Helping Patients With Head and Neck Cancer Understand Dysphagia: Exploring the Use of Video-Animation

Abstract

Purpose Patients newly diagnosed with head and neck cancer should be informed of the ramifications of cancer treatment on swallowing function during their pretreatment consultation. The purpose of this study was to explore (a) the usefulness and (b) the acceptability of video-animation in helping patients to understand the basics of the swallowing mechanism and dysphagia. Method Thirteen patients treated for head and neck cancer participated in this study. Think-aloud, a type of qualitative methodology, was used to encourage patients to verbalize their thoughts while watching two short video-animations showing the process of normal/abnormal swallowing. Transcripts were analyzed using thematic analysis. Results Four main themes were identified as follows: (a) patient interest and engagement, (b) acceptability of visual imagery and narration, (c) information provision and learning, and (d) personal relevance and intended action. Patients appeared interested and engaged in the video-animations, asking several spontaneous questions about how to maintain or improve swallowing function. Learning was evident from patients' recognition and verbalizations of grossly disordered swallowing patterns. Most patients reported the images to be visually acceptable and could often relate what they were seeing to their own swallowing experience. Many patients also verbalized recognition of the need to keep muscles active through exercises. Conclusions These results suggest that the video-animations of swallowing were acceptable, interesting, informative, and relevant for most patients. It was therefore useful not only as an education tool, but also showed potential to influence patients' intentions to undertake preventative interventions that may preserve better swallowing function after cancer treatment.

The Effectiveness of Animation Video to Increase Adolescents’ Nutritional Knowledge

“…The use of animation media during the teaching process attracted students' interests so that they could easily understand the mechanism of the circulatory process. Research by Govender et al (2019) point out that education with animated videos is acceptable, interesting, informative and relevant for most cancer patients. Therefore, animated video is not only useful as an educational medium but also has the potential to infl uence the desire of patients to do preventive interventions.…”

SIP SMART: a parallel group randomised feasibility trial of a tailored pre-treatment swallowing intervention package compared with usual care for patients with head and neck cancer

“…As part of SIP SMART, patients underwent an x-ray swallow assessment that enabled a physiological analysis of swallowing and the selection of specific and targeted exercises. Patients were shown a video-animation of swallowing to anchor the pretreatment discussion, making it more concrete for the patient and promoting an interactive approach [10]. Specific behaviour change techniques such as goal setting, self-monitoring, and behavioural practice were actively employed.…”

“…We have developed a new pre-treatment intervention (SIP SMART: Swallowing Intervention Package-Self Monitoring, Assessment, Rehabilitation Training), designed to address some of the shortcomings of previous clinical trials. The intervention development was informed by a series of studies including: a systematic review to identify behavioural strategies that could potentially promote patient adherence to swallowing exercises [8]; an in-depth interview study to establish patient reported barriers and facilitators to exercise adherence [9]; and a think-aloud study to explore the potential use of video-animation to improve how information about swallowing and dysphagia is conveyed to patients [10]. Further detail about the systematic development of SIP SMART using the Medical Research Council framework for the development and evaluation of complex interventions [11] and the Behaviour Change Wheel [12] is described elsewhere [intervention development manuscript under review].…”

SIP SMART: A parallel group randomised feasibility trial of a tailored pre-treatment Swallowing Intervention Package compared with usual care for patients with head and neck cancer

“…Patients were shown a video-animation of swallowing to anchor the pre-treatment discussion, making it more concrete for the patient and promoting an interactive approach (10). Specific behaviour change techniques such as goal setting, self-monitoring, and behavioural practice were actively employed.…”