Umeå universitets logga

umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Addressing symptoms that affect patients’ eating according to the Head and Neck Patient Symptom Checklist©
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Öron- näs- och halssjukdomar.
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Öron- näs- och halssjukdomar.
Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.ORCID-id: 0000-0002-1248-5581
Visa övriga samt affilieringar
2022 (Engelska)Ingår i: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 30, s. 6163-6173Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Purpose: The purpose of this prospective study was to assess which nutritional impact symptoms (NIS) interfere with oral intake in patients with head and neck cancer (HNC) and how the symptoms interfere with body weight loss, up to 1 year after treatment.

Methods: This was a prospective study of 197 patients with HNC planned for treatment with curative intention. Body weight was measured before the start of treatment, at 7 weeks after the start of treatment, and at 6 and 12 months after completion of treatment. NIS and NIS interfering with oral intake at each follow-up were examined with the Head and Neck Patient Symptom Checklist© (HNSC©).

Results: At 7 weeks of follow-up, patients experienced the greatest symptom and interference burden, and 12 months after treatment the NIS scorings had not returned to baseline. One year after treatment, the highest scored NIS to interfere with oral intake was swallowing problems, chewing difficulties, and loss of appetite. At all 3 follow-ups, the total cumulative NIS and NIS interfering with oral intake were associated with body weight loss. Factors increasing the risk for a body weight loss of ≥ 10% at 12 months after treatment were pain, loss of appetite, feeling full, sore mouth, difficulty swallowing, taste changes, and dry mouth. Women scored higher than men in NIS and NIS interfering with oral intake. Furthermore, during the study period about half of the population had a body weight loss > 5%.

Conclusion: Because both nutritional and clinical factors may affect body weight, this study highlights the importance of a holistic approach when addressing the patients’ nutritional issues. Trial registration: ClinicalTrials.gov NCT03343236, date of registration: November 17, 2017.

Ort, förlag, år, upplaga, sidor
Springer-Verlag New York, 2022. Vol. 30, s. 6163-6173
Nyckelord [en]
Body weight loss, Head and neck cancer, Head and Neck Patient Symptom Checklist©, Health-related quality of life, Nutritional impact symptoms
Nationell ämneskategori
Cancer och onkologi
Identifikatorer
URN: urn:nbn:se:umu:diva-194350DOI: 10.1007/s00520-022-07038-xISI: 000782736400001PubMedID: 35426524Scopus ID: 2-s2.0-85128213086OAI: oai:DiVA.org:umu-194350DiVA, id: diva2:1655668
Tillgänglig från: 2022-05-03 Skapad: 2022-05-03 Senast uppdaterad: 2022-09-13Bibliografiskt granskad
Ingår i avhandling
1. Life after treatment for head and neck cancer
Öppna denna publikation i ny flik eller fönster >>Life after treatment for head and neck cancer
2022 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Alternativ titel[sv]
Livet efter behandling för huvud- och halscancer
Abstract [en]

Background: Treatment for head and neck cancer (HNC) is often multimodal, including surgery, radiotherapy, and chemotherapy. The anatomic location of HNC and its treatments often affect vital functions such as swallowing and speech, but also physical appearance, leading to a risk for social withdrawal and nutritional difficulties that can affect the patient’s quality of life.

Aims: The general aims of this thesis were to describe the physical and social consequences for patients treated for HNC and to identify supportive needs in regaining a new everyday life including intimate relationships, return to work, and nutritional recovery.

