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Content analysis of rehabilitation goals for patients following non-surgical head and neck cancer treatment

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Abstract

Purpose

Following head and neck cancer (HNC) treatment, individuals experience an array of side effects which can impact on physical, emotional, and practical aspects of their lives. Responsive, supportive rehabilitation services are therefore essential to address ongoing survivorship needs. This study examined the nature of patient-reported goals from acute to long-term post-treatment, to inform design/delivery of future rehabilitation services.

Methods

Using a cross-sectional cohort design, 91 patients between 2 weeks and 5 years of post non-surgical HNC treatment (acute n = 29; sub-acute n = 28; long-term n = 34), provided their top four rehabilitation goals considering any aspect of their lives. Content analysis was used to categorise responses at each time point.

Results

Three core categories of patient goals were identified relating to: (1) treatment side effects (TSE), (2) overall health (OH), and (3) living life (LL). TSE goals were a priority during the acute and sub-acute phases, with less focus long-term. LL goals were prevalent across all time points, though increased in the long-term. Approximately a third of all goals at each time point related to OH.

Conclusions

A variety of rehabilitation goals were identified, and the focus shifted over time. These data highlight the importance of changing the focus of rehabilitation as patients’ priorities vary over time. Early multidisciplinary care from allied health services is crucial to provide support with managing side effects and returning to daily activities. In the long-term, greater input from services to address health, nutrition, leisure, and fitness goals may be more beneficial.

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Acknowledgements

The authors wish to thank the speech pathology department, research team, and multidisciplinary team at Prince of Wales Hospital and Princess Alexandra Hospital for their contributions and continued support to this project.

Funding

This project was funded by the Head and Neck Cancer Research Fund at Prince of Wales Hospital, Sydney, Australia.

Author information

Authors and Affiliations

  1. Speech Pathology Department, Prince of Wales Hospital (POWH), Level 2 High Street Entrance, Randwick, Sydney, NSW, 2031, Australia

    Molly K. Barnhart, Rachelle A. Robinson & Sophie J. Chandler

  2. School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia

    Molly K. Barnhart, Elizabeth C. Ward & Rebecca Nund

  3. Centre for Functioning and Health Research, Metro South Hospital and Health Service, Buranda, QLD, 4102, Australia

    Elizabeth C. Ward, Bena Cartmill & Rebecca Nund

  4. Speech Pathology, Princess Alexandra Hospital, Woolloongabba, QLD, 4102, Australia

    Bena Cartmill

  5. Comprehensive Cancer Centre, POWH, Sydney, NSW, 2031, Australia

    Robert I. Smee

  6. The Clinical Teaching School, University New South Wales, Kensington, NSW, Australia

    Robert I. Smee

  7. Tamworth Base Hospital, Tamworth, NSW, 2340, Australia

    Robert I. Smee

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  1. Molly K. Barnhart
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  2. Elizabeth C. Ward
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Correspondence to Molly K. Barnhart.

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Conflict of interest

The author has been funded by the institution (Prince of Wales Hospital, Australia) where the research was conducted. The author has full control of all primary data and agrees to allow the journal to review the data if requested.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Barnhart, M.K., Ward, E.C., Cartmill, B. et al. Content analysis of rehabilitation goals for patients following non-surgical head and neck cancer treatment. Support Care Cancer 27, 639–647 (2019). https://doi.org/10.1007/s00520-018-4364-1

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