The aim of this study was to identify the distress, unmet needs and concerns of head and neck cancer (HNC) survivors in the first 5 years after treatment. Two hundred and eighty HNC survivors from three Scottish health boards responded to a cross-sectional postal survey in 2011. Questionnaires included the Distress Thermometer, Patient Concerns Inventory (PCI) and an adapted version of the PCI to measure unmet needs. One-third of the survivors had moderate or severe levels of distress, and 74% had at least one unmet need. The most common concerns and unmet needs included oral and eating problems, fear of recurrence and fatigue. Multivariate analysis revealed that being younger, out of work (not retired), ever having had a feeding tube fitted, having a greater number of comorbidities and living alone were associated with higher levels of distress, concerns and unmet needs. The diversity of concerns and unmet needs identified in this study highlights the importance of holistic needs assessment as part of follow-up care for HNC survivors with tailoring of support for particular concerns. Specific information resources and self-management strategies are required to help HNC survivors with the practical and functional consequences of HNC treatment.
Abstract:Purpose This study aimed to assess quality of life (QoL) in head and neck cancer (HNC) survivors, and determine factors predictive of poor QoL in the first five years after the end of treatment. Methods A cross-sectional survey, including the Quality of Life in Adult Cancer Survivors (QLACS) measure, was sent to HNC survivors in three Scottish health regions, with responses linked to routinely collected clinical data. Independent sample t-tests, ANOVAs, Pearson correlations and multiple hierarchical regressions were used to explore associations between and to determine the contribution made by demographic, lifestyle and clinical factors to predicting 'generic' and 'cancer-specific' quality of life. Results 280 patients (65%) returned questionnaires. After adjustment, multivariate analysis showed that younger age, lower socio-economic status, unemployment and selfreported comorbidity independently contributed to poorer generic and cancer-specific quality of life. In addition to these factors, having had a feeding tube or a diagnosis of oral cavity cancer were independently predictive of poorer cancer-specific quality of life. Conclusions Socio-economic factors and co-morbidity are important predictors of QoL in HNC survivors. These factors and the detrimental long-term effects of feeding tubes need Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporationfurther attention in research and practice.
Objectives: To measure the prevalence and incidence of pressure ulcers, describe their complications, and identify the proportions of patients followed by the multidisciplinary clinical services at King Abdulaziz Medical City (KAMC) -Jeddah-Saudi Arabia. Methodology:A prospective cohort designed with weekly visits to all general medical and surgical units during the month of August 2016. Patients with new or preexisting pressure ulcers were included. Patients and wounds related variables were followed and recorded weekly. In addition, the clinical disciplines involved in pressure-ulcer's care and their follow-up visits were documented.Results: A total of 370 patients were admitted, and only 21 patients were found to have ulcers. During the total hospital stay for all the patients (2440 days), only 4 new ulcers were developed in the units; the rest developed either at home or in the intensive care unit. The estimated prevalence and incidence of pressure ulcers were 5.7% (95% CI 3.4 -8.0) and 1.6 ulcer/1000 patient-days (95% CI 1.1-2.1) respectively. Sixteen patients, 76%, were bedridden and with urinary catheters. Also, seven patients, 33%, received antibiotics for infected ulcers, and two of them died during the study period due to sepsis. In addition, twenty patients, 95%, were anemic, but only three of them had low body mass index. The proportion of patients, who were seen during the study by dietitians, wound care nurses, occupational therapists and plastic surgery during the study period, was 75%, 33%, 17%, and 17% respectively. Conclusion:Pressure ulcers prevalence and incidence was 5.7% and 1.6 ulcer/1000 patient-days respectively. Majority of pressure ulcer patients were anemic, bedridden, incontinent, and needed home care on hospital discharge. Further research is needed to clarify the best team approach to manage patients with pressure ulcers.
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