Methods: Paper I (n = 131), objectives: to determine how patients with HNC experience changes in intimate relationships and to identify factors interfering with such relations. A semi-structured interview study was carried out on patients after treatment, and the analysis was inspired by the guidelines in constructive Grounded Theory. Paper II (n = 295), objective: to describe the frequency of patients’ returning to work after treatment for oropharyngeal cancer and to identify predictors and physical barriers (with a focus on pain, swallowing and speech difficulties, and physical appearance), that might interfere with the return-to-work process. A cross-sectional study using questionnaires was carried out 15 months after the diagnosis. Data were obtained from the Swedish Head and Neck Cancer Register. Paper III (n = 197), objective: to assess nutritional aspects and body weight in patients with HNC. A nutrition impact symptom-specific questionnaire for HNC was used to assess symptoms interfering with oral intake as well as interfering with body weight during the first year post-treatment. Paper IV (n = 21), objective: to examine how patients with HNC perceive life one year after treatment and how they experience health care. A semi-structured interview study was performed with an interview guide developed using concepts from the literature and clinical experience, and a thematic analysis approach was used.

Results: In Paper I most patients reported no major changes in intimate relationships at the end of treatment. In resuming intimate relationships, facilitating factors were stable relationships before treatment, engagement from others, and being open regarding the cancer, while detrimental factors were patronization and dis-engagement. This was summarised as “being open versus not sharing the cancer journey”. In Paper II, 15 months after diagnosis 84% of the patients who were working at the time for diagnosis had returned to work. Factors negatively associated with return to work were swallowing difficulties, problems talking on the telephone, and changed physical appearance. In Paper III, the post-treatment weight loss was related to the degree of symptoms and interference with oral intake, which also increased the risk for a body weight loss of ≥10% at 12 months after the end of treatment. In Paper IV, the patients were still suffering from side effects one year after treatment and from fear of recurrence, but they tried to live as they did before the cancer diagnosis. Even if most contacts with health care were experienced positively, patients lacked regular follow-ups regarding rehabilitation and contact with their contact nurse.

Conclusions: In Paper I, when resuming intimate relationships, the challenges were related to whether the patients were open or not about the disease. In Paper II, some remaining physical barriers were identified. A positive result from the study that can be reported to future patients is the high number of patients returning to work after treatment. In Paper III, both nutritional and clinical factors were shown to affect body weight, and a holistic approach is needed when addressing the patients’ nutritional needs. In Paper IV, despite the sequelae from treatment, the patients sought to live as they did before the diagnosis. This may disguise continuing needs, and by meeting the patients with engagement, the contact nurse-patient relation may uncover these needs and proper individualized support and rehabilitation can be offered.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå universitet, 2022. s. 57
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 2191
Nyckelord
head and neck cancer, intimate relationships, return to work, nutrition, contact nurse
Nationell ämneskategori
Cancer och onkologi Oto-rino-laryngologi
Forskningsämne
oto-rhino-laryngologi; onkologi
Identifikatorer
urn:nbn:se:umu:diva-199315 (URN)978-91-7855-857-5 (ISBN)978-91-7855-858-2 (ISBN)
Disputation
2022-10-07, Föreläsningssalen ÖNH (målpunkt A82, plan 8), NUS, samt via Zoom, Umeå, 09:00 (Svenska)
Opponent
Handledare
Forskningsfinansiär
CancerfondenCancerforskningsfonden i NorrlandFamiljen Kamprads stiftelseAFA FörsäkringRegion Västerbotten
Tillgänglig från: 2022-09-16 Skapad: 2022-09-13 Senast uppdaterad: 2023-04-17Bibliografiskt granskad

Open Access i DiVA

fulltext(1688 kB)78 nedladdningar
Filinformation
Filnamn FULLTEXT02.pdfFilstorlek 1688 kBChecksumma SHA-512
602b40335edc21bf117b8454391636b63c479e85314be5976bba09cf5f9d2da84003eae5425922df7c8f93972b47a3b6c9c5a12665019d50d6d8030806632805
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMedScopus

Person

Granström, BrithHolmlund, ThorbjörnFransson, Per

Sök vidare i DiVA

Av författaren/redaktören
Granström, BrithHolmlund, ThorbjörnFransson, Per
Av organisationen
Öron- näs- och halssjukdomarInstitutionen för omvårdnad
I samma tidskrift
Supportive Care in Cancer
Cancer och onkologi

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 92 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 278 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf