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

Abstract

Background:Head and neck cancer (HNC) patients are prone to have a poor health-related quality of life after cancer treatment. This study investigated the effect of the nurse counselling and after intervention (NUCAI) on the health-related quality of life and depressive symptoms of HNC patients between 12 and 24 months after cancer treatment.Methods:Two hundred and five HNC patients were randomly allocated to NUCAI (N=103) or usual care (N=102). The 12-month nurse-led NUCAI is problem-focused and patient-driven and aims to help HNC patients manage with the physical, psychological and social consequences of their disease and its treatment. Health-related quality of life was evaluated with the EORTC QLQ-C30 and QLQ H&N35. Depressive symptoms were evaluated with the CES-D.Results:At 12 months the intervention group showed a significant (P<0.05) improvement in emotional and physical functioning, pain, swallowing, social contact, mouth opening and depressive symptoms. At 18 months, global quality of life, role and emotional functioning, pain, swallowing, mouth opening and depressive symptoms were significantly better in the intervention group than in the control group, and at 24 months emotional functioning and fatigue were significantly better in the intervention group.Conclusion:The NUCAI effectively improved several domains of health-related quality of life and depressive symptoms in HNC patients and would seem a promising intervention for implementation in daily clinical practice.

Economic evaluation of a person-centred care intervention in head and neck oncology: results from a randomized controlled trial

“…According to a person-centred approach [10], this team should also include the patient with HNC working in partnership with the healthcare personnel. Our person-centred intervention was coordinated by oncology nurses, which is in line with several previous projects addressing not only the needs in this patient group [8, 32, 33] but also the formation of such a multidisciplinary team. Using nurses to coordinate the project should result in acceptable costs for the intervention, and their general interest in this type of follow-up has been described previously [32, 34].…”

A national survey of healthcare professionals' views on models of follow-up, holistic needs assessment and survivorship care for patients with head and neck cancer

“…) and supportive care (Van der Meulen et al . ) after treatment evaluate interventions that are provided in addition to medical follow‐up.…”

Unintentional weight loss after head and neck cancer

“…Depression symptoms remained significantly lower at 18 months post-diagnosis for patients who received the intervention and were lower, but no longer significantly so, at 24 months (van der Meulen et al, 2014). Importantly, this intervention was also associated with significant improvements in HRQOL (emotional functioning) at 12-, 18-, and 24-months post-diagnosis, and with decreased pain, fewer problems swallowing, and improved mouth-opening abilities at 12 and 18 months (van der Meulen et al, 2014). It is noteworthy that the intervention was associated with improvements in an array of emotional, physical, and functional symptoms, including depressive symptoms, pain, HRQOL, and successful swallowing and mouth openingfactors that the present study identified as important predictors of the trajectory of weight loss.…”

“…Depression symptoms remained significantly lower at 18 months post-diagnosis for patients who received the intervention and were lower, but no longer significantly so, at 24 months (van der Meulen et al, 2014). Importantly, this intervention was also associated with significant improvements in HRQOL (emotional functioning) at 12-, 18-, and 24-months post-diagnosis, and with decreased pain, fewer problems swallowing, and improved mouth-opening abilities at 12 and 18 months (van der Meulen et al, 2014).…”

“…Interestingly a broad array of HNC patients, not simply those that are initially distressed, may benefit from psychosocial interventions. Neither the van der Meulen et al (2013Meulen et al ( , 2014 nor the D'Souza et al 2013intervention recruited patients based on elevated psychosocial symptom criteria. However, the treatment-as-usual control groups in these studies actually experienced increases in depressive symptoms, whereas patients in the intervention groups had declines in symptoms.…”