Functional Assessment and Rehabilitation

Hutcheson, Katherine A.; Lewin, Jan S.

doi:10.1016/j.otc.2013.04.006

Cited by 38 publications

(37 citation statements)

References 59 publications

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“…Speech pathologists are integral members of the head and neck cancer team and specialize in the assessment, management, and rehabilitation of swallowing and communication disorders. Because of the complex nature of these deficits, expertise in a wide range of specialist clinical tasks is required to provide prompt and accurate intervention that minimizes medical complications and optimizes functional outcomes …”

Section: Introductionmentioning

confidence: 99%

Randomized controlled trial of a multisite speech pathology telepractice service providing swallowing and communication intervention to patients with head and neck cancer: Evaluation of service outcomes

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Randomized controlled trial of a multisite speech pathology telepractice service providing swallowing and communication intervention to patients with head and neck cancer: Evaluation of service outcomes

et al. 2017

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“…Recent evidence supports that providing prophylactic exercises during and post-treatment may improve a patient’s swallow function, which impacts nutritional status and overall quality of life during treatment and long-term post-treatment [11–21]. With less functional decline, patients were able to return to an oral diet sooner, leading to less weight loss and shorter enteric tube duration [13, 15, 17, 21, 22]. To this end, routine swallowing and nutritional monitoring, from the point of diagnosis, as well as early swallow intervention should be part of any larger MDT care pathway for this population.…”

Section: Introductionmentioning

confidence: 99%

Establishing a Multidisciplinary Head and Neck Clinical Pathway: An Implementation Evaluation and Audit of Dysphagia-Related Services and Outcomes

et al. 2018

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Head and neck cancer (HNC) guidelines recommend regular multidisciplinary team (MDT) monitoring and early intervention to optimize dysphagia outcomes; however, many factors affect the ability to achieve these goals. The aims of this study were to explore the barriers/facilitators to establishing and sustaining a MDT HNC care pathway and to examine the dysphagia-related speech-language pathology (SLP) and dietetic components of the pathway. Using the Consolidated Framework for Implementation Research (CFIR), a mixed methods study design was used to evaluate an established MDT HNC pathway. Ten MDT members provided perceptions of facilitators/barriers to implementing and sustaining the pathway. Patients attending the SLP and dietetic components of the pathway who commenced treatment between 2013 and 2014 (n = 63) were audited for attendance, outcome data collected per visit, and swallowing outcomes to 24-month post-treatment. Dysphagia outcomes were compared to a published cohort who had received intensive prophylactic dysphagia management. Multiple CFIR constructs were identified as critical to implementing and sustaining the pathway. Complexity was a barrier. Patient attendance was excellent during treatment, with low rates of non-compliance (< 15%) to 24 months. Collection of clinician/patient outcome tools was good during treatment, but lower post-treatment. Dysphagia outcomes were good and comparable to prior published data. The pathway provided patients with access to regular supportive care and provided staff opportunities to provide early and ongoing dysphagia monitoring and management. However, implementing and sustaining a HNC pathway is complex, requiring significant staff resources, financial investment, and perseverance. Regular audits are necessary to monitor the quality of the pathway.

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“…24 We and others have demonstrated that patients who keep the swallow system active during radiotherapy have better acute and long-term swallowing outcomes. Edema, fibrosis, and atrophy of structures that are important for swallowing in the irradiated field lead to irreversible, and, at times, progressive dysfunction of the constrictors, tongue base, and laryngeal apparatus.…”

Section: Radiotherapy and Chemoradiationmentioning

confidence: 91%

2 Oral Cavity Reconstruction

Day¹

2016

Reconstructive Plastic Surgery of the Head and Neck: Current Techniques and Flap Atlas

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Functional Assessment and Rehabilitation

Cited by 38 publications

References 59 publications

Randomized controlled trial of a multisite speech pathology telepractice service providing swallowing and communication intervention to patients with head and neck cancer: Evaluation of service outcomes

Randomized controlled trial of a multisite speech pathology telepractice service providing swallowing and communication intervention to patients with head and neck cancer: Evaluation of service outcomes

Establishing a Multidisciplinary Head and Neck Clinical Pathway: An Implementation Evaluation and Audit of Dysphagia-Related Services and Outcomes

2 Oral Cavity Reconstruction

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