Do the elderly raise different issues when using the Patient Concerns Inventory in routine head and neck cancer follow-up clinics?

Abstract

Head and Neck (H&N) cancer treatment can have a major detrimental impact on patient lives, and these issues can go unrecognised and be inadequately addressed. The aim of this paper is to compare the Patient Concerns Inventory (PCI) responses across age groups attending routine H&N cancer follow-up clinics with particular focus on the elderly (75 years or older). The PCI-HN data were obtained from patients attending follow-up clinics between August 2007 and January 2013. The groups for comparison were: <55 (n = 105), 55-64 (n = 170), 65-69 (n = 64), 70-74 (n = 68), and ≥75 (n = 76), the median in this last group of 79.1 years. Regarding quality of life (QoL) on first completing the PCI the elderly reported better anxiety and mood, higher social-emotional subscale scores and better overall QoL. On the PCI, being elderly did not seem to affect the total numbers of items selected, though fewer items were selected from the psychological, emotional and spiritual well-being domain, and in particular the item about fear of recurrence. Dentist and surgeon were the two health professionals most often selected that patients wished to see or be referred on to. It is possible to recognise concerns in routine clinical care, thus allowing the opportunity for intervention and support to improve the outcome for the elderly.

Cancer patients' needs for support in expressing instrumental concerns and emotions

“…Patients indicated that they were reluctant to discuss emotions with a doctor or nurse. This reluctance is consistent with previous studies that showed that patients more often select medical topics from preparation tools than psychosocial and practical topics (Ghazali et al, ; Rogers, Audisio, & Lowe, ). This result may also explain the lack of effects of (the use of) concern lists on the discussion of concerns during consultations (Farrell et al, ; Hill et al, ) or why concerns in general are discussed to a lesser extent in consultations than information needs (Jansen et al, ).…”

Posttraumatic growth in head and neck cancer survivors: Is it possible and what are the correlates?

“…In breast cancer it has been suggested that perceiving cancer as more threatening facilitates PTG . While information on perceived threat of HNC by age is lacking, younger survivors more often report fear of recurrence as their greatest concern . Bellizzi suggested that younger survivors of traumatic events experience more growth because they realize they have more time left to accomplish desired goals, whereas older survivors reach a peaceful acceptance about their life situation.…”

Investigating the impact of self‐management behaviours on quality of life and fear of recurrence in head and neck cancer survivors: A population‐based survey

“…These include eating and speech difficulties, facial disfigurement, and elevated distress, which have marked negative effects on survivors' QoL following treatment . Fear of recurrence (FoR) can also be a persistent and significant issue in this population, with noted deleterious effects on QoL; FoR is the most frequently cited concern by HNC survivors aged less than 70 years old . Our recent qualitative research has illustrated the variety of strategies that HNC survivors use to self‐manage these ongoing issues, the barriers they encounter in their self‐management attempts, and the processes through which they integrate self‐management into their daily lives .…”