors of head and neck cancer. Laryngoscope, 110, 895–906.Google Scholar
Canadian Cancer Society (2011). Canadian cancer statistics 2011. Toronto. ISSN 0835-2976.Google Scholar
Cella, D.F., Tulsky, D.S., Gray, G., et al. (1993). The Functional Assessment of Cancer Therapy Scale: Development and validation of the general measure. Journal of Clinical Oncology, 11, 570–579.Google Scholar
Chen, S.C., Lai, Y.H., Liao, C.T., et al. (2009 a). Unmet information needs and preferences in newly diagnosed and surgically treated oral cavity cancer patients. Oral Oncology, 45(11), 946–952.CrossRefGoogle ScholarPubMed
Chen, S.C., Liao, C.T., Lin, C.C., et al. (2009 b). Distress and care needs in newly diagnosed oral cavity cancer patients receiving surgery. Oral Oncology, 45(9), 815–820.Google Scholar
Chen, S.C., Tsai, M.C., Liu, C.L., et al. (2009 c). Support needs of patients with oral cancer and burden to their family caregivers. Cancer Nursing, 32(6), 473–481.CrossRefGoogle ScholarPubMed
Chen, S.C., Yu, W.P., Chu, T.L., et al. (2010). Prevalence and correlates of supportive care needs in oral cancer patients with and without anxiety during the diagnostic period. Cancer Nursing, 33(4), 280–289.Google Scholar
Chen, A.M., Chen, L.M., Vaughan, A., et al. (2011 a). Tobacco smoking during radiation therapy for head-and-neck cancer is associated with unfavorable outcome. International Journal of Radiation Oncology, Biology, Physics, 79(2), 414–419.Google Scholar
Chen, S.C., Lai, Y.H., Cheng, S.Y., et al. (2011 b). Psychometric testing of the Chinese-version cancer needs questionnaire short form head and neck cancer-specific version in oral cavity cancer patients. Supportive Care in Cancer, 19(5), 647–656.CrossRefGoogle ScholarPubMed
de Graeef, A., de Leeuw, J.R.J., Ros, W.J.G., et al. (2000). Pretreatment factors predicting quality of life after treatment for head and neck cancer. Head & Neck, 22, 398–407.Google Scholar
de Leeuw, J.R.J., de Graeff, A., Ros, W.J.G., et al. (2001). Prediction of depression 6 months to 3 years after treatment of head and neck cancer. Head & Neck, 23, 892–898.CrossRefGoogle ScholarPubMed
Devin, G.M., Otto, K.J., Irish, J.C., et al. (2010). Head and neck cancer. In Psycho-Oncology, Holland, J.C. et al. (eds.), pp. 135–139. New York: Oxford University Press.Google Scholar
Duffy, S.A., Ronis, D.L., Valenstein, M., et al. (2006). A tailored smoking, alcohol, and depression intervention for head and neck cancer patients. Cancer Epidemiology, Biomarkers & Prevention, 15(11), 2203–2208.Google Scholar
Duffy, S.A., Ronis, D.L., Valenstein, M., et al. (2007). Depressive symptoms, smoking, drinking, and quality of life among head and neck cancer patients. Psychosomatics, 48(2), 142–148.Google Scholar
Falciglia, G.A., Whittle, K.M., Levin, L.S., et al. (2005). A clinical-based intervention improves diet in patients with head and neck cancer at risk for second primary cancer. Journal of the American Dietetic Association, 105(10), 1609–1612.Google Scholar
Goodwin, S.J., McCarthy, C.M., Pusic, A.L., et al. (2005). Complication in smokers after postmastectomy tissue expander/implant breast reconstruction. Annals of Plastic Surgery, 55, 16–19.Google Scholar
Gritz, E.R., Schacherer, C., Koehly, L., et al. (1999). Smoking withdrawal and relapse in head and neck cancer patients. Head & Neck, 21(5), 420–427.Google Scholar
Hammerlid, E. & Taft, C. (2001). Health-related quality of life in long-term head and neck cancer survivors: A comparison with general population norms. British Journal of Cancer, 84, 149–156.Google Scholar
Hammerlid, E., Ahlner-Elmqvist, M., Bjordal, K., et al. (1999 a). A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients. British Journal of Cancer, 80, 766–774.Google Scholar
Hammerlid, E., Persson, L.O., Sullivan, M., et al. (1999 b). Quality-of-life effects of psychosocial intervention in patients with head and neck cancer. Otolaryngology—Head and Neck Surgery, 120(4), 507–516.Google Scholar
Hammerlid, E., Silander, E., Hornestam, L., et al. (2001). Health-related quality of life three years after diagnosis of head and neck cancer: A longitudinal study. Head & Neck, 23, 113–125.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Harrison, J.D., Young, J.M., Price, M.A., et al. (2009). What are the supportive care needs of people with cancer? A systematic review. Supportive Care Cancer, 17, 1117–1128.Google Scholar
Hassanein, K.A., Musgrove, B.T. & Bradbury, E. (2001). Functional status of patients with oral cancer and its relation to style of coping, social support and psychological status. British Journal of Oral Maxillofacial Surgery, 39, 340–345.Google Scholar
Head, B.A., Studts, J.L., Bumpous, J.M., et al. (2009). Development of a telehealth intervention for head and neck cancer patients. Telemedicine Journal and E-Health, 15(1), 44–52.Google Scholar
Health Canada (2001). Language barriers in access to health care. Retrieved online October 10, 2012 from: http://www.hc-sc.gc.ca/hcs-sss/alt_formats/hpb-dgps/pdf/pubs/2001-lang-acces/2001-lang-acces-eng.pdf.Google Scholar
Hem, E., Loge, J.H., Haldorsen, T., et al. (2004). Suicide risk in cancer patients from 1960 to 1999. Journal of Clinical Oncology, 26, 4209–4216.Google Scholar
Hopwood, P., Howell, A. & Maguire, P. (1991). Screening for psychiatric morbidity in patients with advanced breast cancer: Validation of two self-report questionnaires. British Journal of Cancer, 64, 353–356.Google Scholar
Howell, D., Currie, S., Mayo, S., et al. (2009). A pan-Canadian clinical practice guideline: Assessment of psychosocial health care needs of the adult cancer patient. Toronto: Canadian Partnership Against Cancer (Cancer Journey Action Group) and the Canadian Association of Psychosocial Oncology.Google Scholar
Humphris, G. & Ozakinci, G. (2008). The AFTER intervention: A structured psychological approach to reduce fears of recurrence in patients with head and neck cancer. British Journal of Health Psychology, 13(2), 223–230.Google Scholar
Humphris, G. & Rogers, S.N. (2012). AFTER and beyond: Cancer recurrence fears and a test of an intervention in oral and oropharyngeal patients. Social Science and Dentistry, 2(1), 29–38.Google Scholar
Isenring, E., Capra, S. & Bauer, J. (2004 a). Patient satisfaction is rated higher by radiation oncology outpatients receiving nutrition intervention compared with usual care. Journal of Human Nutrition and Dietetics, 17(2), 145–152.Google Scholar
Isenring, E.A., Capra, S. & Bauer, J.D. (2004 b). Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area. British Journal of Cancer, 91(3), 447–452.Google Scholar
Jensen, K., Jensen, A.B. & Grau, C. (2007). Smoking has a negative impact upon health-related quality of life after treatment for head and neck cancer. Oral Oncology, 43(2), 187–192.Google Scholar
Katz, M.R., Irish, J.C., Devins, et al. (2003). Psychosocial adjustment in head and neck cancer: The impact of disfigurement, gender and social support. Head & Neck, 25, 103–112.CrossRefGoogle ScholarPubMed
Kugaya, A., Akechi, T., Okuyama, T., et al. (2000). Prevalence, predictive factors, and screening for psychologic distress in patients with newly diagnosed head and neck cancer. Cancer, 88, 2817–2823.Google Scholar
Ledeboer, Q.C.P., van der Verden, L.A., de Boer, M.F., et al. (2005). Physical and psychosocial correlates of head and neck cancer: An update of the literature and challenges for the future (1996–2003). Clinical Otolaryngology, 30, 303–319.CrossRefGoogle ScholarPubMed
Leon, X., Del Prado Venegas, M., Orus, C., et al. (2009). Influence of the persistence of tobacco and alcohol use in the appearance of second neoplasm in patients with a head and neck cancer: A case-control study. Cancer Causes & Control, 20(5), 645–652.Google Scholar
List, M.A., D'Antonio, L.L., Cella, D.F., et al. (1996). The Performance Status Scale for Head and Neck Cancer Patients and the Functional Assessment of Cancer Therapy–Head and Neck (FACT-H&N) Scale: A study of utility and validity. Cancer, 77, 2294–2301.Google Scholar
Lydiatt, W., Moran, J. & Burke, W.J. (2009). A review of depression in the head and neck cancer patient. Clinical Advances in Hematology & Oncology, 7(6), 397–403.Google Scholar
McElduff, P., Boyes, A., Zucca, A., et al. (2004). The Supportive Care Needs Survey: A guide to administration, scoring and analysis. Newcastle: Centre for Health Research and Psycho-Oncology.Google Scholar
