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Supportive Care in Cancer
Published in: Supportive Care in Cancer 3/2016

01-03-2016 | Original Article

Evaluation of a weekly speech pathology/dietetic service model for providing supportive care intervention to head and neck cancer patients and their carers during (chemo)radiotherapy

Authors: Laurelie R. Wall, Bena Cartmill, Elizabeth C. Ward, Anne J. Hill, Elizabeth Isenring, Sandro V. Porceddu

Published in: Supportive Care in Cancer | Issue 3/2016

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Abstract

Purpose

Dysphagia is a common and debilitating side effect for head and neck cancer (HNC) patients undergoing radiotherapy (RT) with or without chemotherapy ([C]RT) and is associated with nutritional and emotional comorbidities. Emotional sequelae and distress are also known to affect carers of HNC patients. A weekly, joint speech pathology/dietetic (SP/DN) service-delivery model has been employed to manage swallowing/nutritional and associated emotional issues during (C)RT. This study aimed to conduct a service evaluation of the weekly SP/DN clinical model.

Methods

Cross-sectional sampling of core service metrics and perceptions of key stakeholders (70 HNC patients, 30 carers, and 10 clinicians) were collated from the Metro South Radiation Oncology Service in Brisbane, Australia. Data from each source was examined separately and then triangulated.

Results

An average of 28 patients (SD = 5.54) attended SP/DN appointments per week, with 58 % reporting swallowing and/or nutritional issues. Distress was reported by 27 % of patients and 30 % of carers. Clinicians felt able to adequately identify and manage swallowing and nutrition 90 % of the time but only 10 % of the time for distress. Seventy-six percent of scheduled SP/DN sessions were perceived as necessary by either patients, clinicians or both.

Conclusions

Findings demonstrated a third of patients and their carers had a high level of distress during HNC [C]RT, supporting need for the provision of a weekly SP/DN service in a select cohort. However, the routine weekly SP/DN assessment model for all patients undergoing HNC treatment demonstrates the potential for over-servicing. Alternative service-delivery models warrant further evaluation.
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Metadata
Title
Evaluation of a weekly speech pathology/dietetic service model for providing supportive care intervention to head and neck cancer patients and their carers during (chemo)radiotherapy
Authors
Laurelie R. Wall
Bena Cartmill
Elizabeth C. Ward
Anne J. Hill
Elizabeth Isenring
Sandro V. Porceddu
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 3/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2912-5

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