Distress, concerns and unmet needs in survivors of head and neck cancer: a cross-sectional survey

Abstract

The aim of this study was to identify the distress, unmet needs and concerns of head and neck cancer (HNC) survivors in the first 5 years after treatment. Two hundred and eighty HNC survivors from three Scottish health boards responded to a cross-sectional postal survey in 2011. Questionnaires included the Distress Thermometer, Patient Concerns Inventory (PCI) and an adapted version of the PCI to measure unmet needs. One-third of the survivors had moderate or severe levels of distress, and 74% had at least one unmet need. The most common concerns and unmet needs included oral and eating problems, fear of recurrence and fatigue. Multivariate analysis revealed that being younger, out of work (not retired), ever having had a feeding tube fitted, having a greater number of comorbidities and living alone were associated with higher levels of distress, concerns and unmet needs. The diversity of concerns and unmet needs identified in this study highlights the importance of holistic needs assessment as part of follow-up care for HNC survivors with tailoring of support for particular concerns. Specific information resources and self-management strategies are required to help HNC survivors with the practical and functional consequences of HNC treatment.

Unmet supportive care needs in patients treated with total laryngectomy and its associated factors

“…[1][2][3][4] This is higher than the 25% found among Dutch mixed patients with cancer. [1][2][3][4] This is higher than the 25% found among Dutch mixed patients with cancer.…”

“…[1][2][3][4] This is higher than the 25% found among Dutch mixed patients with cancer. [2][3][4][6][7][8][9][10][11][12][13] In addition, head and neck cancer-specific supportive care needs are often reported, for instance, dry mouth, dental health, eating, and speech problems. [2][3][4][6][7][8][9][10][11][12][13] In addition, head and neck cancer-specific supportive care needs are often reported, for instance, dry mouth, dental health, eating, and speech problems.…”

“…In addition, the association of sociodemographic, clinical and lifestyle factors, and health-related quality of life (HR-QOL) with unmet needs was investigated. Age, 2,9,19 sex, [2][3][4]7,19 having children, 3 education level, 2 smoking status, 2,4,10 and alcohol consumption 2,4 were not expected to be associated with unmet needs. In addition, living alone, 4 being unemployed, 10 and more intensive types of treatment 2,10,19 were hypothesized to be associated with a higher prevalence of unmet needs.…”

“…[2][3][4][6][7][8][9][10][11][12][13] In addition, head and neck cancer-specific supportive care needs are often reported, for instance, dry mouth, dental health, eating, and speech problems. 3,4,9,11,13 Patients with head and neck cancer who specifically may have a high need for supportive care are patients treated with total laryngectomy. 3,4,9,11,13 Patients with head and neck cancer who specifically may have a high need for supportive care are patients treated with total laryngectomy.…”

Development and feasibility of an electronic-Swallowing Intervention Package (e-SiP) to support swallowing function in patients with head and neck cancer (Preprint)

“…In Scotland the rates of HNC are almost 40% higher than in England [2].There is a link between HNC and the presence of the human papillomavirus (HPV), and HPV-positive cases now account for around 30-65% of HNCs [3]. The demographic of HNC is therefore changing, as patients who are positive for the human papillomavirus tend to be younger at diagnosis, generally have a higher socioeconomic status and better education, and a better prognosis (despite often presenting at a more advanced stage of cancer) than patients with HPV-negative HNCs [3][4][5]. Younger age at diagnosis and improved treatment effectiveness mean that more people are now living with the consequences of HNC and its treatment.…”