McNeely, M.L. (2008). Exercise rehabilitation for breast and head and neck cancer survivors. Dissertation Abstracts International: Section B: The Sciences and Engineering, 68(10-B), 6627.Google Scholar
Mehanna, H., Paleri, V., West, C.M.L., et al. (2010). Head and neck cancer, part 1: Epidemiology, presentation, and prevention. British Medical Journal, 341, c4684.Google Scholar
Miller, W.R. & Rollnick, S. (1991). Motivational interviewing: Preparing people to change addictive behavior. New York: The Guilford Press.Google Scholar
Miyamoto, Y. & Ryff, C. (2011). Cultural differences in the dialectical and non-dialectical emotional styles and their implications for health. Cognition and Emotion, 25, 22–30.Google Scholar
Olstad, R., Sexton, H. & Soogard, A.J. (2001). The Finmark study: A prospective population study of the social support buffer hypothesis, specific stressors and mental distress. Social Psychiatry and Psychiatric Epidemiology, 36(12), 582–589.Google Scholar
Ostroff, J., Ross, S., Steinglass, P., et al. (2004). Interest in and barriers to participation in multiple family groups among head and neck cancer survivors and their primary family caregivers. Family Process, 43(2), 195–208.Google Scholar
Perry, A.R., Shaw, M.A. & Cotton, S. (2003). An evaluation of functional outcomes (speech, swallowing) in patients attending speech pathology after head and neck cancer treatment(s): Results and analysis at 12 months post-intervention. Journal of Laryngology & Otology, 117(5), 368–381.Google Scholar
Public Health Agency of Canada (2009). Cancer surveillance online. Retrieved online December 9 from: http://dsol-smed.hc-sc.gc.ca/dsol-smed/index.html.Google Scholar
Quebec Government (2002). Rural Canada: Access to health care. Retrieved online October 10, 2012 from: http://www.publications.gc.ca/collections/Collection-R/LoPBdP/BP/prb0245-e.htm.Google Scholar
Razavi, D., Delvaux, N., Bredart, A., et al. (1992). Screening for psychiatric disorders in lymphoma outpatient population. European Journal of Cancer, 28, 1869–1872.Google Scholar
Sanson-Fisher, R., Boyes, A., Girgis, A., et al. (2000). The unmet supportive care needs of patients with cancer. Cancer, 88(1), 226–237.Google Scholar
Semple, C.J., Dunwoody, L., Kernohan, W.G., et al. (2009). Development and evaluation of a problem-focused psychosocial intervention for patients with head and neck cancer. Supportive Care in Cancer, 17(4), 379–388.CrossRefGoogle ScholarPubMed
Sobin, L.H., Gospodarowicz, M.K. & Wittekind, C. (2010). TNM Classification of malignant tumours, 7th ed.Hoboken, NJ: Blackwell Publishing.Google Scholar
Streiner, D.L. & Norman, G.R. (2008). Health measurement scales: A practical guide to their development and use. New York: Oxford University Press.Google Scholar
Tavio, M., Milan, I. & Tirelli, U. (2002). Cancer-related fatigue. International Journal of Oncology, 21(5), 1093–1099.Google Scholar
Tromp, D.M., Brouha, X.D.R., Hordijk, G.J., et al. (2005). Medical care-seeking and health-risk behavior in patients with head and neck cancer: The role of health value, control beliefs and psychological distress. Health Education Research, 20(6), 665–675.Google Scholar
Van Der Meulen, I.C., May, A.M., Ros, W.J.G., et al. (2013). One-year effect of a nurse-led psychosocial intervention on depressive symptoms in patients with head and neck cancer: A randomized controlled trial. The Oncologist, 18(3), 336–344.Google Scholar
Vilela, L.D., Nicolau, B., Mahmud, S., et al. (2006). Comparison of psychosocial outcomes in head and neck cancer patients receiving a coping strategies intervention and control subjects receiving no intervention. Journal of Otolaryngology, 35(2), 88–96.Google Scholar
Yousaf, U., Christensen, M.L., Engholm, G., et al. (2005). Suicides among Danish cancer patients, 1971–1999. British Journal of Cancer, 92, 995–1000.CrossRefGoogle ScholarPubMed
Zabora, J., Brintzenhofe-Szoc, K., Curbow, B., et al. (2001). The prevalence of psychological distress by cancer site. Psycho-Oncology, 10, 19–28.Google Scholar
Zaza, C. & Baine, N. (2002). Cancer pain and psychosocial factors. Journal of Pain and Symptom Management, 24(5), 526–542.Google Scholar
Zigmond, A.S. & Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed